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CPT 0939T Medicare payment status

Contractor-priced

0939T · PFS Q4 2026

No national PFS rate in Q4 2026

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

Check for a published amount in your locality.

View contractor sources and effective dates

PFS status evidence

Physician relative value file (Q4 2026) · rvu26d-updated-08-26-2026.zip (PPRRVU2026_Oct_nonQPP.csv row 973)
Inspect PFS status evidence
Code
0939T
Release
Q4 2026, revision 2
Result
Contractor-priced

Citations

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

    Physician relative value file (PPRRVU)CMS RVU26DOctober 1 – December 31, 2026revision 2

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

    PPRRVU2026_Oct_nonQPP.csv row 973 in rvu26d-updated-08-26-2026.zip

    In the CMS file

    Loading rows 971–975 of PPRRVU2026_Oct_nonQPP.csv…

    Download rvu26d-updated-08-26-2026.zip from CMS File fingerprint 4d0d3f19bd954ffc0f5b8439169d267da023d4f6911f4539bb6e98723cb1a626

Report a problem

CPT 0939T has no published national rate. It carries status C (carrier-priced) in the Q4 2026 release. Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation. The blank amount means unpriced, not $0.

Why is there no national PFS amount for 0939T?

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

Which billing rules and modifiers apply? Copy link

CMS indicators that apply to 0939T: PCTC 3 (technical component only) · MULT PROC 6 (cardiovascular reduction applies).

Professional/technical split

Technical component only

PCTC

3

Only a technical component exists for this code—there is no corresponding professional-component amount to bill.

Multiple procedures

Cardiovascular reduction applies

MULT PROC

6

The technical component of the second and subsequent ranked diagnostic cardiovascular procedure on the same day is reduced; the professional component is never reduced.

-51 depends on the other codes on the same claim, so it's a claim-level number rather than a per-code one.

Global surgery period XXX (does not apply).

Why would a Medicare claim for 0939T 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
  • 20 codes form NCCI pairs with 0939T carrying modifier indicator 0—no NCCI-associated modifier bypasses the edit, so billed together on the same date of service, a line of the pair denies. See billing together
  • 77 codes pair with 0939T under modifier indicator 1—separately payable only when an NCCI-associated modifier (59, or a more specific XE, XS, XP, or XU) is clinically appropriate and the documentation supports a distinct service; without one, a line of the pair denies. See billing together
  • More than 1 unit per patient per date of service exceeds 0939T's Medically Unlikely Edit (MUE) limit. See billing together
  • Only a technical component exists for 0939T—there is no professional-component amount to bill. See billing policy
  • Bilateral surgery: no bilateral adjustment. 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 RVU26DOctober 1 – December 31, 2026revision 2

Can you bill it with another code? Copy link

0939T has 97 NCCI pairs (Q4 2026) and an MUE of 1 unit per patient per date of service.

This code

0939T

Modifier indicator 0

20 pairs

No modifier bypasses the edit

Modifier indicator 1

77 pairs

Only with an appropriate, documented modifier

Medically Unlikely Edit (MUE) limit

1 unit

Per patient per date of service

All 97 NCCI pairs for 0939T →

Reconciling a contractor-priced payment for 0939T Copy link

Checking a paid 0939T line?

Check an actual payment Model this code in a contract
What to check (5)

There is no national allowed amount for 0939T, 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.
  • 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 for a second cardiovascular diagnostic line on the same date: the lower-ranked technical component is reduced by rule, while the professional component is never reduced.
  • Check for documentation on file before appealing an assistant-at-surgery denial: payment on the -80 or -AS line is restricted for this procedure unless medical necessity is established.
  • 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); CMS Transmittal R1149OTN: MPPR on the Technical Component of Diagnostic Cardiovascular and Ophthalmology Procedures.

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.

  1. 01 PPRRVU2026_Oct_nonQPP.csv · Q4 2026 (RVU26D) · row 973—priced by the contractor
    Source
    Physician relative value file (PPRRVU), Q4 2026 release
    Effective
    October 1 – December 31, 2026
    Locator
    PPRRVU2026_Oct_nonQPP.csv in rvu26d-updated-08-26-2026.zip · row 973 of 19,453 · via CMS
    Fields read
    Status C (col 4)
    SHA-256 4d0d3f19bd954ffc…
  2. 02 NCCI · Q4 2026—the code-pair edits
    Source
    National Correct Coding Initiative (NCCI)
    Effective
    Same quarter as the Q4 2026 rate

Cite this rate

CPT 0939T National PFS baseline: No national PFS rate (Q4 2026; participating physician; whole service; GPCI 1.000; sequestration excluded). CMS RVU26D, PPRRVU2026_Oct_nonQPP.csv row 973. Localis. https://localishealth.com/cpt/0939T/2026/D

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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