CPT 97814
Excluded from PFS
97814 · PFS Q4 2018 · Historical
No national PFS rate in Q4 2018
Status N: non-covered. Medicare covers no part of this service, so the PFS produces no payment amount.
CPT 97814 has no published national rate. It carries status N (non-covered) in the Q4 2018 release. Medicare covers no part of this service. The blank amount means unpriced, not $0.
PFS status evidence
Inspect PFS status evidence
- Code
- 97814
- Release
- Q4 2018, revision 1
- Result
- Excluded from PFS
Citations
-
Shows this code’s PFS status (N). Result: Excluded from PFS.
Physician relative value file (PPRRVU)Q4 2018 · revision 1
Latest revision of this release
Release period: October 1 – December 31, 2018
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
PPRRVU18_OCT.csv in rvu18d.zip (row 16,451)- hcpcs (col 1)
- 97814
- modifier (col 2)
- blank
- status_code (col 4)
- N
SHA-256: c6312c12acd1b8ed78b409e8508357929aa7e764e333ec568ebb9c0774b7dc4d
Why is there no national PFS amount for 97814?
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
Here are the inputs and payment rules that apply to this code. Each link takes you to the detail below.
Other payment indicators (10)
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, Other fee-schedule routing: Does not apply, Contractor pricing: Does not apply.
Why would a Medicare claim for 97814 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
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.
Why a 97814 line may not pay separately Copy link
CMS publishes no separately payable amount for 97814 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.
- 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.
Codes to compare
National Q4 2018 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).
Which billing rules and modifiers apply? Copy link
Global period: what 97814'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
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.
How has it changed? Copy link
Rate history by release Copy link
National Office (non-facility) amount for 97814 across quarterly releases. -17.1% decrease since Q2 2020 · peak $38.76 in Q1 2022
| Release | Status | Office | Facility |
|---|---|---|---|
| Q4 2026 takes effect Oct 1, 2026 | A | $28.72 (0.0% no change ) | $21.04 (0.0% no change ) |
| Q3 2026 Jul 1, 2026 – Sep 30, 2026 | A | $28.72 (0.0% no change ) | $21.04 (0.0% no change ) |
| Q2 2026 Apr 1, 2026 – Jun 30, 2026 | A | $28.72 (0.0% no change ) | $21.04 (0.0% no change ) |
| Q1 2026 Jan 1, 2026 – Mar 31, 2026 | A | $28.72 (-0.2% decrease ) | $21.04 (-9.7% decrease ) |
| Q4 2025 Oct 1, 2025 – Dec 31, 2025 | A | $28.79 (0.0% no change ) | $23.29 (0.0% no change ) |
| Q3 2025 Jul 1, 2025 – Sep 30, 2025 | A | $28.79 (0.0% no change ) | $23.29 (0.0% no change ) |
| Q2 2025 Apr 1, 2025 – Jun 30, 2025 | A | $28.79 (0.0% no change ) | $23.29 (0.0% no change ) |
| Q1 2025 Jan 1, 2025 – Mar 31, 2025 | A | $28.79 (-21.4% decrease ) | $23.29 (-16.7% decrease ) |
| Q4 2024 Oct 1, 2024 – Dec 31, 2024 | A | $36.62 (0.0% no change ) | $27.96 (0.0% no change ) |
| Q3 2024 Jul 1, 2024 – Sep 30, 2024 | A | $36.62 (0.0% no change ) | $27.96 (0.0% no change ) |
| Q2 2024 Apr 1, 2024 – Jun 30, 2024 | A | $36.62 (0.0% no change ) | $27.96 (0.0% no change ) |
| Q1 2024 Mar 9, 2024 – Mar 31, 2024 | A | $36.62 (+1.7% increase ) | $27.96 (+1.6% increase ) |
| Q1 2024 Jan 1, 2024 – Mar 8, 2024 | A | $36.02 (-3.4% decrease ) | $27.51 (-3.4% decrease ) |
| Q4 2023 Oct 1, 2023 – Dec 31, 2023 | A | $37.28 (0.0% no change ) | $28.47 (0.0% no change ) |
| Q3 2023 Jul 1, 2023 – Sep 30, 2023 | A | $37.28 (0.0% no change ) | $28.47 (0.0% no change ) |
| Q2 2023 Apr 1, 2023 – Jun 30, 2023 | A | $37.28 (0.0% no change ) | $28.47 (0.0% no change ) |
| Q1 2023 Jan 1, 2023 – Mar 31, 2023 | A | $37.28 (-3.8% decrease ) | $28.47 (-3.2% decrease ) |
| Q4 2022 Oct 1, 2022 – Dec 31, 2022 | A | $38.76 (0.0% no change ) | $29.42 (0.0% no change ) |
| Q3 2022 Jul 1, 2022 – Sep 30, 2022 | A | $38.76 (0.0% no change ) | $29.42 (0.0% no change ) |
| Q2 2022 Apr 1, 2022 – Jun 30, 2022 | A | $38.76 (0.0% no change ) | $29.42 (0.0% no change ) |
| Q1 2022 Jan 1, 2022 – Mar 31, 2022 | A | $38.76 (+11.1% increase ) | $29.42 (+4.1% increase ) |
| Q4 2021 Oct 1, 2021 – Dec 31, 2021 | A | $34.89 (0.0% no change ) | $28.26 (0.0% no change ) |
| Q3 2021 Jul 1, 2021 – Sep 30, 2021 | A | $34.89 (0.0% no change ) | $28.26 (0.0% no change ) |
| Q2 2021 Apr 1, 2021 – Jun 30, 2021 | A | $34.89 (0.0% no change ) | $28.26 (0.0% no change ) |
| Q1 2021 Jan 1, 2021 – Mar 31, 2021 | A | $34.89 (+0.7% increase ) | $28.26 (-3.3% decrease ) |
| Q4 2020 Oct 1, 2020 – Dec 31, 2020 | A | $34.65 (0.0% no change ) | $29.23 (0.0% no change ) |
| Q3 2020 Jul 1, 2020 – Sep 30, 2020 | A | $34.65 (0.0% no change ) | $29.23 (0.0% no change ) |
| Q2 2020 Apr 1, 2020 – Jun 30, 2020 | A | $34.65 | $29.23 |
| Q1 2020 Jan 1, 2020 – Mar 31, 2020 | N | — | — |
| Q4 2019 Oct 1, 2019 – Dec 31, 2019 | N | — | — |
| Q3 2019 Jul 1, 2019 – Sep 30, 2019 | N | — | — |
| Q2 2019 Apr 1, 2019 – Jun 30, 2019 | N | — | — |
| Q1 2019 Jan 1, 2019 – Mar 31, 2019 | N | — | — |
| Q4 2018 Oct 1, 2018 – Dec 31, 2018 | N | — | — |
| Q3 2018 Jul 1, 2018 – Sep 30, 2018 | N | — | — |
| Q2 2018 Apr 1, 2018 – Jun 30, 2018 | N | — | — |
| Q1 2018 Jan 1, 2018 – Mar 31, 2018 | N | — | — |
| Q4 2017 Oct 1, 2017 – Dec 31, 2017 | N | — | — |
| Q3 2017 Jul 1, 2017 – Sep 30, 2017 | N | — | — |
| Q2 2017 Apr 1, 2017 – Jun 30, 2017 | N | — | — |
| Q1 2017 Jan 1, 2017 – Mar 31, 2017 | N | — | — |
| Q4 2016 Oct 1, 2016 – Dec 31, 2016 | N | — | — |
| Q3 2016 Jul 1, 2016 – Sep 30, 2016 | N | — | — |
| Q2 2016 Apr 1, 2016 – Jun 30, 2016 | N | — | — |
| Q1 2016 Jan 1, 2016 – Mar 31, 2016 | N | — | — |
| Q4 2015 Oct 1, 2015 – Dec 31, 2015 | N | — | — |
| Q3 2015 Jul 1, 2015 – Sep 30, 2015 | N | — | — |
| Q2 2015 Apr 1, 2015 – Jun 30, 2015 | N | — | — |
| Q1 2015 Jan 1, 2015 – Mar 31, 2015 | N | — | — |
| Q4 2014 Oct 1, 2014 – Dec 31, 2014 | N | — | — |
| Q3 2014 Jul 1, 2014 – Sep 30, 2014 | N | — | — |
| Q2 2014 Apr 1, 2014 – Jun 30, 2014 | N | — | — |
| Q2 2013 Apr 1, 2013 – Jun 30, 2013 | N | — | — |
| Q1 2013 Jan 1, 2013 – Mar 31, 2013 | 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.
The 97814 rate last moved in Q1 2026. See its rate history.
Sources: CMS Medicare Physician Fee Schedule Relative Value Files.
Usage and related codes Copy link
How often 97814 is billed Copy link
Across Original Medicare in CY2024, 97814 ranked #1,906 of the 7,879 CPT codes billed to Medicare that year, by patients served or total allowed dollars. It repeats: a patient billed for it in 2024 was billed 9.3 times on average that year.
2024 Medicare fee-for-service national totals. They exclude Medicare Advantage, Medicaid and commercial volume, so real-world use runs higher. This is a calendar-year snapshot from the CMS Physician & Other Practitioners dataset, on a different cycle from the Q4 2018 fee schedule above.
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Source & method
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This page uses CMS's Medicare Physician Fee Schedule Q4 2018 release (effective October 2018). 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.
Use the (i) buttons next to each amount above for the exact row, columns, and math.
Cite this rate
The citation names the release, so anyone can check it even after CMS publishes a newer one.
CPT 97814 National PFS baseline: No national PFS rate (Q4 2018; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/cpt/97814/2018/D