CPT 0348T

Contractor-priced

0348T · PFS Q3 2026

Contractor-published range

$29.12–$35.14

Participating · Office (non-facility) · Whole service

MAC-published fee schedules available in Localis: 20 of 144 payment localities. Missing data does not establish a $0 allowance.

No national PFS rate in Q3 2026

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 0348T carries status C (carrier-priced) in the Q3 2026 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 $29.12–$35.14 across 20 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: 0348T
Release: Q3 2026, 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)
Q3 2026 · revision 1

Latest revision of this release

Release period: July 1 – September 30, 2026

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
PPRRVU2026_Jul_nonQPP.csv in rvu26c-updated-06-30-2026.zip (row 361)

hcpcs (col 1)

0348T

modifier (col 2)

blank

status_code (col 4)

C

SHA-256: b7d197e73211ef6854c213c267d5fa9dec8df995db8e1ee7d44c0556ad7cee21

Original source file

Compact facts

Why is there no national PFS amount for 0348T?

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 NCCI same-day edits Applies Contractor pricing Applies

Other payment indicators (7)

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, MUE behavior: Not determined, Other fee-schedule routing: Does not apply.

Find the local Medicare amount for 0348T Copy link

Medicare sets this price locally

0348T 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 and Novitas across JH and JN, most recently effective Jan 1, 2026. 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 20 published fee rows

Jurisdiction / locality	Modifier	Note	Par	Non-par	Limiting charge	Effective	Source
JH · Arkansas, Area 13 CMS 07102-13	—	—	$29.12	$27.66	$31.81	Jan 1, 2026	Contractor file
JH · Colorado, Area 01 CMS 04112-01	—	—	$34.65	$32.92	$37.86	Jan 1, 2026	Contractor file
JH · Louisiana, Area 01 CMS 07202-01	—	—	$31.64	$30.06	$34.57	Jan 1, 2026	Contractor file
JH · Louisiana, Area 99 CMS 07202-99	—	—	$30.08	$28.58	$32.87	Jan 1, 2026	Contractor file
JH · Mississippi, Area 00 CMS 07302-00	—	—	$29.32	$27.85	$32.03	Jan 1, 2026	Contractor file
JH · New Mexico, Area 05 CMS 04212-05	—	—	$31.07	$29.52	$33.95	Jan 1, 2026	Contractor file
JH · Oklahoma, Area 00 CMS 04312-00	—	—	$30.17	$28.66	$32.96	Jan 1, 2026	Contractor file
JH · Texas, Area 09 CMS 04412-09	—	—	$32.74	$31.10	$35.77	Jan 1, 2026	Contractor file
JH · Texas, Area 11 CMS 04412-11	—	—	$32.93	$31.28	$35.97	Jan 1, 2026	Contractor file
JH · Texas, Area 15 CMS 04412-15	—	—	$32.83	$31.19	$35.87	Jan 1, 2026	Contractor file
JH · Texas, Area 18 CMS 04412-18	—	—	$33.19	$31.53	$36.26	Jan 1, 2026	Contractor file
JH · Texas, Area 20 CMS 04412-20	—	—	$30.70	$29.17	$33.55	Jan 1, 2026	Contractor file
JH · Texas, Area 28 CMS 04412-28	—	—	$32.68	$31.05	$35.71	Jan 1, 2026	Contractor file
JH · Texas, Area 31 CMS 04412-31	—	—	$34.50	$32.78	$37.70	Jan 1, 2026	Contractor file
JH · Texas, Area 99 CMS 04412-99	—	—	$31.69	$30.11	$34.63	Jan 1, 2026	Contractor file
JN · Florida, Area 03 CMS 09102-03	—	—	$33.94	$32.24	$37.08	Jan 1, 2026	Contractor file
JN · Florida, Area 04 CMS 09102-04	—	—	$35.14	$33.38	$38.39	Jan 1, 2026	Contractor file
JN · Florida, Area 99 CMS 09102-99	—	—	$32.27	$30.66	$35.26	Jan 1, 2026	Contractor file
JN · Puerto Rico, Area 20 CMS 09202-20	—	—	$33.34	$31.67	$36.42	Jan 1, 2026	Contractor file
JN · U.S. Virgin Islands, Area 50 CMS 09202-50	—	—	$33.34	$31.67	$36.42	Jan 1, 2026	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 0348T Copy link

There is no national allowed amount for 0348T, 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 Q3 2026 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 0348T'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 0348T.

See every current NCCI pair for 0348T →

Billing together (NCCI edits) Copy link

NCCI Q3 2026

Based on CMS's National Correct Coding Initiative (NCCI). A few examples appear here; use the complete edit page to check a specific pair.

Not separately payable with 0348T on the same date of service—no modifier bypasses the edit (modifier indicator 0)

36591 36591 denies

36592 36592 denies

96523 96523 denies

Separately payable with 0348T only when an NCCI-associated modifier is appropriate and documented (modifier indicator 1)

0694T 0694T denies

72020 72020 denies

72040 72040 denies

Showing 3 of 14.

Modifier 59 and the X modifiers are not a universal bypass—CMS expects the most specific applicable modifier, and which one that is depends on the pair and the documented circumstances.

Check a paired code or view all 17 NCCI pairs →

Common payment questions Copy link

Why would a Medicare claim for 0348T 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
3 codes form NCCI pairs with 0348T carrying modifier indicator 0—no NCCI-associated modifier bypasses the edit, so billed together on the same date of service, a line of the pair denies. See billing together
14 codes pair with 0348T under modifier indicator 1—separately payable only when an NCCI-associated modifier (59, or a more specific XE, XS, XP, or XU) is clinically appropriate and the documentation supports a distinct service; without one, a line of the pair denies. See billing together

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 0348T?

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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 (Q3 2026) · rvu26c-updated-06-30-2026.zip (PPRRVU2026_Jul_nonQPP.csv row 361)

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 0348T National PFS baseline: No national PFS rate (Q3 2026; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/cpt/0348T/2026/C