CPT 83735 Medicare payment status

Which billing rules and modifiers apply? Copy link

CMS's surgical and split-billing indicators don't adjust 83735's amount.

CMS RVU20D · October 1 – December 31, 2020

Can you bill it with another code? Copy link

Source & method Copy link

1. 01 PPRRVU20_OCT.csv · Q4 2020 (RVU20D) · row 14,617—status X, RVUs limits

   Source

   Physician relative value file (PPRRVU), Q4 2020 release

   Effective

   October 1 – December 31, 2020

   Locator

   PPRRVU20_OCT.csv in rvu20d-updated-11232020.zip · row 14,617 of 17,346 · via CMS

   Fields read

   Status X (col 4)

   SHA-256 504fd19a9bc1d2ee…

   Doesn’t establish

   A locality-adjusted allowed amount, or the payment after sequestration. National baselines use GPCI 1.000 and exclude sequestration.

   Note

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

2. 02 Physician & Other Practitioners · CY2024—volume and who bills it limits

   Source

   CMS Physician & Other Practitioners dataset

   Effective

   Calendar-year snapshot, on a different cycle from the Q4 2020 fee schedule

   Doesn’t establish

   Medicare Advantage, Medicaid or commercial volume, or the exact place of service: CMS publishes only the facility vs non-facility split, so the Office (non-facility) share does not identify urgent care or any other specific setting.

   Note

   The dataset suppresses rows under 11 beneficiaries. Specialty groups with fewer than 30 observed clinicians are omitted, so the shares can fall short of 100%.

How has it changed? Copy link

— Office (non-facility) and — Facility since Jan 1, 2013.

Usage and related codes Copy link

In CY2024, 83735 ranked #101 of the 7,879 CPT codes billed to Medicare that year, by patients served or total allowed dollars.

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.