Contractor-priced
0701T · PFS Q2 2022 · Historical
Contractor-published range
$14.68–$15.71
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 Q2 2022
Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation.
Check for a published amount in your locality.
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
- 0701T
- Release
- Q2 2022, revision 1
- Result
- Contractor-priced
Citations
-
Shows this code’s PFS status (C). Result: Contractor-priced.
Physician relative value file (PPRRVU)CMS RVU22BApril 1 – June 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_APR.csv row 5,887 in rvu22b.zip
In the CMS file
Loading rows 5,885–5,889 of PPRRVU22_APR.csv…
Download rvu22b.zip from CMS File fingerprint
7a64189403d440641280d5e90c1ebf39bbdc950a292e6d6f2a8bf8dc144ae305
CPT 0701T carries status C (carrier-priced) in the Q2 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 $14.68–$15.71 across 3 localities; enter a ZIP for the exact local amount.
Why is there no national PFS amount for 0701T?
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 0701T Copy link
Medicare sets this price locally
0701T 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.
View all 3 published fee rows
| Jurisdiction / locality | Modifier | Note | Par | Non-par | Limiting charge | Effective | Source |
|---|---|---|---|---|---|---|---|
| JN · Florida, Area 03 CMS 09102-03 | — | — | $15.35 | $14.58 | $16.77 | Jan 1, 2022 | Contractor file |
| JN · Florida, Area 04 CMS 09102-04 | — | — | $15.71 | $14.92 | $17.16 | Jan 1, 2022 | Contractor file |
| JN · Florida, Area 99 CMS 09102-99 | — | — | $14.68 | $13.95 | $16.04 | 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 indicators that apply to 0701T: GLOB DAYS ZZZ (add-on code) · PCTC 1 (splits into professional and technical) · BILAT SURG 3 (both sides paid at 100%).
Add-on code
GLOB DAYS
ZZZ
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.
Splits into professional and technical
PCTC
1
This procedure splits into a professional component (modifier 26) and a technical component (modifier TC), each separately payable.
Both sides paid at 100%
BILAT SURG
3
No special bilateral adjustment applies here—each side is paid at 100% of the fee schedule amount, subject to the usual multiple-procedure rules for other services billed the same day.
Why would a Medicare claim for 0701T 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
- 0701T splits into a professional component (modifier 26) and a technical component (modifier TC)—a claim for only one part needs that modifier to price correctly. See billing policy
- Assistant at surgery: restricted without documentation. See billing policy
- Co-surgeons: not permitted. See billing policy
- Team surgery: not permitted. See billing policy
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 RVU22BApril 1 – June 30, 2022
Can you bill it with another code? Copy link
Reconciling a contractor-priced payment for 0701T Copy link
What to check (5)
There is no national allowed amount for 0701T, 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.
- 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.
- Confirm which component the line carried before comparing anything: the same code prices three ways—globally, as a professional component with modifier 26, and as a technical component with modifier TC.
- 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.
- Confirm both sides were priced at 100%: this procedure takes no bilateral adjustment, though anything else billed the same day may still rank under the multiple-procedure rule.
- 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.
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).
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_APR.csv · Q2 2022 (RVU22B) · row 5,887—priced by the contractor
- Effective
- April 1 – June 30, 2022
- Locator
- PPRRVU22_APR.csv in rvu22b.zip · row 5,887 of 17,630 · via CMS
- Fields read
-
Status C (col 4)SHA-256 7a64189403d44064…
-
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 0701T National PFS baseline: No national PFS rate (Q2 2022; participating physician; whole service; GPCI 1.000; sequestration excluded). CMS RVU22B, PPRRVU22_APR.csv row 5,887. Localis. https://localishealth.com/cpt/0701T/2022/B
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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