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CPT 81401

Priced under CLFS

81401 · PFS Q4 2018 · Historical

Status X is not separately payable under the PFS.

View applicable payment rules
View CMS source and method

CPT 81401 has no published national rate. It carries status X (statutory exclusion) in the Q4 2018 release. The statutory definition of physician services does not include this item. The blank amount means unpriced, not $0.

PFS status evidence

Physician relative value file (Q4 2018) · rvu18d.zip (PPRRVU18_OCT.csv row 13,702)
Inspect PFS status evidence
Code
81401
Release
Q4 2018, revision 1
Result
Priced under CLFS

Citations

  • Shows this code’s PFS status (X). Result: Priced under CLFS.

    Physician relative value file (PPRRVU)

    Q4 2018 · revision 1

    Latest revision of this release

    Release period: October 1 – December 31, 2018

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

    Record details PPRRVU18_OCT.csv in rvu18d.zip (row 13,702)
    hcpcs (col 1)
    81401
    modifier (col 2)
    blank
    status_code (col 4)
    X

    SHA-256: c6312c12acd1b8ed78b409e8508357929aa7e764e333ec568ebb9c0774b7dc4d

    Original source file

Plain-text summary

Why is there no national PFS amount for 81401?

Its status indicator is X (statutory exclusion). The statutory definition of physician services does not include this item. Status X is not separately payable under the PFS.

Payment considerations Copy link

Here are the inputs and payment rules that apply to this code. Each link takes you to the detail below.

Other fee-schedule routing Applies
Other payment indicators (9)

Facility/non-facility: Not determined, Professional/technical component: Does not apply, 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, Contractor pricing: Does not apply.

Why would a Medicare claim for 81401 be denied or paid less?

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

  • Its status indicator is X (statutory exclusion)—The statutory definition of physician services does not include this item. See status indicators

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.

Which billing rules and modifiers apply? Copy link

Global period: what 81401's fee already covers Copy link

XXX Does not apply

The global surgery concept does not apply to this code.

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 81401 →

How has it changed? Copy link

Rate history by release Copy link

National Office (non-facility) amount for 81401 across quarterly releases.

Release Status Office Facility
Q4 2026 takes effect Oct 1, 2026 X — —
Q3 2026 Jul 1, 2026 – Sep 30, 2026 X — —
Q2 2026 Apr 1, 2026 – Jun 30, 2026 X — —
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 81401 is billed Copy link

Across Original Medicare in CY2024, 81401 ranked #4,174 of the 7,879 CPT codes billed to Medicare that year, by patients served or total allowed dollars.

Beneficiaries
1,232
Office + facility beneficiaries combined
Services
1,296
Times it was billed
Allowed
$173,849
Total Medicare allowed dollars
Compare: ↑ #4,172 more popular · 62326 ↓ #4,179 less popular · 93304

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 Q4 2018 fee schedule above.

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Source & method

Show sources

This page uses CMS's Medicare Physician Fee Schedule Q4 2018 release (effective October 2018). 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 (Q4 2018) · rvu18d.zip (PPRRVU18_OCT.csv row 13,702)

Use the (i) buttons next to each amount above for the exact row, columns, and math.

Cite this rate

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

CPT 81401 National PFS baseline: No national PFS rate (Q4 2018; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/cpt/81401/2018/D