CPT 96376
Priced under CLFS
96376 · PFS Q2 2026 · Historical
Status X is not separately payable under the PFS.
Not at a published national rate. CPT 96376 carries status X (statutory exclusion) in the Q2 2026 release. The statutory definition of physician services does not include this item. Treat the blank amount as unpriced, not as $0.
PFS status evidence
Inspect PFS status evidence
- Code
- 96376
- Release
- Q2 2026, revision 1
- Result
- Priced under CLFS
Citations
-
Establishes the PFS status (X) and the resulting pathway for this code: priced under clfs.
Physician relative value file (PPRRVU)Q2 2026 · revision 1
Latest revision of this release
Release period: April 1 – June 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_Apr_nonQPP.csv in rvu26b-updated-05-01-2026.zip (row 12,687)- hcpcs (col 1)
- 96376
- modifier (col 2)
- blank
- status_code (col 4)
- X
SHA-256: afc9cf9fe60742518cf6aaccd507edc035052ab9ab1be48644be39f38fceec48
Why is there no national PFS amount for 96376?
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
Review the applicable inputs and payment rules. Each link opens the supporting detail on this page.
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: Not determined, NCCI same-day edits: Not determined, MUE behavior: Not determined, Contractor pricing: Does not apply.
Why a 96376 line may not pay separately Copy link
CMS publishes no separately payable amount for 96376 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.
- Reconcile this line together with the primary procedure on the same claim—it is an add-on that is never billed alone and carries no global period of its own.
- 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 Q2 2026 amounts at GPCI 1.000. A blank means this schedule does not publish a payable PFS amount.
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).
Global period: what 96376's fee already covers Copy link
This code is always billed alongside another service and carries no follow-up period of its own. The primary procedure's global period governs; this indicator does not determine whether either line is payable.
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 96376.
Common payment questions Copy link
Why would a Medicare claim for 96376 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.
Rate history by release Copy link
National non-facility amount for 96376 across quarterly releases.
| Release | Status | Non-facility | Facility |
|---|---|---|---|
| Q4 2026 takes effect Oct 1, 2026 | X | — | — |
| Q3 2026 Jul 1, 2026 – Sep 30, 2026 | X | — | — |
| Q2 2026 Apr 1, 2026 – Jun 30, 2026 | X | — | — |
| Q1 2026 Jan 1, 2026 – Mar 31, 2026 | X | — | — |
| Q4 2025 Oct 1, 2025 – Dec 31, 2025 | X | — | — |
| Q3 2025 Jul 1, 2025 – Sep 30, 2025 | X | — | — |
| Q2 2025 Apr 1, 2025 – Jun 30, 2025 | X | — | — |
| Q1 2025 Jan 1, 2025 – Mar 31, 2025 | X | — | — |
| Q4 2024 Oct 1, 2024 – Dec 31, 2024 | X | — | — |
| Q3 2024 Jul 1, 2024 – Sep 30, 2024 | X | — | — |
| Q2 2024 Apr 1, 2024 – Jun 30, 2024 | X | — | — |
| Q1 2024 Mar 9, 2024 – Mar 31, 2024 | X | — | — |
| Q1 2024 Jan 1, 2024 – Mar 8, 2024 | X | — | — |
| Q4 2023 Oct 1, 2023 – Dec 31, 2023 | X | — | — |
| Q3 2023 Jul 1, 2023 – Sep 30, 2023 | X | — | — |
| Q2 2023 Apr 1, 2023 – Jun 30, 2023 | X | — | — |
| Q1 2023 Jan 1, 2023 – Mar 31, 2023 | X | — | — |
| Q4 2022 Oct 1, 2022 – Dec 31, 2022 | X | — | — |
| Q3 2022 Jul 1, 2022 – Sep 30, 2022 | X | — | — |
| Q2 2022 Apr 1, 2022 – Jun 30, 2022 | X | — | — |
| Q1 2022 Jan 1, 2022 – Mar 31, 2022 | X | — | — |
| Q4 2021 Oct 1, 2021 – Dec 31, 2021 | X | — | — |
| Q3 2021 Jul 1, 2021 – Sep 30, 2021 | X | — | — |
| Q2 2021 Apr 1, 2021 – Jun 30, 2021 | X | — | — |
| Q1 2021 Jan 1, 2021 – Mar 31, 2021 | X | — | — |
| Q4 2020 Oct 1, 2020 – Dec 31, 2020 | X | — | — |
| Q3 2020 Jul 1, 2020 – Sep 30, 2020 | X | — | — |
| Q2 2020 Apr 1, 2020 – Jun 30, 2020 | X | — | — |
| Q1 2020 Jan 1, 2020 – Mar 31, 2020 | X | — | — |
| Q4 2019 Oct 1, 2019 – Dec 31, 2019 | X | — | — |
| Q3 2019 Jul 1, 2019 – Sep 30, 2019 | X | — | — |
| Q2 2019 Apr 1, 2019 – Jun 30, 2019 | X | — | — |
| Q1 2019 Jan 1, 2019 – Mar 31, 2019 | X | — | — |
| Q4 2018 Oct 1, 2018 – Dec 31, 2018 | X | — | — |
| Q3 2018 Jul 1, 2018 – Sep 30, 2018 | X | — | — |
| Q2 2018 Apr 1, 2018 – Jun 30, 2018 | X | — | — |
| Q1 2018 Jan 1, 2018 – Mar 31, 2018 | X | — | — |
| Q4 2017 Oct 1, 2017 – Dec 31, 2017 | X | — | — |
| Q3 2017 Jul 1, 2017 – Sep 30, 2017 | X | — | — |
| Q2 2017 Apr 1, 2017 – Jun 30, 2017 | X | — | — |
| Q1 2017 Jan 1, 2017 – Mar 31, 2017 | X | — | — |
| Q4 2016 Oct 1, 2016 – Dec 31, 2016 | X | — | — |
| Q3 2016 Jul 1, 2016 – Sep 30, 2016 | X | — | — |
| Q2 2016 Apr 1, 2016 – Jun 30, 2016 | X | — | — |
| Q1 2016 Jan 1, 2016 – Mar 31, 2016 | X | — | — |
| Q4 2015 Oct 1, 2015 – Dec 31, 2015 | X | — | — |
| Q3 2015 Jul 1, 2015 – Sep 30, 2015 | X | — | — |
| Q2 2015 Apr 1, 2015 – Jun 30, 2015 | X | — | — |
| Q1 2015 Jan 1, 2015 – Mar 31, 2015 | X | — | — |
| Q4 2014 Oct 1, 2014 – Dec 31, 2014 | X | — | — |
| Q3 2014 Jul 1, 2014 – Sep 30, 2014 | X | — | — |
| Q2 2014 Apr 1, 2014 – Jun 30, 2014 | X | — | — |
| Q1 2013 Jan 1, 2013 – Mar 31, 2013 | 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.
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Source & method
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This page uses CMS's Medicare Physician Fee Schedule Q2 2026 release (effective April 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.
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 96376 National PFS baseline: No national PFS rate (Q2 2026; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/cpt/96376/2026/B