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CPT 76390 Medicare payment status

Excluded from PFS

76390 · PFS Q1 2013 · Historical

No national PFS rate in Q1 2013

Status N: non-covered. Medicare covers no part of this service, so the PFS produces no payment amount.

View applicable payment rules
View CMS source and method

CMS RVU13AJanuary 1 – March 31, 2013revision 2

PFS status evidence

Physician relative value file (Q1 2013) · rvu13ar.zip (PPRRVU13_V1226_UP0.csv row 11,680)
Inspect PFS status evidence
Code
76390
Release
Q1 2013, revision 2
Result
Excluded from PFS

Citations

  • Shows this code’s PFS status (N). Result: Excluded from PFS.

    Physician relative value file (PPRRVU)CMS RVU13AJanuary 1 – March 31, 2013revision 2

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

    PPRRVU13_V1226_UP0.csv row 11,680 in rvu13ar.zip

    In the CMS file

    Loading rows 11,678–11,682 of PPRRVU13_V1226_UP0.csv…

    Download rvu13ar.zip from CMS File fingerprint 79b1988bb9cbab6a61634b6463d26ce88cca431c3e36fa3b73792f29882d95b4

Plain-text summaryReport a problem

CPT 76390 has no published national rate. It carries status N (non-covered) in the Q1 2013 release. Medicare covers no part of this service. The blank amount means unpriced, not $0.

Why is there no national PFS amount for 76390?

Its status indicator is N (non-covered). Medicare covers no part of this service. Status N: non-covered. Medicare covers no part of this service, so the PFS produces no payment amount.

What do commercial payers pay? Copy link

Which billing rules and modifiers apply? Copy link

Payment rules for 76390 Copy link

Professional/technical component Applies
Other payment indicators (9)
Facility/non-facility: Not determined, Bilateral adjustment: Does not apply, 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, Contractor pricing: Does not apply.
Why would a Medicare claim for 76390 be denied or paid less?

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

  • Its status indicator is N (non-covered)—Medicare covers no part of this service. See status indicators
  • 76390 splits into a professional component (modifier 26) and a technical component (modifier TC)—a claim for only one part needs that modifier to price correctly. 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.

Global period: what 76390's fee already covers Copy link

XXX Does not apply

The global surgery concept does not apply to this code.

Billing policy Copy link

These billing-policy indicators explain how 76390 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
Professional/technical split 1 Splits into professional and technical. This procedure splits into a professional component (modifier 26) and a technical component (modifier TC), each separately payable.

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.

See every current NCCI pair for 76390 →

Why a 76390 line may not pay separately Copy link

CMS publishes no separately payable amount for 76390 in this release, so reconciling the line means establishing which status governed the date of service rather than chasing a fee-schedule difference.

What to check

  • Confirm the status that governed the date of service before working this line as a short payment—CMS publishes no separately payable fee-schedule amount for it in this release.
  • Confirm which component the line carried before comparing anything: the same code prices three ways—globally, as a professional component with modifier 26, and as a technical component with modifier TC.
  • 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.
Check an actual payment Model this code in a contract

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).

How has it changed? Copy link

Rate history by release Copy link

National Office (non-facility) amount for 76390 across quarterly releases.

Release Status Office Facility
Q4 2026 Oct 1, 2026 – present C — —
Q3 2026 Jul 1, 2026 – Sep 30, 2026 C — —
Q2 2026 Apr 1, 2026 – Jun 30, 2026 C — —
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.

Usage and related codes Copy link

How often 76390 is billed Copy link

Across Original Medicare in CY2024, 76390 ranked #4,867 of the 7,879 CPT codes billed to Medicare that year, by patients served or total allowed dollars.

Beneficiaries
608
Office + facility beneficiaries combined
Services
661
Times it was billed
Allowed
$71,323
Total Medicare allowed dollars
Compare: ↑ #4,866 more popular · 69662 ↓ #4,872 less popular · 75746

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. Whether a national amount exists depends on the status and CMS’s payment instructions; blank RVUs are never treated as zero. 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.

Physician relative value file (Q1 2013) · rvu13ar.zip (PPRRVU13_V1226_UP0.csv row 11,680)

Cite this rate

The citation names the release, so anyone can check it even after CMS publishes a newer one.

CPT 76390 National PFS baseline: No national PFS rate (Q1 2013; participating physician; whole service; GPCI 1.000; sequestration excluded). CMS RVU13A, PPRRVU13_V1226_UP0.csv row 11,680. Localis. https://localishealth.com/cpt/76390/2013/A