# CPT 96380

> The national PFS baseline is $30.06 for CPT 96380 in the Office (non-facility) setting and $30.06 in a facility under the Q4 2026 Physician Fee Schedule, effective October 2026. These are the national allowed amounts before locality (GPCI) adjustment; sequestration is excluded. Across payment localities, both settings' amount is $26.91–$39.64. This amount has been unchanged since Q1 2026, when it increased 34.7%.

## Selected release

- Release: Q4 2026 (2026 D)
- Effective: October 1 – December 31, 2026
- Status indicator: A
- Office (non-facility) national allowed amount: $30.06
- Facility national allowed amount: $30.06
- Sequestration: not applied

## RVUs and formula

- Work RVU: 0.28
- Office (non-facility) practice expense RVU: 0.60
- Facility practice expense RVU: 0.60
- Malpractice RVU: 0.02
- Conversion factor: 33.4009
- Formula: `(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor`

## NCCI edits

- Never-billable pair count: 5
- Modifier-allowed pair count: 55
- MUE units per patient per date of service: 1
- Complete list: https://localishealth.com/cpt/96380/ncci-edits.txt

## Source and citation

- Source: Physician relative value file (Q4 2026)
- CMS file: https://www.cms.gov/files/zip/rvu26d-updated-08-26-2026.zip
- Parsed file: PPRRVU2026_Oct_nonQPP.csv, row 12,793
- Canonical page: https://localishealth.com/cpt/96380
- Release-specific citation URL: https://localishealth.com/cpt/96380/2026/D
- Last significant update: 2026-09-01T06:33:29+00:00