CPT 0480T
Contractor-priced
0480T · PFS Q4 2025 · Historical
Contractor-published range
$60.22–$145.11
Participating · Office (non-facility) · Whole service
MAC-published fee schedules available in Localis: 18 of 144 payment localities. Missing data does not establish a $0 allowance.
No national PFS rate in Q4 2025
Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation.
Check for a published amount in your locality.
CPT 0480T carries status C (carrier-priced) in the Q4 2025 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 $60.22–$145.11 across 18 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
- 0480T
- Release
- Q4 2025, 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)Q4 2025 · revision 1
Latest revision of this release
Release period: October 1 – December 31, 2025
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
PPRRVU2025_Oct.csv in rvu25d-updated-09-11-2025.zip (row 426)- hcpcs (col 1)
- 0480T
- modifier (col 2)
- blank
- status_code (col 4)
- C
SHA-256: 8af460f38bf982b79b07269fbc8b7256a8ef3bd3aa025a9c5cb71c1e52523c56
Why is there no national PFS amount for 0480T?
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 (9)
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, Global surgery: Not determined, NCCI same-day edits: Not determined, MUE behavior: Not determined, Other fee-schedule routing: Does not apply.
Find the local Medicare amount for 0480T Copy link
Medicare sets this price locally
0480T 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, 2025. 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.
View all 36 published fee rows
| Jurisdiction / locality | Modifier | Note | Par | Non-par | Limiting charge | Effective | Source |
|---|---|---|---|---|---|---|---|
| JH · Arkansas, Area 13 CMS 07102-13 | — | — | $60.49 | $57.47 | $66.09 | Jan 1, 2025 | Contractor file |
| JH · Arkansas, Area 13 CMS 07102-13 | — | # | $22.80 | $21.66 | $24.91 | Jan 1, 2025 | Contractor file |
| JH · Colorado, Area 01 CMS 04112-01 | — | — | $71.29 | $67.73 | $77.89 | Jan 1, 2025 | Contractor file |
| JH · Colorado, Area 01 CMS 04112-01 | — | # | $25.14 | $23.88 | $27.46 | Jan 1, 2025 | Contractor file |
| JH · Louisiana, Area 01 CMS 07202-01 | — | — | $64.98 | $61.73 | $70.99 | Jan 1, 2025 | Contractor file |
| JH · Louisiana, Area 01 CMS 07202-01 | — | # | $24.00 | $22.80 | $26.22 | Jan 1, 2025 | Contractor file |
| JH · Louisiana, Area 99 CMS 07202-99 | — | — | $61.93 | $58.83 | $67.65 | Jan 1, 2025 | Contractor file |
| JH · Louisiana, Area 99 CMS 07202-99 | — | # | $23.32 | $22.15 | $25.47 | Jan 1, 2025 | Contractor file |
| JH · Mississippi, Area 00 CMS 07302-00 | — | — | $60.22 | $57.21 | $65.79 | Jan 1, 2025 | Contractor file |
| JH · Mississippi, Area 00 CMS 07302-00 | — | # | $22.88 | $21.74 | $25.00 | Jan 1, 2025 | Contractor file |
| JH · New Mexico, Area 05 CMS 04212-05 | — | — | $145.11 | $137.85 | $158.53 | Mar 1, 2024 | Contractor file |
| JH · New Mexico, Area 05 CMS 04212-05 | — | # | $30.39 | $28.87 | $33.20 | Mar 1, 2024 | Contractor file |
| JH · Oklahoma, Area 00 CMS 04312-00 | — | — | $62.37 | $59.25 | $68.14 | Jan 1, 2025 | Contractor file |
| JH · Oklahoma, Area 00 CMS 04312-00 | — | # | $23.32 | $22.15 | $25.47 | Jan 1, 2025 | Contractor file |
| JH · Texas, Area 09 CMS 04412-09 | — | — | $68.79 | $65.35 | $75.15 | Jan 1, 2025 | Contractor file |
| JH · Texas, Area 09 CMS 04412-09 | — | # | $24.70 | $23.47 | $26.99 | Jan 1, 2025 | Contractor file |
| JH · Texas, Area 11 CMS 04412-11 | — | — | $68.86 | $65.42 | $75.23 | Jan 1, 2025 | Contractor file |
| JH · Texas, Area 11 CMS 04412-11 | — | # | $24.73 | $23.49 | $27.01 | Jan 1, 2025 | Contractor file |
| JH · Texas, Area 15 CMS 04412-15 | — | — | $68.51 | $65.08 | $74.84 | Jan 1, 2025 | Contractor file |
| JH · Texas, Area 15 CMS 04412-15 | — | # | $24.68 | $23.45 | $26.97 | Jan 1, 2025 | Contractor file |
| JH · Texas, Area 18 CMS 04412-18 | — | — | $69.03 | $65.58 | $75.42 | Jan 1, 2025 | Contractor file |
| JH · Texas, Area 18 CMS 04412-18 | — | # | $25.07 | $23.82 | $27.39 | Jan 1, 2025 | Contractor file |
| JH · Texas, Area 20 CMS 04412-20 | — | — | $63.11 | $59.95 | $68.94 | Jan 1, 2025 | Contractor file |
| JH · Texas, Area 20 CMS 04412-20 | — | # | $23.53 | $22.35 | $25.70 | Jan 1, 2025 | Contractor file |
| JH · Texas, Area 28 CMS 04412-28 | — | — | $68.39 | $64.97 | $74.72 | Jan 1, 2025 | Contractor file |
| JH · Texas, Area 28 CMS 04412-28 | — | # | $24.65 | $23.42 | $26.93 | Jan 1, 2025 | Contractor file |
| JH · Texas, Area 31 CMS 04412-31 | — | — | $70.86 | $67.32 | $77.42 | Jan 1, 2025 | Contractor file |
| JH · Texas, Area 31 CMS 04412-31 | — | # | $25.01 | $23.76 | $27.32 | Jan 1, 2025 | Contractor file |
| JH · Texas, Area 99 CMS 04412-99 | — | — | $65.38 | $62.11 | $71.43 | Jan 1, 2025 | Contractor file |
| JH · Texas, Area 99 CMS 04412-99 | — | # | $23.96 | $22.76 | $26.17 | Jan 1, 2025 | Contractor file |
| JN · Florida, Area 03 CMS 09102-03 | — | — | $68.80 | $65.36 | $75.16 | Jan 1, 2025 | Contractor file |
| JN · Florida, Area 03 CMS 09102-03 | — | # | $25.06 | $23.81 | $27.38 | Jan 1, 2025 | Contractor file |
| JN · Florida, Area 04 CMS 09102-04 | — | — | $70.85 | $67.31 | $77.41 | Jan 1, 2025 | Contractor file |
| JN · Florida, Area 04 CMS 09102-04 | — | # | $25.84 | $24.55 | $28.23 | Jan 1, 2025 | Contractor file |
| JN · Florida, Area 99 CMS 09102-99 | — | — | $65.45 | $62.18 | $71.51 | Jan 1, 2025 | Contractor file |
| JN · Florida, Area 99 CMS 09102-99 | — | # | $24.25 | $23.04 | $26.50 | Jan 1, 2025 | 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 0480T Copy link
There is no national allowed amount for 0480T, 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.
- Reconcile this line together with the primary procedure on the same claim—it is an add-on that is never billed alone and carries no global period of its own.
- 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 Q4 2025 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).
Global period: what 0480T's fee already covers Copy link
This code is always billed alongside another service and carries no follow-up period of its own. The primary procedure's global period governs; this indicator does not determine whether either line is payable.
Billing policy Copy link
What 0480T's billing-policy indicators mean. These show for every code, priced or not: a restriction like "bilateral not allowed" still matters on a carrier-priced code.
| Policy | Value | What it means |
|---|---|---|
| Multiple procedures | 0 | No reduction. No payment reduction applies when this procedure is billed with other procedures on the same date—each is treated as unrelated. |
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 0480T.
Common payment questions Copy link
Why would a Medicare claim for 0480T 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.
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.
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Source & method
Show sources
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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.
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 0480T National PFS baseline: No national PFS rate (Q4 2025; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/cpt/0480T/2025/D