CPT 0704T
Contractor-priced
0704T · PFS Q4 2022 · Historical
No national PFS rate in Q4 2022
Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation.
Check for a published amount in your locality.
CPT 0704T has no published national rate. It carries status C (carrier-priced) in the Q4 2022 release. Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation. The blank amount means unpriced, not $0.
PFS status evidence
Inspect PFS status evidence
- Code
- 0704T
- Release
- Q4 2022, revision 1
- Result
- Contractor-priced
Citations
-
Shows this code’s PFS status (C). Result: Contractor-priced.
Physician relative value file (PPRRVU)Q4 2022 · revision 1
Latest revision of this release
Release period: October 1 – December 31, 2022
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
PPRRVU22_OCT.csv in rvu22d.zip (row 5,950)- hcpcs (col 1)
- 0704T
- modifier (col 2)
- blank
- status_code (col 4)
- C
SHA-256: f8774a019545e1fd71536837b20b74674c014b1acef3435d93456857885190ab
Why is there no national PFS amount for 0704T?
Its status indicator is C (carrier-priced). Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation.
Payment considerations Copy link
Here are the inputs and payment rules that apply to this code. Each link takes you to the detail below.
Other payment indicators (7)
Facility/non-facility: Not determined, Multiple-procedure reduction: Does not apply, Assistant/co-surgeon treatment: Does not apply, Global surgery: Does not apply, NCCI same-day edits: Not determined, MUE behavior: Not determined, Other fee-schedule routing: Does not apply.
Why would a Medicare claim for 0704T 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
- Only a technical component exists for 0704T—there is no professional-component amount to bill. 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.
Reconciling a contractor-priced payment for 0704T Copy link
There is no national allowed amount for 0704T, 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 check
- 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.
- Only a technical-component amount is published for this code, so a professional charge billed on it has no fee-schedule amount behind it.
- Check whether a second side was billed separately—the published RVUs already price both sides, so there is no additional amount behind that line.
- 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.
Codes to compare
National Q4 2022 amounts at GPCI 1.000. A blank means this schedule does not publish a payable PFS amount.
None of the comparison codes are 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).
Which billing rules and modifiers apply? Copy link
Global period: what 0704T's fee already covers Copy link
The global surgery concept does not apply to this code.
Billing policy Copy link
These billing-policy indicators explain how 0704T is treated. They apply whether the code is nationally priced or carrier-priced: a restriction like "bilateral not allowed" still matters on a carrier-priced code.
| Policy | Value | What it means |
|---|---|---|
| Bilateral surgery | 2 | RVUs already reflect bilateral pricing. The published RVUs already account for a bilateral procedure—no additional bilateral adjustment applies on top of the fee schedule amount. |
| Professional/technical split | 3 | Technical component only. Only a technical component exists for this code—there is no corresponding professional-component amount to bill. |
Can you bill it with another code? Copy link
Check a pair of codes 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 for the pair.
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.
Did this answer your question about CPT 0704T?
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.
Source & method
Show sources
Hide
Contractor amounts come from the MAC-published schedules and effective dates shown above. The PFS file shows this code is priced by the contractor. Past releases are never edited, so these sources stay valid after CMS publishes a newer one. Our methodology explains sourcing, parsing, versioning, and how we cross-check claims before we publish them.
Use the (i) buttons next to each amount above for the exact row, columns, and math.
Cite this rate
The citation names the release, so anyone can check it even after CMS publishes a newer one.
CPT 0704T National PFS baseline: No national PFS rate (Q4 2022; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/cpt/0704T/2022/D