localis

Type a CPT/HCPCS code, a place, a service in plain words, or a whole claim line like 90837 LCSW 94110.

Try

CPT 44137 Medicare carrier-priced amounts

Contractor-priced

44137 · PFS Q3 2026 · Historical

Contractor-published range

$1,092.83–$1,261.61

Participating · Office (non-facility) · Whole service

MAC-published fee schedules available in Localis: 29 of 144 payment localities. Missing data does not establish a $0 allowance.

No national PFS rate in Q3 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

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
44137
Release
Q3 2026, revision 1
Result
Contractor-priced

Citations

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

    Physician relative value file (PPRRVU)CMS RVU26CJuly 1 – September 30, 2026

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

    PPRRVU2026_Jul_nonQPP.csv row 5,286 in rvu26c-updated-06-30-2026.zip

    In the CMS file

    Loading rows 5,284–5,288 of PPRRVU2026_Jul_nonQPP.csv…

    Download rvu26c-updated-06-30-2026.zip from CMS File fingerprint b7d197e73211ef6854c213c267d5fa9dec8df995db8e1ee7d44c0556ad7cee21

Report a problem

CPT 44137 carries status C (carrier-priced) in the Q3 2026 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 $1,092.83–$1,261.61 across 29 localities; enter a ZIP for the exact local amount.

Why is there no national PFS amount for 44137?

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 44137 Copy link

Medicare sets this price locally

44137 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 Noridian across JE, most recently effective Jan 1, 2026. 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 29 published fee rows
Jurisdiction / locality Modifier Note Par Non-par Limiting charge Effective Source
JE · California, Area 05 CMS 01112-05 — — $1,261.61 $1,198.53 $1,378.31 Jan 1, 2026 Contractor file
JE · California, Area 09 CMS 01112-09 — — $1,251.53 $1,188.95 $1,367.29 Jan 1, 2026 Contractor file
JE · California, Area 17 CMS 01182-17 — — $1,141.11 $1,084.05 $1,246.66 Jan 1, 2026 Contractor file
JE · California, Area 18 CMS 01182-18 — — $1,173.83 $1,115.14 $1,282.41 Jan 1, 2026 Contractor file
JE · California, Area 51 CMS 01112-51 — — $1,172.51 $1,113.88 $1,280.96 Jan 1, 2026 Contractor file
JE · California, Area 52 CMS 01112-52 — — $1,172.51 $1,113.88 $1,280.96 Jan 1, 2026 Contractor file
JE · California, Area 53 CMS 01112-53 — — $1,172.51 $1,113.88 $1,280.96 Jan 1, 2026 Contractor file
JE · California, Area 54 CMS 01112-54 — — $1,092.83 $1,038.19 $1,193.92 Jan 1, 2026 Contractor file
JE · California, Area 55 CMS 01112-55 — — $1,092.83 $1,038.19 $1,193.92 Jan 1, 2026 Contractor file
JE · California, Area 56 CMS 01112-56 — — $1,092.83 $1,038.19 $1,193.92 Jan 1, 2026 Contractor file
JE · California, Area 57 CMS 01112-57 — — $1,092.83 $1,038.19 $1,193.92 Jan 1, 2026 Contractor file
JE · California, Area 58 CMS 01112-58 — — $1,092.83 $1,038.19 $1,193.92 Jan 1, 2026 Contractor file
JE · California, Area 59 CMS 01112-59 — — $1,092.83 $1,038.19 $1,193.92 Jan 1, 2026 Contractor file
JE · California, Area 60 CMS 01112-60 — — $1,092.83 $1,038.19 $1,193.92 Jan 1, 2026 Contractor file
JE · California, Area 61 CMS 01112-61 — — $1,092.83 $1,038.19 $1,193.92 Jan 1, 2026 Contractor file
JE · California, Area 62 CMS 01112-62 — — $1,092.83 $1,038.19 $1,193.92 Jan 1, 2026 Contractor file
JE · California, Area 63 CMS 01112-63 — — $1,092.83 $1,038.19 $1,193.92 Jan 1, 2026 Contractor file
JE · California, Area 64 CMS 01112-64 — — $1,092.83 $1,038.19 $1,193.92 Jan 1, 2026 Contractor file
JE · California, Area 65 CMS 01112-65 — — $1,092.83 $1,038.19 $1,193.92 Jan 1, 2026 Contractor file
JE · California, Area 66 CMS 01112-66 — — $1,092.83 $1,038.19 $1,193.92 Jan 1, 2026 Contractor file
JE · California, Area 67 CMS 01112-67 — — $1,092.83 $1,038.19 $1,193.92 Jan 1, 2026 Contractor file
JE · California, Area 68 CMS 01112-68 — — $1,092.83 $1,038.19 $1,193.92 Jan 1, 2026 Contractor file
JE · California, Area 69 CMS 01112-69 — — $1,092.83 $1,038.19 $1,193.92 Jan 1, 2026 Contractor file
JE · California, Area 70 CMS 01112-70 — — $1,092.83 $1,038.19 $1,193.92 Jan 1, 2026 Contractor file
JE · California, Area 71 CMS 01182-71 — — $1,092.83 $1,038.19 $1,193.92 Jan 1, 2026 Contractor file
JE · California, Area 72 CMS 01182-72 — — $1,092.83 $1,038.19 $1,193.92 Jan 1, 2026 Contractor file
JE · California, Area 73 CMS 01182-73 — — $1,092.83 $1,038.19 $1,193.92 Jan 1, 2026 Contractor file
JE · California, Area 74 CMS 01182-74 — — $1,092.83 $1,038.19 $1,193.92 Jan 1, 2026 Contractor file
JE · California, Area 75 CMS 01112-75 — — $1,092.83 $1,038.19 $1,193.92 Jan 1, 2026 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 44137: MULT PROC 2 (standard reduction applies) · ASST SURG 2 (payable) · CO SURG 1 (payable with documentation).

Multiple procedures

Standard reduction applies

MULT PROC

2

When billed with other procedures on the same date, the highest-valued one is paid at 100% and the next four at 50% each.

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

Assistant at surgery

Payable

ASST SURG

2

An assistant at surgery may be separately paid for this procedure, typically as a percentage of the fee schedule amount.

Co-surgeons

Payable with documentation

CO SURG

1

Co-surgeons may be paid, but only with supporting documentation establishing the medical necessity of two surgeons.

Global surgery period XXX (does not apply).

Why would a Medicare claim for 44137 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
  • 8 codes form NCCI pairs with 44137 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
  • 80 codes pair with 44137 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
  • Bilateral surgery: no bilateral adjustment. See billing policy
  • Co-surgeons: payable with documentation. See billing policy
  • Team surgery: not permitted. See billing policy
  • Multiple procedures: standard reduction applies. 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 RVU26CJuly 1 – September 30, 2026

Can you bill it with another code? Copy link

44137 has 88 NCCI pairs (Q3 2026).

This code

44137

Modifier indicator 0

8 pairs

No modifier bypasses the edit

Modifier indicator 1

80 pairs

Only with an appropriate, documented modifier

All 88 NCCI pairs for 44137 →

Reconciling a contractor-priced payment for 44137 Copy link

Checking a paid 44137 line?

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

There is no national allowed amount for 44137, 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.
  • Rank the claim’s procedure lines before calling a reduced line short-paid—under the standard multiple-procedure rule only the highest-valued one prices in full.
  • Check that any -80 or -AS line was priced from the same release and locality as the primary line; an assistant at surgery prices at a percentage of the fee-schedule amount.
  • Check for documentation supporting two surgeons before appealing a modifier 62 denial—co-surgeon payment on this procedure depends on it.
  • 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); 42 USC 1395w-4(i)(2) (SSA §1848(i)(2))—Assistants-at-surgery.

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_Jul_nonQPP.csv · Q3 2026 (RVU26C) · row 5,286—priced by the contractor
    Source
    Physician relative value file (PPRRVU), Q3 2026 release
    Effective
    July 1 – September 30, 2026
    Locator
    PPRRVU2026_Jul_nonQPP.csv in rvu26c-updated-06-30-2026.zip · row 5,286 of 19,356 · via CMS
    Fields read
    Status C (col 4)
    SHA-256 b7d197e73211ef68…
  2. 02 MAC-published fee schedules · 29 on file—the contractor amounts
    Source
    MAC-published fee schedules
    Effective
    Effective dates shown above
  3. 03 NCCI · Q3 2026—the code-pair edits
    Source
    National Correct Coding Initiative (NCCI)
    Effective
    Same quarter as the Q3 2026 rate

Cite this rate

CPT 44137 National PFS baseline: No national PFS rate (Q3 2026; participating physician; whole service; GPCI 1.000; sequestration excluded). CMS RVU26C, PPRRVU2026_Jul_nonQPP.csv row 5,286. Localis. https://localishealth.com/cpt/44137/2026/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.

Did this answer your question about CPT 44137?

Tell us what you were trying to work out and we'll answer you or build the page that does.

Did this page answer your question?