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

CPT 98967 Medicare payment status

Excluded from PFS

98967 · PFS Q2 2013 · Historical

No national PFS rate in Q2 2013

Status N: non-covered. Medicare covers no part of this service, so the PFS produces no payment amount.

View applicable payment rules
View CMS source and method

CMS RVU13BApril 1 – June 30, 2013

PFS status evidence

Physician relative value file (Q2 2013) · rvu13b.zip (PPRRVU13.V0215_04162013.csv row 15,420)
Inspect PFS status evidence
Code
98967
Release
Q2 2013, revision 1
Result
Excluded from PFS

Citations

  • Shows this code’s PFS status (N). Result: Excluded from PFS.

    Physician relative value file (PPRRVU)CMS RVU13BApril 1 – June 30, 2013

    This PFS record alone does not establish a $0 allowance or a coverage determination. Any amount from another schedule needs its own evidence.

    PPRRVU13.V0215_04162013.csv row 15,420 in rvu13b.zip

    In the CMS file

    Loading rows 15,418–15,422 of PPRRVU13.V0215_04162013.csv…

    Download rvu13b.zip from CMS File fingerprint 7fa3270fb0a8148879b2996a1887928fbf73b8e70349c1dbd21d890154392e54

Plain-text summaryReport a problem

CPT 98967 has no published national rate. It carries status N (non-covered) in the Q2 2013 release. Medicare covers no part of this service. The blank amount means unpriced, not $0.

Why is there no national PFS amount for 98967?

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.

Which billing rules and modifiers apply? Copy link

Payment rules for 98967 Copy link

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: Does not apply, 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 98967 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.

Global period: what 98967'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

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 98967 →

How has it changed? Copy link

Rate history by release Copy link

National Office (non-facility) amount for 98967 across quarterly releases. -11.0% decrease since Q2 2020 · peak $28.15 in Q2 2020

Q2 2020 · $28.15 Q3 2020 · $28.15 (0.0%) Q4 2020 · $28.15 (0.0%) Q1 2021 · $26.87 (-4.5%) Q2 2021 · $26.87 (0.0%) Q3 2021 · $26.87 (0.0%) Q4 2021 · $26.87 (0.0%) Q1 2022 · $24.22 (-9.9%) Q2 2022 · $24.22 (0.0%) Q3 2022 · $24.22 (0.0%) Q4 2022 · $24.22 (0.0%) Q1 2023 · $24.06 (-0.7%) Q2 2023 · $24.06 (0.0%) Q3 2023 · $24.06 (0.0%) Q4 2023 · $24.06 (0.0%) Q1 2024 · $23.58 (-2.0%) Q1 2024 · $23.97 (+1.7%) Q2 2024 · $23.97 (0.0%) Q3 2024 · $23.97 (0.0%) Q4 2024 · $23.97 (0.0%) Q1 2025 · $23.94 (-0.1%) Q2 2025 · $23.94 (0.0%) Q3 2025 · $23.94 (0.0%) Q4 2025 · $23.94 (0.0%) Q1 2026 · $25.05 (+4.6%) Q2 2026 · $25.05 (0.0%) Q3 2026 · $25.05 (0.0%) Q4 2026 · $25.05 (0.0%)
Office (non-facility) Facility
Release Status Office Facility
Q4 2026 Oct 1, 2026 – present A $25.05 (0.0% no change) $20.04 (0.0% no change)
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 98967 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 98967 is billed Copy link

Across Original Medicare in CY2024, 98967 ranked #2,665 of the 7,879 CPT codes billed to Medicare that year, by patients served or total allowed dollars.

Beneficiaries
6,416
Office + facility beneficiaries combined
Services
9,578
Times it was billed
Allowed
$205,004
Total Medicare allowed dollars

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 Q2 2013 fee schedule above.

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Source & method

Show sources

This page uses CMS's Medicare Physician Fee Schedule Q2 2013 release (effective April 2013). 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.

Physician relative value file (Q2 2013) · rvu13b.zip (PPRRVU13.V0215_04162013.csv row 15,420)

Cite this rate

The citation names the release, so anyone can check it even after CMS publishes a newer one.

CPT 98967 National PFS baseline: No national PFS rate (Q2 2013; participating physician; whole service; GPCI 1.000; sequestration excluded). CMS RVU13B, PPRRVU13.V0215_04162013.csv row 15,420. Localis. https://localishealth.com/cpt/98967/2013/B