CPT 0338T

Contractor-priced

0338T · PFS Q1 2024 · Historical

Contractor-published range

$1,491.58–$1,638.60

Participating · Office (non-facility) · Whole service

MAC-published fee schedules available in Localis: 3 of 144 payment localities. Missing data does not establish a $0 allowance.

No national PFS rate in Q1 2024

Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation.

Check for a published amount in your locality.

Service-location ZIP

View contractor sources and effective dates

CPT 0338T carries status C (carrier-priced) in the Q1 2024 release, so there is no single national rate—Medicare contractors publish their own amounts. Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation. Contractor-published amounts on file range $1,491.58–$1,638.60 across 3 localities; enter a ZIP for the exact local amount.

Amount evidence: MAC-published fee schedules and effective dates. The PFS row establishes contractor pricing.

Inspect PFS status evidence

Code: 0338T
Release: Q1 2024, revision 1
Result: Contractor-priced

Citations

Establishes the PFS status (C) and the resulting pathway for this code: contractor-priced.
Physician relative value file (PPRRVU)
Q1 2024 · revision 1

Superseded revision

Release period: January 1 – March 8, 2024

This PFS record alone does not establish a $0 allowance or a coverage determination. Any amount from another schedule needs its own evidence.

Record details
PPRRVU24_JAN.csv in rvu24a-updated-04-01-2024.zip (row 6,134)

hcpcs (col 1)

0338T

modifier (col 2)

blank

status_code (col 4)

C

SHA-256: 034f3aa88a63e6f7ca3859c09b3945dce139171a6fc5a710300fc7b815e9b65b

Original source file

Compact facts

Why is there no national PFS amount for 0338T?

Its status indicator is C (carrier-priced). Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation. Carrier-priced: no national payment amount.

Payment considerations Copy link

Review the applicable inputs and payment rules. Each link opens the supporting detail on this page.

Global surgery Context required Contractor pricing Applies

Other payment indicators (8)

Facility/non-facility: Not determined, Professional/technical component: Does not apply, Bilateral adjustment: Does not apply, Multiple-procedure reduction: Does not apply, Assistant/co-surgeon treatment: Does not apply, NCCI same-day edits: Not determined, MUE behavior: Not determined, Other fee-schedule routing: Does not apply.

Find the local Medicare amount for 0338T Copy link

Medicare sets this price locally

0338T has no single national Physician Fee Schedule amount. Use the ZIP, modifier, setting, and participation fields above to match it to a Medicare locality and the contractor amount we have on file.

Your practical estimate will appear here

We hold files from First_coast across JN, most recently effective Jan 1, 2024. A missing locality means our contractor coverage is incomplete—not that Medicare pays $0.

This is the published amount for this code—not necessarily the entire visit or procedure. A hospital may bill a separate facility charge, and other services, drugs, or supplies can add to the total.

Contractor-published source figures, not a national rate. Par = participating-provider amount Non-par = nonparticipating-provider amount C = technical component capped at the OPPS amount # = facility-setting amount

View all 6 published fee rows

Jurisdiction / locality	Modifier	Note	Par	Non-par	Limiting charge	Effective	Source
JN · Florida, Area 03 CMS 09102-03	—	—	$1,605.43	$1,525.16	$1,753.93	Jan 1, 2024	Contractor file
JN · Florida, Area 03 CMS 09102-03	—	#	$343.30	$326.14	$375.06	Jan 1, 2024	Contractor file
JN · Florida, Area 04 CMS 09102-04	—	—	$1,638.60	$1,556.67	$1,790.17	Jan 1, 2024	Contractor file
JN · Florida, Area 04 CMS 09102-04	—	#	$372.82	$354.18	$407.31	Jan 1, 2024	Contractor file
JN · Florida, Area 99 CMS 09102-99	—	—	$1,491.58	$1,417.00	$1,629.55	Jan 1, 2024	Contractor file
JN · Florida, Area 99 CMS 09102-99	—	#	$322.79	$306.65	$352.65	Jan 1, 2024	Contractor file

The authenticated MAC fees API returns the same source rows. ZIP5s that span localities are flagged and use only the crosswalk's dominant locality until ZIP+4 overrides are available.

Reconciling a contractor-priced payment for 0338T Copy link

There is no national allowed amount for 0338T, so every reconciliation of this line runs against the MAC fee schedule that was in force for the date of service rather than against a national baseline.

What to reconcile

Compare the paid amount against the MAC fee schedule in force for the date of service; there is no national allowed amount here to reconcile against.
Ask the MAC which global period it assigned: the contractor sets the follow-up window for this code, so whether a post-operative visit should have paid depends on the contractor that priced it.
Reprice the line against the release, locality, setting, modifier and participation status that applied to the date of service before treating any difference as an underpayment.

Nearby payment lines

National Q1 2024 amounts at GPCI 1.000. A blank means this schedule does not publish a payable PFS amount.

No comparison lines are present in this release.

Check an actual payment Model this code in a contract

Sources: CMS Medicare Physician Fee Schedule Relative Value Files; CMS Medicare Physician Fee Schedule Relative Value Files (status indicator field); CMS Medicare Claims Processing Manual (Pub. 100-04).

Payment rules

Global period: what 0338T's fee already covers Copy link

YYY Contractor decides

Your Medicare Administrative Contractor decides whether a global period applies and sets its length when it prices the code. The result is 0, 10, or 90 days.

Can you bill it with another code? Copy link

Enter a second CPT or HCPCS code billed on the same date of service. We'll check the current NCCI procedure-to-procedure edit between it and 0338T.

See every current NCCI pair for 0338T →

Common payment questions Copy link

Why would a Medicare claim for 0338T be denied or paid less?

These come from CMS indicators on this page, not general billing advice.

Its status indicator is C (carrier-priced)—Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation. See status indicators

Payer-specific coverage and documentation rules live outside these files, so a claim that clears every check here can still be denied on other grounds.

History

When does this rate change?

CMS publishes a fee schedule release every quarter (January, April, July, October), and each is versioned here. See what changed each release, or get an email when a new release moves rates.

Sources: CMS Medicare Physician Fee Schedule Relative Value Files.

Did this answer your question about CPT 0338T?

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Source & method

Show sources

Contractor amounts come from the MAC-published schedules and effective dates identified above. The PFS file establishes contractor pricing. Releases are immutable: historical evidence remains tied to the specified release. Our methodology covers the depth: sourcing, parsing, versioning, and how we cross-check claims before they ship.

Physician relative value file (Q1 2024) · rvu24a-updated-04-01-2024.zip (PPRRVU24_JAN.csv row 6,134)

Use the (i) buttons next to each amount above for the exact row, columns, and math.

Cite this rate

This citation identifies the source release, so its evidence remains reproducible after a newer release lands.

CPT 0338T National PFS baseline: No national PFS rate (Q1 2024; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/cpt/0338T/2024/A/1