Contractor-priced
66983 · PFS Q2 2020 · Historical
No national PFS rate in Q2 2020
Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation.
PFS status evidence
Inspect PFS status evidence
- Code
- 66983
- Release
- Q2 2020, revision 1
- Result
- Contractor-priced
Citations
-
Shows this code’s PFS status (C). Result: Contractor-priced.
Physician relative value file (PPRRVU)CMS RVU20BApril 1 – June 30, 2020
This PFS record alone does not establish a $0 allowance or a coverage determination. Any amount from another schedule needs its own evidence.
PPRRVU20_APR.csv row 11,716 in rvu20b-updated-05012020.zip
In the CMS file
Loading rows 11,714–11,718 of PPRRVU20_APR.csv…
Download rvu20b-updated-05012020.zip from CMS File fingerprint
672d21e247262386ad5b386092de9835fecec65fabbeaae050718f9afeef097b
CPT 66983 has no published national rate. It carries status C (carrier-priced) in the Q2 2020 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 66983?
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 66983: GLOB DAYS 090 (90-day follow-up) · BILAT SURG 1 (150% bilateral adjustment applies) · MULT PROC 2 (standard reduction applies).
90-day follow-up
GLOB DAYS
090
Major surgery. The fee covers the day before surgery, the day of surgery, and the 90 days after it. Related follow-up care inside that window is not billed separately.
150% bilateral adjustment applies
BILAT SURG
1
Billed bilaterally (modifier 50, or on both sides), Medicare pays 150% of the single-side fee schedule amount.
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.
Why would a Medicare claim for 66983 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
- 66983 carries a 90-day global period—routine post-operative care within that window is included in the surgical payment rather than paid on its own claim. See how it's computed
- Assistant at surgery: never separately payable. See billing policy
- Co-surgeons: not permitted. 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 RVU20BApril 1 – June 30, 2020
Can you bill it with another code? Copy link
Reconciling a contractor-priced payment for 66983 Copy link
What to check (5)
There is no national allowed amount for 66983, 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.
- Check the dates before appealing a denial: related follow-up care in the 90 days after the procedure is already paid in this fee, so a post-operative visit denied in that window was denied correctly.
- 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.
- 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.
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 PPRRVU20_APR.csv · Q2 2020 (RVU20B) · row 11,716—priced by the contractor
- Effective
- April 1 – June 30, 2020
- Locator
- PPRRVU20_APR.csv in rvu20b-updated-05012020.zip · row 11,716 of 17,250 · via CMS
- Fields read
-
Status C (col 4)SHA-256 672d21e247262386…
-
02 Physician & Other Practitioners · CY2024—volume and who bills it limits
- Effective
- Calendar-year snapshot, on a different cycle from the Q2 2020 fee schedule
- Doesn’t establish
- Medicare Advantage, Medicaid or commercial volume.
- Note
- The dataset suppresses rows under 11 beneficiaries.
Cite this rate
CPT 66983 National PFS baseline: No national PFS rate (Q2 2020; participating physician; whole service; GPCI 1.000; sequestration excluded). CMS RVU20B, PPRRVU20_APR.csv row 11,716. Localis. https://localishealth.com/cpt/66983/2020/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.
The 66983 rate last moved in Q1 2019. See its rate history.
Sources: CMS Medicare Physician Fee Schedule Relative Value Files.
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Usage and related codes Copy link
In CY2024, 66983 ranked #6,367 of the 7,879 CPT codes billed to Medicare that year, by patients served or total allowed dollars.
- Services
- 167
- Allowed
- $52,617
- Beneficiaries
- 66
CY2024 Medicare fee-for-service, from the CMS Physician & Other Practitioners dataset (limits). Localis groups related codes for payment research; the grouping isn't the AMA's code families.