CPT 0488T Medicare carrier-priced amount: $41.91–$45.54 on file (Q3 2022)

Contractor-priced

0488T · PFS Q3 2022 · Historical

Contractor-published range

$41.91–$45.54

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 Q3 2022

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

Amount evidence: MAC-published fee schedules and effective dates. The PFS row shows this code is priced by the contractor.

Inspect PFS status evidence

Code: 0488T
Release: Q3 2022, revision 1
Result: Contractor-priced

Citations

Shows this code’s PFS status (C). Result: Contractor-priced.

Physician relative value file (PPRRVU)CMS RVU22CJuly 1 – September 30, 2022

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

PPRRVU22_JUL.csv row 5,614 in rvu22c-updated-06172022.zip

In the CMS file

Loading rows 5,612–5,616 of PPRRVU22_JUL.csv…

Download rvu22c-updated-06172022.zip from CMS File fingerprint f0a493a192a21b1faa980aa71d22c8ae064e87b564f51a67e1229fcee376df41

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CPT 0488T carries status C (carrier-priced) in the Q3 2022 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 $41.91–$45.54 across 3 localities; enter a ZIP for the exact local amount.

Why is there no national PFS amount for 0488T?

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

Find the local Medicare amount for 0488T Copy link

Medicare sets this price locally

0488T 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, 2022. 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	—	—	$43.79	$41.60	$47.84	Jan 1, 2022	Contractor file
JN · Florida, Area 03 CMS 09102-03	—	#	$34.36	$32.64	$37.54	Jan 1, 2022	Contractor file
JN · Florida, Area 04 CMS 09102-04	—	—	$45.54	$43.26	$49.75	Jan 1, 2022	Contractor file
JN · Florida, Area 04 CMS 09102-04	—	#	$35.92	$34.12	$39.24	Jan 1, 2022	Contractor file
JN · Florida, Area 99 CMS 09102-99	—	—	$41.91	$39.81	$45.78	Jan 1, 2022	Contractor file
JN · Florida, Area 99 CMS 09102-99	—	#	$33.04	$31.39	$36.10	Jan 1, 2022	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.

Which billing rules and modifiers apply? Copy link

CMS's surgical and split-billing indicators don't adjust 0488T's amount.

Global surgery period XXX (does not apply).

Why would a Medicare claim for 0488T 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.

CMS RVU22CJuly 1 – September 30, 2022

Can you bill it with another code? Copy link

See every current NCCI pair for 0488T →

Source & method Copy link

The PFS file shows this code is priced by the contractor. Its amounts come from the MAC-published schedules and effective dates shown above.

01 PPRRVU22_JUL.csv · Q3 2022 (RVU22C) · row 5,614—priced by the contractor

Source

Physician relative value file (PPRRVU), Q3 2022 release

Effective

July 1 – September 30, 2022

Locator

PPRRVU22_JUL.csv in rvu22c-updated-06172022.zip · row 5,614 of 17,695 · via CMS

Fields read

Status C (col 4)

SHA-256 f0a493a192a21b1f…
02 MAC-published fee schedules · 3 on file—the contractor amounts

Source

MAC-published fee schedules

Effective

Effective dates shown above

Cite this rate

CPT 0488T National PFS baseline: No national PFS rate (Q3 2022; participating physician; whole service; GPCI 1.000; sequestration excluded). CMS RVU22C, PPRRVU22_JUL.csv row 5,614. Localis. https://localishealth.com/cpt/0488T/2022/C

Past releases are never edited, so the citation stays checkable after CMS publishes a newer one. Methodology · Plain-text summary · JSON

How has it changed? Copy link

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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