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CPT 92650

Excluded from PFS

92650 · PFS Q3 2026

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

Not at a published national rate. CPT 92650 carries status N (non-covered) in the Q3 2026 release. Medicare covers no part of this service. Treat the blank amount as unpriced, not as $0.

PFS status evidence

Physician relative value file (Q3 2026) · rvu26c-updated-06-30-2026.zip (PPRRVU2026_Jul_nonQPP.csv row 11,838)
Inspect PFS status evidence
Code
92650
Release
Q3 2026, revision 1
Result
Excluded from PFS

Citations

  • Establishes the PFS status (N) and the resulting pathway for this code: excluded from pfs.

    Physician relative value file (PPRRVU)

    Q3 2026 · revision 1

    Latest revision of this release

    Release period: July 1 – September 30, 2026

    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 PPRRVU2026_Jul_nonQPP.csv in rvu26c-updated-06-30-2026.zip (row 11,838)
    hcpcs (col 1)
    92650
    modifier (col 2)
    blank
    status_code (col 4)
    N

    SHA-256: b7d197e73211ef6854c213c267d5fa9dec8df995db8e1ee7d44c0556ad7cee21

    Original source file

Compact facts

Why is there no national PFS amount for 92650?

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.

Payment considerations Copy link

Review the applicable inputs and payment rules. Each link opens the supporting detail on this page.

Bilateral adjustment Applies NCCI same-day edits Applies
Other payment indicators (8)

Facility/non-facility: Not determined, Professional/technical component: Does not apply, Multiple-procedure reduction: Does not apply, Assistant/co-surgeon treatment: Does not apply, Global surgery: Does not apply, MUE behavior: Not determined, Other fee-schedule routing: Does not apply, Contractor pricing: Does not apply.

Why a 92650 line may not pay separately Copy link

CMS publishes no separately payable amount for 92650 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 reconcile

  • 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.
  • Check whether a second side was billed separately—the published RVUs already price both sides, so there is no additional amount behind that line.
  • Check for documentation on file before appealing an assistant-at-surgery denial: payment on the -80 or -AS line is restricted for this procedure unless medical necessity is established.
  • 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.

Nearby payment lines

National Q3 2026 amounts at GPCI 1.000. A blank means this schedule does not publish a payable PFS amount.

Code Why compare Office Facility
92640 Priced as active rather than non-covered $106.21 $75.15
92651 Priced as active rather than non-covered $80.16 $80.16
92633 Priced as not valid rather than non-covered — —
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); 42 USC 1395w-4(i)(2) (SSA §1848(i)(2))—Assistants-at-surgery.

Payment rules

Global period: what 92650's fee already covers Copy link

XXX Does not apply

The global surgery concept does not apply to this code.

Billing policy Copy link

What 92650's billing-policy indicators mean. These show for every code, priced or not: a restriction like "bilateral not allowed" still matters on a carrier-priced code.

Policy Value What it means
Bilateral surgery 2 RVUs already reflect bilateral pricing. The published RVUs already account for a bilateral procedure—no additional bilateral adjustment applies on top of the fee schedule amount.
Assistant at surgery 0 Restricted without documentation. Payment for an assistant at surgery is restricted for this procedure unless supporting documentation establishes medical necessity.
Co-surgeons 0 Not permitted. Medicare does not recognize co-surgeons (modifier 62) for this procedure.
Team surgery 0 Not permitted. Medicare does not recognize a surgical team (modifier 66) for this procedure.
Multiple procedures 0 No reduction. No payment reduction applies when this procedure is billed with other procedures on the same date—each is treated as unrelated.
Professional/technical split 0 No PC/TC split. This is a physician service code; the professional/technical split does not apply, and the code is billed as a single service.

Can you bill it with another code? 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 between it and 92650.

See every current NCCI pair for 92650 →

Billing together (NCCI edits) Copy link

NCCI Q3 2026

Based on CMS's National Correct Coding Initiative (NCCI). A few examples appear here; use the complete edit page to check a specific pair.

Not separately payable with 92650 on the same date of service—no modifier bypasses the edit (modifier indicator 0)

36591 36591 denies
36592 36592 denies
69209 69209 denies

Showing 3 of 5.

Separately payable with 92650 only when an NCCI-associated modifier is appropriate and documented (modifier indicator 1)

0728T 92650 denies
0729T 92650 denies
92601 92650 denies

Showing 3 of 8.

Modifier 59 and the X modifiers are not a universal bypass—CMS expects the most specific applicable modifier, and which one that is depends on the pair and the documented circumstances.

Check a paired code or view all 13 NCCI pairs →

Common payment questions Copy link

Why would a Medicare claim for 92650 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
  • 5 codes form NCCI pairs with 92650 carrying modifier indicator 0—no NCCI-associated modifier bypasses the edit, so billed together on the same date of service, a line of the pair denies. See billing together
  • 8 codes pair with 92650 under modifier indicator 1—separately payable only when an NCCI-associated modifier (59, or a more specific XE, XS, XP, or XU) is clinically appropriate and the documentation supports a distinct service; without one, a line of the pair denies. See billing together
  • Assistant at surgery: restricted without documentation. See billing policy
  • Co-surgeons: not permitted. See billing policy
  • Team surgery: not permitted. 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.

History

Rate history by release Copy link

National non-facility amount for 92650 across quarterly releases.

Release Status Non-facility Facility
Q4 2026 takes effect Oct 1, 2026 N — —
Q3 2026 Jul 1, 2026 – Sep 30, 2026 N — —
Q2 2026 Apr 1, 2026 – Jun 30, 2026 N — —
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 & related

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Source & method

Show sources

This page uses CMS's Medicare Physician Fee Schedule Q3 2026 release (effective July 2026). National baselines use GPCI 1.000 and exclude sequestration. Status and payment instructions determine whether a national amount is established; blank RVUs stay blank. Releases are immutable: historical evidence remains tied to the specified release. Our methodology covers the depth: sourcing, parsing, versioning, and how we cross-check claims before they ship.

Physician relative value file (Q3 2026) · rvu26c-updated-06-30-2026.zip (PPRRVU2026_Jul_nonQPP.csv row 11,838)

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

Cite this rate

This citation identifies the source release, so its evidence remains reproducible after a newer release lands.

CPT 92650 National PFS baseline: No national PFS rate (Q3 2026; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/cpt/92650/2026/C