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CPT 20982

National PFS baseline · Q1 2013

20982 · Historical

GPCIs 1.000 · Participating · Before sequestration

Find the locality-adjusted allowed amount

Nationally priced under PFS, using the RVU formula.

The national PFS baseline was $2,672.59 for CPT 20982 in the office (non-facility) setting and $275.26 in a facility under the Q1 2013 Physician Fee Schedule, effective January 2013. These are the national allowed amounts before locality (GPCI) adjustment; sequestration is excluded.

Calculation evidence

Compact facts

Why are the facility and non-facility amounts different?

Only the practice-expense RVU changes with the setting. For 20982 it's 98.83 RVUs in the office versus 2.94 in a facility—the whole $2,397.33 gap between $2,672.59 and $275.26. In an office the practice bears the overhead, so Medicare pays more; in a hospital or ASC the facility bills its own fee, so the professional payment is lower. See facility vs non-facility.

Sources: CMS Medicare Physician Fee Schedule Relative Value Files; CMS Practice Expense methodology (cms.gov).

What could change this amount? Copy link

Review the applicable inputs and payment rules. Each link opens the supporting detail on this page.

Service location and setting · Participation and payment shares

Other payment indicators (6)

Professional/technical component: 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, Contractor pricing: Does not apply.

Compare payment localities

The national baseline uses GPCI 1.000. These locality-adjusted allowed amounts use each payment locality's own GPCIs. Select a state to see its localities.

Maine: no locality amount on file for this code ME Wisconsin: no locality amount on file for this code WI Vermont: no locality amount on file for this code VT New Hampshire: no locality amount on file for this code NH Montana: $2,664.65 MT North Dakota: $2,656.75 ND Minnesota: no locality amount on file for this code MN Michigan: $2,482.08–$2,749.69 across 2 localities MI New York: $2,510.74–$3,214.13 across 5 localities NY Massachusetts: no locality amount on file for this code MA Rhode Island: no locality amount on file for this code RI Washington: $2,698.18–$3,030.55 across 2 localities WA Idaho: $2,399.28 ID Wyoming: $2,672.16 WY South Dakota: $2,651.96 SD Iowa: $2,374.87 IA Illinois: no locality amount on file for this code IL Indiana: $2,468.96 IN Ohio: $2,496.65 OH Pennsylvania: $2,457.72–$2,833.39 across 2 localities PA New Jersey: $2,988.63–$3,141.06 across 2 localities NJ Connecticut: $2,953.44 CT Oregon: $2,567.56–$2,774.71 across 2 localities OR Nevada: no locality amount on file for this code NV Utah: $2,461.81 UT Colorado: $2,679.18 CO Nebraska: $2,415.83 NE Missouri: $2,296.89–$2,582.92 across 3 localities MO Kentucky: $2,343.62 KY West Virginia: $2,245.46 WV Virginia: $2,609.10 VA Maryland: $2,760.80–$2,921.28 across 2 localities MD Delaware: $2,776.92 DE California: no locality amount on file for this code CA Arizona: $2,614.17 AZ New Mexico: $2,462.79 NM Kansas: $2,402.91 KS Oklahoma: $2,303.11 OK Arkansas: $2,322.03 AR Tennessee: no locality amount on file for this code TN North Carolina: $2,480.84 NC South Carolina: $2,433.78 SC District of Columbia: $3,173.32 DC Texas: $2,408.81–$2,712.91 across 8 localities TX Louisiana: $2,357.56–$2,608.62 across 2 localities LA Mississippi: $2,329.81 MS Alabama: no locality amount on file for this code AL Georgia: no locality amount on file for this code GA Florida: $2,601.31–$2,841.40 across 3 localities FL Alaska: $2,922.23 AK Hawaii: no locality amount on file for this code HI
$1,845–$2,067 $2,067–$2,288 $2,288–$2,509 $2,509–$2,731 $2,731–$2,952 $2,952–$3,173 No amount on file

Highest-paying locality

$3,214.13

NY flag NYC Suburbs/Long I., Ny, NY

Lowest-paying locality

$1,845.24

PR flag Puerto Rico, PR

Maine: no locality amount on file for this code ME Wisconsin: no locality amount on file for this code WI Vermont: no locality amount on file for this code VT New Hampshire: no locality amount on file for this code NH Montana: $267.32 MT North Dakota: $259.42 ND Minnesota: no locality amount on file for this code MN Michigan: $269.34–$297.23 across 2 localities MI New York: $259.65–$310.68 across 5 localities NY Massachusetts: no locality amount on file for this code MA Rhode Island: no locality amount on file for this code RI Washington: $272.09–$288.01 across 2 localities WA Idaho: $256.07 ID Wyoming: $274.83 WY South Dakota: $254.63 SD Iowa: $248.44 IA Illinois: no locality amount on file for this code IL Indiana: $256.22 IN Ohio: $274.33 OH Pennsylvania: $268.96–$294.62 across 2 localities PA New Jersey: $289.24–$297.83 across 2 localities NJ Connecticut: $292.41 CT Oregon: $261.33–$271.90 across 2 localities OR Nevada: no locality amount on file for this code NV Utah: $265.85 UT Colorado: $272.27 CO Nebraska: $248.64 NE Missouri: $256.77–$273.01 across 3 localities MO Kentucky: $255.55 KY West Virginia: $260.47 WV Virginia: $266.92 VA Maryland: $279.57–$291.42 across 2 localities MD Delaware: $274.11 DE California: no locality amount on file for this code CA Arizona: $269.58 AZ New Mexico: $266.84 NM Kansas: $259.70 KS Oklahoma: $250.99 OK Arkansas: $248.34 AR Tennessee: no locality amount on file for this code TN North Carolina: $258.52 NC South Carolina: $254.61 SC District of Columbia: $301.32 DC Texas: $260.80–$276.30 across 8 localities TX Louisiana: $255.10–$268.82 across 2 localities LA Mississippi: $253.72 MS Alabama: no locality amount on file for this code AL Georgia: no locality amount on file for this code GA Florida: $280.70–$314.62 across 3 localities FL Alaska: $364.28 AK Hawaii: no locality amount on file for this code HI
$220–$244 $244–$268 $268–$292 $292–$316 $316–$340 $340–$364 No amount on file

Highest-paying locality

$364.28

AK flag Alaska , AK

Lowest-paying locality

$219.85

PR flag Puerto Rico, PR

Look up your exact locality →

Q1 2013 amounts, computed with each locality's own GPCIs, before the ~2% sequestration cut. A state with more than one payment locality shows a range—its tile is colored by the mean across those localities, which is a shading choice, not an amount anyone is paid.

How this amount is computed Copy link

CPT 20982 has a work RVU of 7.27, a non-facility practice expense RVU of 98.83, a facility practice expense RVU of 2.94 and a malpractice RVU of 0.80—for total non-facility RVUs of 106.90 and total facility RVUs of 11.01 in the Q1 2013 release.

amount = (work RVU × work GPCI + PE RVU × PE GPCI + MP RVU × MP GPCI) × conversion factor. National amounts use GPCI = 1.000. To price an RVU figure of your own, use the RVU-to-dollars converter.

Release Q1 2013

Every rate combines three parts: work (the clinician’s time, skill and effort), practice expense (office overhead—higher when the service is done in a doctor’s own office), and malpractice (the share of liability-insurance cost). A blank means CMS publishes no national number for that part. Read it as unknown, and never as zero.

Payment review for 20982 Copy link

Four published payment rules can change what 20982 allows on a claim: the office/facility differential, the same-day global package, the standard multiple-procedure reduction and the 150% bilateral adjustment. Each is a legitimate reason for a paid amount to differ from the fee-schedule amount on this page.

What to reconcile

  • Check the place-of-service code before attributing the gap to the payer: office and facility pricing differ by $2,397.33 nationally at GPCI 1.000, before any locality adjustment.
  • Check the visit date: this code carries no follow-up window, so a related visit the day after the procedure is separately payable and should not have bundled.
  • Rank the claim’s procedure lines before calling this one short-paid: ranked below a higher-valued procedure on the same date it prices at $1,336.30 rather than $2,672.59 nationally at GPCI 1.000, which is the rule working rather than a payer error.
  • Look for modifier 50 or a second-side line before comparing: billed for both sides, this procedure should price at 150% of the single-side amount.
  • 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 Q1 2013 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 Practice Expense methodology (cms.gov); CMS Medicare Claims Processing Manual (Pub. 100-04).

Payment rules

Global period: what 20982's fee already covers Copy link

000 Same day only

The fee covers pre-operative and post-operative work on the day of the procedure only—there is no follow-up window afterward. A visit the next day is separately payable.

Modifiers that report work outside 20982's global period
Modifier Reports
-25 A significant, separately identifiable E/M on the same day as the procedure, beyond its usual pre- and post-operative care.

A modifier reports what happened; it does not by itself make a service payable. Documentation has to support it.

Billing policy Copy link

What 20982'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. See modifier amounts below for the dollar figures these support.

Policy Value What it means
Bilateral surgery 1 150% bilateral adjustment applies. Billed bilaterally (modifier 50, or on both sides), Medicare pays 150% of the single-side fee schedule amount.
Assistant at surgery 1 Never separately payable. An assistant at surgery may never be separately paid for this procedure—a statutory restriction.
Co-surgeons 0 Not permitted. Medicare does not recognize co-surgeons (modifier 62) for this procedure.
Team surgery 0 Not permitted. Medicare does not recognize a surgical team (modifier 66) for this procedure.
Multiple procedures 2 Standard reduction applies. The same standard ranking-and-reduction rule as indicator 1 applies to this procedure when billed with others on the same date.
Professional/technical split 0 No PC/TC split. This is a physician service code; the professional/technical split does not apply, and the code is billed as a single service.

Modifier amounts: -26/TC, -50, -80/81/82, -AS, -62, -66 Copy link

National non-facility amounts for the modifiers this code's indicators support. Single-line modifiers only. -51 (multiple-procedure reduction) depends on the other codes on the same claim, so it's a claim-level number rather than a per-code one. Use the calculator for a locality-adjusted, sequestration-aware amount.

Modifier What it means Amount
-26/TC Professional/technical split Not payable
-50 Bilateral procedure (150%) $4,008.89
-80/81/82 Assistant surgeon (physician) Not payable
-AS Assistant at surgery (PA, NP, or CNS) Not payable
-62 Co-surgeons, each Not payable
-66 Team surgery Not payable

These apply standard MPFS percentages—assistant surgeon 16%, co-surgeon 62.5%, bilateral 150%—to the national non-facility amount above, and require both the RVU inputs and the applicable payment rule as evidence. They are derived here rather than read from a CMS column: check them against the current Medicare Claims Processing Manual before relying on them for payment.

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 20982.

See every current NCCI pair for 20982 →

Allowed amount, program payment, and patient share Copy link

These figures use the same national baseline, with different participation and payment assumptions.

Computed from the Q1 2013 CMS release

Medicare allowed amount

What Medicare recognizes as the full price for 20982 in the office (non-facility) setting. Every figure below derives from it.

$2,672.59
Medicare's share

80% of the allowed amount, before the ~2% sequestration cut.

$2,138.07
Patient coinsurance

The remaining 20%, once the annual Part B deductible is met. Medigap or Medicaid often covers it.

$534.52
Limiting charge

The ceiling a non-participating provider can bill a patient on an unassigned claim—109.25% of the allowed amount.

$2,919.80

National Q1 2013 figures at GPCI 1.000. Adjust for your locality and sequestration, or expand the explanations below for each figure in full.

Is $2,672.59 what a practice actually receives?

It's the national allowed amount—the starting point. Medicare pays 80% of it ($2,138.07) and the patient owes 20% coinsurance ($534.52). Sequestration trims Medicare's share by about 2%, your locality's GPCIs scale the total up or down, and the expected-payment calculator applies all three. What lands is practice revenue: staff, space, equipment and billing, not clinician take-home pay. The practice-expense RVU above is CMS's estimate of that overhead share.

Sources: Budget Control Act sequestration provisions; CMS Medicare Fee-for-Service payment guidance; CMS Geographic Practice Cost Index (GPCI) files; CMS Physician Fee Schedule overview (cms.gov).

What's the non-participating amount for 20982?

$2,538.96 in the office (non-facility) setting—95% of the $2,672.59 participating fee schedule amount above. A participating provider takes the fee schedule amount as payment in full on every claim. A non-participating provider is paid this reduced amount, but chooses claim by claim whether to accept assignment. See participating vs non-participating.

Sources: CMS Physician Fee Schedule overview (cms.gov); CMS Medicare Fee-for-Service payment guidance.

What's the limiting charge for 20982?

$2,919.80 in the office (non-facility) setting—the ceiling on what a non-participating provider can bill the patient on an unassigned claim. That's 109.25% of the $2,672.59 amount above. The non-participating amount is 95% of the fee schedule rate ($2,538.96), and the statutory cap is 115% of that. See limiting charge.

Sources: CMS Physician Fee Schedule overview (cms.gov); CMS Medicare Fee-for-Service payment guidance.

Common payment questions Copy link

Why would a Medicare claim for 20982 be denied or paid less?

These come from CMS indicators on this page, not general billing advice.

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.

History

Rate history by release Copy link

National non-facility amount for 20982 across quarterly releases. +30.3% increase since Q1 2013 · high $4,020.38 in Q1 2021

$4,020 $3,084 $2,148 $1,212 $275 Q1 2013 · $2,672.59 Q2 2014 · $3,719.48 (+39.2%) Q3 2014 · $3,719.48 (0.0%) Q4 2014 · $3,719.48 (0.0%) Q1 2015 · $3,796.08 (+2.1%) Q2 2015 · $3,796.08 (0.0%) Q3 2015 · $3,796.08 (0.0%) Q4 2015 · $3,815.06 (+0.5%) Q1 2016 · $3,077.38 (-19.3%) Q2 2016 · $3,077.38 (0.0%) Q3 2016 · $3,077.38 (0.0%) Q4 2016 · $3,077.38 (0.0%) Q1 2017 · $1,736.30 (-43.6%) Q2 2017 · $1,736.30 (0.0%) Q3 2017 · $1,736.30 (0.0%) Q4 2017 · $1,736.30 (0.0%) Q1 2018 · $4,008.56 (+130.9%) Q2 2018 · $4,008.56 (0.0%) Q3 2018 · $4,008.56 (0.0%) Q4 2018 · $4,008.56 (0.0%) Q1 2019 · $3,969.35 (-1.0%) Q2 2019 · $3,969.35 (0.0%) Q3 2019 · $3,969.35 (0.0%) Q4 2019 · $3,969.35 (0.0%) Q1 2020 · $3,938.10 (-0.8%) Q2 2020 · $3,938.10 (0.0%) Q3 2020 · $3,938.10 (0.0%) Q4 2020 · $3,938.10 (0.0%) Q1 2021 · $4,020.38 (+2.1%) Q2 2021 · $4,020.38 (0.0%) Q3 2021 · $4,020.38 (0.0%) Q4 2021 · $4,020.38 (0.0%) Q1 2022 · $3,750.62 (-6.7%) Q2 2022 · $3,750.62 (0.0%) Q3 2022 · $3,750.62 (0.0%) Q4 2022 · $3,750.62 (0.0%) Q1 2023 · $3,594.75 (-4.2%) Q2 2023 · $3,594.75 (0.0%) Q3 2023 · $3,594.75 (0.0%) Q4 2023 · $3,594.75 (0.0%) Q1 2024 · $3,369.71 (-6.3%) Q1 2024 · $3,425.62 (+1.7%) Q2 2024 · $3,425.62 (0.0%) Q3 2024 · $3,425.62 (0.0%) Q4 2024 · $3,425.62 (0.0%) Q1 2025 · $3,226.89 (-5.8%) Q2 2025 · $3,226.89 (0.0%) Q3 2025 · $3,226.89 (0.0%) Q4 2025 · $3,226.89 (0.0%) Q1 2026 · $3,482.38 (+7.9%) Q2 2026 · $3,482.38 (0.0%) Q3 2026 · $3,482.38 (0.0%) Q4 2026 · $3,482.38 (0.0%) Q1 2013 Q3 2016 Q2 2019 Q4 2021 Q2 2024 Q4 2026
Non-facility Facility
Release Status Non-facility Facility
Q4 2026 takes effect Oct 1, 2026 A $3,482.38 (0.0% no change ) $321.65 (0.0% no change )
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.

The 20982 rate last moved in Q1 2026. See its rate history.

Sources: CMS Medicare Physician Fee Schedule Relative Value Files.

Beyond Medicare

Contracted rate: % of Medicare Copy link

Commercial payer contracts usually price off the Medicare amount above ("BCBS pays 115% of Medicare"). Enter your contract's percentage below to see what 20982 pays at that rate—$2,672.59 is 100%.

We want to build this: store your multipliers once, and every code page shows your rate instead of Medicare's. Tell us if you'd use it →

See how to find your contract's actual percentage.

Usage & related

How often 20982 is billed Copy link

Across Original Medicare in CY2024, 20982 ranked #3,543 of the 7,879 CPT codes billed to Medicare that year, by patients served or total allowed dollars.

Beneficiaries
1,501
Office + facility patients combined
Services
1,598
Times it was billed
Allowed
$653,507
Total Medicare allowed dollars

2024 Medicare fee-for-service national totals. They exclude Medicare Advantage, Medicaid and commercial volume, so real-world use runs higher. This is a calendar-year snapshot from the CMS Physician & Other Practitioners dataset, on a different cycle from the Q1 2013 fee schedule above.

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Source & method

Show sources

This page uses CMS's Medicare Physician Fee Schedule Q1 2013 release (effective January 2013). National baselines use GPCI 1.000 and exclude sequestration. Status and payment instructions determine whether a national amount is established; blank RVUs stay blank. Releases are immutable: historical evidence remains tied to the specified release. Modifier amounts apply standard MPFS percentages to this code's billing indicators. We derive them here rather than read them from CMS, so confirm them against the current Claims Processing Manual before relying on them for payment. Our methodology covers the depth: sourcing, parsing, versioning, and how we cross-check claims before they ship.

Conversion factor $25.0008 read from the same file, row 11, column 25.

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 20982 National PFS baseline: Office (non-facility) $2,672.59; Facility $275.26 (Q1 2013; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/cpt/20982/2013/A