{
    "code": "78491",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/78491",
    "release_specific_url": "https://localishealth.com/cpt/78491/2026/C",
    "answer": {
        "question": "What is the Medicare allowed amount for CPT 78491?",
        "text": "CPT 78491 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 $781.48–$1,626.50 across 63 localities; enter a ZIP for the exact local amount."
    },
    "release": {
        "schedule": "pfs",
        "year": 2026,
        "quarter": "C",
        "label": "Q3 2026",
        "effective": "July 1 – September 30, 2026",
        "revision": 1
    },
    "status": {
        "code": "C",
        "non_facility_payable": false,
        "facility_payable": false
    },
    "national_rates_usd": {
        "office_non_facility": null,
        "facility": null,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": null,
        "practice_expense_non_facility": null,
        "practice_expense_facility": null,
        "malpractice": null
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 33.4009,
    "ncci": {
        "release": "Q3 2026",
        "never_billable_pair_count": 13,
        "modifier_allowed_pair_count": 17,
        "mue_units_per_date_of_service": null,
        "url": "https://localishealth.com/cpt/78491/ncci-edits",
        "complete_text_url": "https://localishealth.com/cpt/78491/ncci-edits.txt"
    },
    "source": {
        "label": "Physician relative value file (Q3 2026)",
        "cms_url": "https://www.cms.gov/files/zip/rvu26c-updated-06-30-2026.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2026/C",
        "file": "PPRRVU2026_Jul_nonQPP.csv",
        "row": 9350,
        "sha256": "b7d197e73211ef6854c213c267d5fa9dec8df995db8e1ee7d44c0556ad7cee21"
    },
    "modified_at": "2026-09-14T06:28:28+00:00"
}
