Medicare expected-payment calculator

Enter a code, service location, and date to calculate an allowed amount with CMS evidence.

Claim details

CPT / HCPCS code

Location

Date of service

CMS release: 2026 C

Place of service

Office (non-facility)

Facility

Modifiers: None

Select a supplied modifier. Click it again to remove it.

Professional/technical component concept concept does not apply to this code.

Bilateral adjustment concept does not apply to this code.

Assistant-at-surgery concept does not apply to this code.

Co-surgeon concept does not apply to this code.

Team surgery concept does not apply to this code.

Single-line modifiers only. Pricing -51? Use the MPPR calculator.

No expected amount for 81560

Status X is not separately payable under the PFS. Release 2026 C · status X (Statutory exclusion)

The statutory definition of physician services does not include this item.

Why no amount for these inputs? View evidence

Code: 81560
DOS: Not supplied
Locality: National (GPCI 1.000)
Service ZIP: Not supplied
Setting: Office (non-facility)
Participation: Participating provider
Modifiers: None
Units: 1
Release: Q3 2026, revision 1
Sequestration: Shown separately from the allowed amount

Status X is not separately payable under the PFS.

Citations

Establishes the PFS status of the base code.
Physician relative value file (PPRRVU)
Q3 2026 · revision 1

Latest revision of this release

Release period: July 1 – September 30, 2026

This status record alone does not establish an allowed amount or a coverage determination.

Record details
PPRRVU2026_Jul_nonQPP.csv in rvu26c-updated-06-30-2026.zip (row 9,994)

hcpcs (col 1)

81560

modifier (col 2)

blank

status_code (col 4)

X

SHA-256: b7d197e73211ef6854c213c267d5fa9dec8df995db8e1ee7d44c0556ad7cee21

Original source file

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