Unable to determine from available CMS sources
98970 · PFS Q1 2020 · Historical
No national PFS rate in Q1 2020
Status I is not separately payable under the PFS.
CMS RVU20AJanuary 1 – March 31, 2020
PFS status evidence
Inspect PFS status evidence
- Code
- 98970
- Release
- Q1 2020, revision 1
- Result
- Unable to determine from available CMS sources
Citations
-
Shows this code’s PFS status (I). Result: Unable to determine from available CMS sources.
Physician relative value file (PPRRVU)CMS RVU20AJanuary 1 – March 31, 2020
This PFS record alone does not establish a $0 allowance or a coverage determination. Any amount from another schedule needs its own evidence.
PPRRVU20_Jan.csv row 17,009 in rvu20a-updated-01312020.zip
In the CMS file
Loading rows 17,007–17,011 of PPRRVU20_Jan.csv…
Download rvu20a-updated-01312020.zip from CMS File fingerprint
28d2c1e57daa957d1eef39cb96dc0e0f55fd4e6ab886473e117d9b4f43a9875d
CPT 98970 has no published national rate. It carries status I (not valid) in the Q1 2020 release. Medicare uses a different code to report and pay for this service. The blank amount means unpriced, not $0.
Why is there no national PFS amount for 98970?
Its status indicator is I (not valid). Medicare uses a different code to report and pay for this service. Status I is not separately payable under the PFS.
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)
Why would a Medicare claim for 98970 be denied or paid less?
These come from CMS indicators on this page, not general billing advice.
- Its status indicator is I (not valid)—Medicare uses a different code to report and pay for 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.
Which billing rules and modifiers apply? Copy link
Global period: what 98970's fee already covers Copy link
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.
How has it changed? Copy link
Rate history by release Copy link
National Office (non-facility) amount for 98970 across quarterly releases. +4.2% increase since Q1 2021 · peak $12.36 in Q1 2026
| Release | Status | Office | Facility |
|---|---|---|---|
| Q4 2026 Oct 1, 2026 – present | A | $12.36 (0.0% no change) | $10.35 (0.0% no change) |
| Q3 2026 Jul 1, 2026 – Sep 30, 2026 | A | $12.36 (0.0% no change) | $10.35 (0.0% no change) |
| Q2 2026 Apr 1, 2026 – Jun 30, 2026 | A | $12.36 (0.0% no change) | $10.35 (0.0% no change) |
| Q1 2026 Jan 1, 2026 – Mar 31, 2026 | A | $12.36 (+9.2% increase) | $10.35 (-8.6% decrease) |
| Q4 2025 Oct 1, 2025 – Dec 31, 2025 | A | $11.32 (0.0% no change) | $11.32 (0.0% no change) |
| Q3 2025 Jul 1, 2025 – Sep 30, 2025 | A | $11.32 (0.0% no change) | $11.32 (0.0% no change) |
| Q2 2025 Apr 1, 2025 – Jun 30, 2025 | A | $11.32 (0.0% no change) | $11.32 (0.0% no change) |
| Q1 2025 Jan 1, 2025 – Mar 31, 2025 | A | $11.32 (-2.8% decrease) | $11.32 (-2.8% decrease) |
| Q4 2024 Oct 1, 2024 – Dec 31, 2024 | A | $11.65 (0.0% no change) | $11.65 (0.0% no change) |
| Q3 2024 Jul 1, 2024 – Sep 30, 2024 | A | $11.65 (0.0% no change) | $11.65 (0.0% no change) |
| Q2 2024 Apr 1, 2024 – Jun 30, 2024 | A | $11.65 (0.0% no change) | $11.65 (0.0% no change) |
| Q1 2024 Mar 9, 2024 – Mar 31, 2024 | A | $11.65 (+1.7% increase) | $11.65 (+1.7% increase) |
| Q1 2024 Jan 1, 2024 – Mar 8, 2024 | A | $11.46 (-0.5% decrease) | $11.46 (-0.5% decrease) |
| Q4 2023 Oct 1, 2023 – Dec 31, 2023 | A | $11.52 (0.0% no change) | $11.52 (0.0% no change) |
| Q3 2023 Jul 1, 2023 – Sep 30, 2023 | A | $11.52 (0.0% no change) | $11.52 (0.0% no change) |
| Q2 2023 Apr 1, 2023 – Jun 30, 2023 | A | $11.52 (0.0% no change) | $11.52 (0.0% no change) |
| Q1 2023 Jan 1, 2023 – Mar 31, 2023 | A | $11.52 (-2.1% decrease) | $11.52 (-2.1% decrease) |
| Q4 2022 Oct 1, 2022 – Dec 31, 2022 | A | $11.77 (0.0% no change) | $11.77 (0.0% no change) |
| Q3 2022 Jul 1, 2022 – Sep 30, 2022 | A | $11.77 (0.0% no change) | $11.77 (0.0% no change) |
| Q2 2022 Apr 1, 2022 – Jun 30, 2022 | A | $11.77 (0.0% no change) | $11.77 (0.0% no change) |
| Q1 2022 Jan 1, 2022 – Mar 31, 2022 | A | $11.77 (-0.8% decrease) | $11.77 (+2.3% increase) |
| Q4 2021 Oct 1, 2021 – Dec 31, 2021 | A | $11.86 (0.0% no change) | $11.51 (0.0% no change) |
| Q3 2021 Jul 1, 2021 – Sep 30, 2021 | A | $11.86 (0.0% no change) | $11.51 (0.0% no change) |
| Q2 2021 Apr 1, 2021 – Jun 30, 2021 | A | $11.86 (0.0% no change) | $11.51 (0.0% no change) |
| Q1 2021 Jan 1, 2021 – Mar 31, 2021 | A | $11.86 | $11.51 |
| Q4 2020 Oct 1, 2020 – Dec 31, 2020 | I | — | — |
| Q3 2020 Jul 1, 2020 – Sep 30, 2020 | I | — | — |
| Q2 2020 Apr 1, 2020 – Jun 30, 2020 | I | — | — |
| Q1 2020 Jan 1, 2020 – Mar 31, 2020 | I | — | — |
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 98970 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 98970 is billed Copy link
Across Original Medicare in CY2024, 98970 ranked #5,553 of the 7,879 CPT codes billed to Medicare that year, by patients served or total 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 Q1 2020 fee schedule above.
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Source & method
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This page uses CMS's Medicare Physician Fee Schedule Q1 2020 release (effective January 2020). 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.
Cite this rate
The citation names the release, so anyone can check it even after CMS publishes a newer one.
CPT 98970 National PFS baseline: No national PFS rate (Q1 2020; participating physician; whole service; GPCI 1.000; sequestration excluded). CMS RVU20A, PPRRVU20_Jan.csv row 17,009. Localis. https://localishealth.com/cpt/98970/2020/A