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Medicare Physician Fee Schedule Effective CMS RVU19A Updated

CPT 94150 Medicare payment status

Bundled / not separately paid

94150 · PFS Q1 2019 · Historical

Status B is not separately payable under the PFS.

View applicable payment rules
View CMS source and method

CMS RVU19AJanuary 1 – March 31, 2019

PFS status evidence

Physician relative value file (Q1 2019) · rvu19a.zip (PPRRVU19_V1213.csv row 16,196)
Inspect PFS status evidence
Code
94150
Release
Q1 2019, revision 1
Result
Bundled / not separately paid

Citations

  • Shows this code’s PFS status (B). Result: Bundled / not separately paid.

    Physician relative value file (PPRRVU)CMS RVU19AJanuary 1 – March 31, 2019

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

    PPRRVU19_V1213.csv row 16,196 in rvu19a.zip

    In the CMS file

    Loading rows 16,194–16,198 of PPRRVU19_V1213.csv…

    Download rvu19a.zip from CMS File fingerprint 027b1b615e25a1c68ccff88175acf40056bc59d858295f8e37b0c5a88a2e7d35

Plain-text summaryReport a problem

CPT 94150 has no published national rate. It carries status B (bundled) in the Q1 2019 release. Medicare folds payment for this code into the service it is incident to, never onto its own line. The blank amount means unpriced, not $0.

Why is there no national PFS amount for 94150?

Its status indicator is B (bundled). Medicare folds payment for this code into the service it is incident to, never onto its own line. Status B 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.

Professional/technical component Applies
Other payment indicators (9)
Facility/non-facility: Not determined, 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, Other fee-schedule routing: Does not apply, Contractor pricing: Does not apply.
Why would a Medicare claim for 94150 be denied or paid less?

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

  • Its status indicator is B (bundled)—Medicare folds payment for this code into the service it is incident to, never onto its own line. See status indicators
  • 94150 splits into a professional component (modifier 26) and a technical component (modifier TC)—a claim for only one part needs that modifier to price correctly. 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.

Which billing rules and modifiers apply? Copy link

Global period: what 94150's fee already covers Copy link

XXX Does not apply

The global surgery concept does not apply to this code.

Billing policy Copy link

These billing-policy indicators explain how 94150 is treated. They apply whether the code is nationally priced or carrier-priced: a restriction like "bilateral not allowed" still matters on a carrier-priced code.

Policy Value What it means
Professional/technical split 1 Splits into professional and technical. This procedure splits into a professional component (modifier 26) and a technical component (modifier TC), each separately payable.

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 94150 →

Why a 94150 line may not pay separately Copy link

CMS publishes no separately payable amount for 94150 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 check

  • 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.
  • Confirm which component the line carried before comparing anything: the same code prices three ways—globally, as a professional component with modifier 26, and as a technical component with modifier TC.
  • 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.

Compare against 94070, 94200 and 94060: their amounts are in Related codes.

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).

How has it changed? Copy link

Rate history by release Copy link

National Office (non-facility) amount for 94150 across quarterly releases.

Release Status Office Facility
Q4 2026 Oct 1, 2026 – present B — —
Q3 2026 Jul 1, 2026 – Sep 30, 2026 B — —
Q2 2026 Apr 1, 2026 – Jun 30, 2026 B — —
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 Q1 2019 release (effective January 2019). 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 (Q1 2019) · rvu19a.zip (PPRRVU19_V1213.csv row 16,196)

Cite this rate

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

CPT 94150 National PFS baseline: No national PFS rate (Q1 2019; participating physician; whole service; GPCI 1.000; sequestration excluded). CMS RVU19A, PPRRVU19_V1213.csv row 16,196. Localis. https://localishealth.com/cpt/94150/2019/A