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

Medicare expected-payment calculator

Enter a code, ZIP and date of service to get the allowed amount, what Medicare pays, and the CMS file and row 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 D

Place of service
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 J9395

CMS marks this service status E (Excluded). A regulation removes this code from the fee schedule. When covered, it is paid under reasonable charge procedures instead.

The available evidence does not establish a $0 allowance. Release 2026 D · status E (Excluded)

A regulation removes this code from the fee schedule. When covered, it is paid under reasonable charge procedures instead.

View the CMS evidence
Code
J9395
DOS
Not supplied
Locality
National (GPCI 1.000)
Service ZIP
Not supplied
Setting
Office (non-facility)
Participation
Participating provider
Modifiers
None
Units
1
Release
Q4 2026, revision 2
Sequestration
Shown separately from the allowed amount

Status E is not separately payable under the PFS.

Citations

  • Establishes the PFS status of the base code.

    Physician relative value file (PPRRVU)CMS RVU26DOctober 1 – December 31, 2026revision 2

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

    PPRRVU2026_Oct_nonQPP.csv row 17,529 in rvu26d-updated-08-26-2026.zip

    In the CMS file

    Loading rows 17,527–17,531 of PPRRVU2026_Oct_nonQPP.csv…

    Download rvu26d-updated-08-26-2026.zip from CMS File fingerprint 4d0d3f19bd954ffc0f5b8439169d267da023d4f6911f4539bb6e98723cb1a626

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