CPT 94776

Contractor-priced

94776 · PFS Q3 2025 · Historical

No national PFS rate in Q3 2025

Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation.

Check for a published amount in your locality.

Service-location ZIP

View contractor sources and effective dates

CPT 94776 has no published national rate. It carries status C (carrier-priced) in the Q3 2025 release. Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation. The blank amount means unpriced, not $0.

PFS status evidence

Physician relative value file (Q3 2025) · rvu25c-updated-06-05-2025.zip (PPRRVU2025_Jul.csv row 12,249)

Inspect PFS status evidence

Code: 94776
Release: Q3 2025, revision 1
Result: Contractor-priced

Citations

Shows this code’s PFS status (C). Result: Contractor-priced.
Physician relative value file (PPRRVU)
Q3 2025 · revision 1

Latest revision of this release

Release period: July 1 – September 30, 2025

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
PPRRVU2025_Jul.csv in rvu25c-updated-06-05-2025.zip (row 12,249)

hcpcs (col 1)

94776

modifier (col 2)

blank

status_code (col 4)

C

SHA-256: b7937472967288d5c4dcf43ecbc5d2d792e97d768c9f5ec9b1e88a99f3d0bbe7

Original source file

Plain-text summary

Why is there no national PFS amount for 94776?

Its status indicator is C (carrier-priced). Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation.

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 Global surgery Context required Contractor pricing Applies

Other payment indicators (7)

Facility/non-facility: Not determined, Bilateral adjustment: Does not apply, Multiple-procedure reduction: Does not apply, Assistant/co-surgeon treatment: Does not apply, NCCI same-day edits: Not determined, MUE behavior: Not determined, Other fee-schedule routing: Does not apply.

Why would a Medicare claim for 94776 be denied or paid less?

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

Its status indicator is C (carrier-priced)—Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation. See status indicators
Only a technical component exists for 94776—there is no professional-component amount to bill. See billing policy
Bilateral surgery: no bilateral adjustment. See billing policy
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.

Reconciling a contractor-priced payment for 94776 Copy link

There is no national allowed amount for 94776, so every reconciliation of this line runs against the MAC fee schedule that was in force for the date of service rather than against a national baseline.

What to check

Compare the paid amount against the MAC fee schedule in force for the date of service; there is no national allowed amount here to reconcile against.
Only a technical-component amount is published for this code, so a professional charge billed on it has no fee-schedule amount behind it.
Ask the MAC which global period it assigned: the contractor sets the follow-up window for this code, so whether a post-operative visit should have paid depends on the contractor that priced it.
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.

Codes to compare

National Q3 2025 amounts at GPCI 1.000. A blank means this schedule does not publish a payable PFS amount.

Code	Office	Facility
94775 Nearby medicine services line in the same release	—	—
94777 Nearby medicine services line in the same release	—	—
94774 Nearby medicine services line in the same release	—	—

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.

Which billing rules and modifiers apply? Copy link

Global period: what 94776's fee already covers Copy link

YYY Contractor decides

Your Medicare Administrative Contractor decides whether a global period applies and sets its length when it prices the code. The result is 0, 10, or 90 days.

Billing policy Copy link

These billing-policy indicators explain how 94776 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
Bilateral surgery	0	No bilateral adjustment. The 150% bilateral payment adjustment does not apply to this procedure.
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 multiple-procedure reduction applies when this procedure is billed with others on the same date; each is paid at its full fee schedule amount.
Professional/technical split	3	Technical component only. Only a technical component exists for this code—there is no corresponding professional-component amount to bill.

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 94776 →

How has it changed? Copy link

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

Contractor amounts come from the MAC-published schedules and effective dates shown above. The PFS file shows this code is priced by the contractor. 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.