localis

Describe a service in plain words, or type a CPT/HCPCS code.

Q4 2026 starts Oct 1, 2026. Preview changes

Preview this code · Quarterly changes

CPT 98962

Bundled / not separately paid

98962 · PFS Q3 2026

Status B is not separately payable under the PFS.

View applicable payment rules

Not at a published national rate. CPT 98962 carries status B (bundled) in the Q3 2026 release. Medicare folds payment for this code into the service it is incident to, never onto its own line. Treat the blank amount as unpriced, not as $0.

PFS status evidence

Inspect PFS status evidence
Code
98962
Release
Q3 2026, revision 1
Result
Bundled / not separately paid

Citations

  • Establishes the PFS status (B) and the resulting pathway for this code: bundled / not separately paid.

    Physician relative value file (PPRRVU)

    Q3 2026 · revision 1

    Latest revision of this release

    Release period: July 1 – September 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_Jul_nonQPP.csv in rvu26c-updated-06-30-2026.zip (row 12,887)
    hcpcs (col 1)
    98962
    modifier (col 2)
    blank
    status_code (col 4)
    B

    SHA-256: b7d197e73211ef6854c213c267d5fa9dec8df995db8e1ee7d44c0556ad7cee21

    Original source file

Compact facts

Why is there no national PFS amount for 98962?

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

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: Does not apply, MUE behavior: Not determined, Other fee-schedule routing: Does not apply, Contractor pricing: Does not apply.

Payment rules

Global period: what 98962's fee already covers Copy link

XXX Does not apply

The global surgery concept does not apply to this code.

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 98962.

See every current NCCI pair for 98962 →

Billing together (NCCI edits) Copy link

NCCI Q3 2026

Based on CMS's National Correct Coding Initiative (NCCI). A few examples appear here; use the complete edit page to check a specific pair.

Not separately payable with 98962 on the same date of service—no modifier bypasses the edit (modifier indicator 0)

0593T 0593T denies
0734T 98962 denies
36591 36591 denies

Showing 3 of 16.

Separately payable with 98962 only when an NCCI-associated modifier is appropriate and documented (modifier indicator 1)

0403T 98962 denies
0488T 98962 denies
99424 99424 denies

Showing 3 of 7.

Modifier 59 and the X modifiers are not a universal bypass—CMS expects the most specific applicable modifier, and which one that is depends on the pair and the documented circumstances.

Check a paired code or view all 23 NCCI pairs →

Common payment questions Copy link

Why would a Medicare claim for 98962 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
  • 16 codes form NCCI pairs with 98962 carrying modifier indicator 0—no NCCI-associated modifier bypasses the edit, so billed together on the same date of service, a line of the pair denies. See billing together
  • 7 codes pair with 98962 under modifier indicator 1—separately payable only when an NCCI-associated modifier (59, or a more specific XE, XS, XP, or XU) is clinically appropriate and the documentation supports a distinct service; without one, a line of the pair denies. See billing together

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.

History

Rate history by release Copy link

National non-facility amount for 98962 across quarterly releases.

Release Status Non-facility Facility
Q4 2026 takes effect Oct 1, 2026 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 & related

Did this answer your question about CPT 98962?

We're building this out in the open. Tell us what you were actually trying to work out and we'll either answer you directly or build the page that does.

Did this page answer your question?

Source & method

Show sources

This page uses CMS's Medicare Physician Fee Schedule Q3 2026 release (effective July 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 98962 National PFS baseline: No national PFS rate (Q3 2026; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/cpt/98962/2026/C