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Medicare Physician Fee Schedule Effective CMS RVU18C Updated

CPT 85547 Medicare payment status

CPT 85547 has no published national rate. It carries status X (statutory exclusion) in the Q3 2018 release. The statutory definition of physician services does not include this item. The blank amount means unpriced, not $0.

Priced under CLFS

85547 · PFS Q3 2018 · Historical

Status X is not separately payable under the PFS.

View applicable payment rules
View CMS source and method

CMS RVU18CJuly 1 – September 30, 2018

CPT 85547 has no published national rate. It carries status X (statutory exclusion) in the Q3 2018 release. The statutory definition of physician services does not include this item. The blank amount means unpriced, not $0.

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PFS status evidence

Physician relative value file (Q3 2018) · rvu18c1.zip (PPRRVU18_JUL.csv row 14,240)
Inspect PFS status evidence
Code
85547
Release
Q3 2018, revision 1
Result
Priced under CLFS

Citations

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

    Physician relative value file (PPRRVU)CMS RVU18CJuly 1 – September 30, 2018

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

    PPRRVU18_JUL.csv row 14,240 in rvu18c1.zip

    In the CMS file

    Loading rows 14,238–14,242 of PPRRVU18_JUL.csv…

    Download rvu18c1.zip from CMS File fingerprint 514e3c115f8e62a35eb5f78fef7ed12ed7b60b22a5fe3f3f1bb5aadf119663c5

Plain-text summary

Why is there no national PFS amount for 85547?

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 85547 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 85547'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 85547 →

How has it changed? Copy link

Rate history by release Copy link

National Office (non-facility) amount for 85547 across quarterly releases.

Release Status Office Facility
Q4 2026 Oct 1, 2026 – present 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

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Source & method

Show sources

This page uses CMS's Medicare Physician Fee Schedule Q3 2018 release (effective July 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 (Q3 2018) · rvu18c1.zip (PPRRVU18_JUL.csv row 14,240)

Cite this rate

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

CPT 85547 National PFS baseline: No national PFS rate (Q3 2018; participating; whole service; GPCI 1.000; sequestration excluded). CMS RVU18C, PPRRVU18_JUL.csv row 14,240. Localis. https://localishealth.com/cpt/85547/2018/C