CMS CPT Query
(2023 Query) | (2022 Query)

CPT:   

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Information is obtained from CMS tables and is only as accurate as the information CMS provided in data files - Linked Here

 

CPT Code / Description - Location:
CMS Reimbursement $0.00
Work RVU wRVUs
Global Period (DAYS) Days No global period.
Asst Surg No Assistant Surgeon Allowed.
Bilateral No Assistant Surgeon Allowed.
Multiple No Multiprocedure Allowed.


0 = Add on code (ZZZ) do not use Modifier 51 , Bill by units one line up to max units, 2nd line additional units over MUE;  
1 = CPT code needs Lt, RT or 50 =bill on 1 line with a 50 modifier (not used on hands),  
2 = Use modifier 51, paid 100%, 50%, 50%, 50% and by report, to unbundle use 59-only if appropriate.  
3 = add modifier 59 or XS,   XE Separate encounter, XP separate dr, XS separate structure, XU unusual non-overlapping service.  Endoscopy base will not be paid with another endo;  
4 = TC Diagnostic imaging ;      
9 = concept does not apply.  
Co-Surgeon No Co-Surgeon Allowed.
Status Code No Status Code.
Status Code B are not payable under any circumstances - (Medicare/Medicaid). Some insurance may pay.  
ASC Case Not an ASC case.
-
ASC CMS Reimbursement $0.00
IPO Case Not an IPO case.