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Describe a service in plain words, or type a CPT/HCPCS code.

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Medicare expected-payment calculator

Enter a billing code, the service-location ZIP and the date of service. Get the Medicare allowed amount, how it splits between Medicare and coinsurance, and the CMS evidence behind each figure.

Claim details

CPT / HCPCS code
Service location
ZIP
Locality

Leave blank for the national baseline.

Date of service
Date of service
CMS release

CMS release: 2026 C

Place of service Office (non-facility) Facility
Modifiers: None
Supplied modifier

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

Professional/technical component concept concept does not apply to this code.
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.
Assistant-at-surgery concept does not apply to this code.
Assistant-at-surgery 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.

Payment answer

No separate PFS payment for 87653

CMS marks this service status X (Statutory exclusion). The statutory definition of physician services does not include this item.

The available evidence does not establish a $0 allowance. Release 2026 C · status X (Statutory exclusion)

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

View the CMS evidence
Code
87653
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 10,993)
    hcpcs (col 1)
    87653
    modifier (col 2)
    blank
    status_code (col 4)
    X

    SHA-256: b7d197e73211ef6854c213c267d5fa9dec8df995db8e1ee7d44c0556ad7cee21

    Original source file

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