localis

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

CPT 0353T

Contractor-priced

0353T · PFS Q3 2014 · Historical

No national PFS rate in Q3 2014

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

View applicable payment rules

Not at a published national rate. CPT 0353T carries status C (carrier-priced) in the Q3 2014 release. Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation. Treat the blank amount as unpriced, not as $0.

PFS status evidence

Physician relative value file (Q3 2014) · rvu14c.zip (PPRRVU14_V0515.csv row 4,585)
Inspect PFS status evidence
Code
0353T
Release
Q3 2014, 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 2014 · revision 1

    Latest revision of this release

    Release period: July 1 – September 30, 2014

    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 PPRRVU14_V0515.csv in rvu14c.zip (row 4,585)
    hcpcs (col 1)
    0353T
    modifier (col 2)
    blank
    status_code (col 4)
    C

    SHA-256: c77da0d012ff73dec8680d5f6f50582fc7e72005bc55edb2f131a02f0b1c293c

    Original source file

Compact facts

Why is there no national PFS amount for 0353T?

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.

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.

Reconciling a contractor-priced payment for 0353T Copy link

There is no national allowed amount for 0353T, 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 2014 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.

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 0353T'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 0353T.

See every current NCCI pair for 0353T →

Common payment questions Copy link

Why would a Medicare claim for 0353T 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 0353T?

We're building this out in the open. Tell us what you were actually trying to work out and we'll either answer you directly or build the page that does.

Did this page answer your question?

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 2014) · rvu14c.zip (PPRRVU14_V0515.csv row 4,585)

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 0353T National PFS baseline: No national PFS rate (Q3 2014; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/cpt/0353T/2014/C