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Medicare Physician Fee Schedule Effective CMS RVU23B Updated

CPT 99360 Medicare payment status

CPT 99360 has no published national rate. It carries status X (statutory exclusion) in the Q2 2023 release. The statutory definition of physician services does not include this item. The blank amount means unpriced, not $0.

Priced under CLFS

99360 · PFS Q2 2023 · Historical

Status X is not separately payable under the PFS.

View applicable payment rules
View CMS source and method

CMS RVU23BApril 1 – June 30, 2023

CPT 99360 has no published national rate. It carries status X (statutory exclusion) in the Q2 2023 release. The statutory definition of physician services does not include this item. The blank amount means unpriced, not $0.

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PFS status evidence

Physician relative value file (Q2 2023) · rvu23b-updated-02-27-2023.zip (PPRRVU23_APR.csv row 17,930)
Inspect PFS status evidence
Code
99360
Release
Q2 2023, revision 1
Result
Priced under CLFS

Citations

  • Shows this code’s PFS status (X). Result: Priced under CLFS.

    Physician relative value file (PPRRVU)CMS RVU23BApril 1 – June 30, 2023

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

    PPRRVU23_APR.csv row 17,930 in rvu23b-updated-02-27-2023.zip

    In the CMS file

    Loading rows 17,928–17,932 of PPRRVU23_APR.csv…

    Download rvu23b-updated-02-27-2023.zip from CMS File fingerprint 6a47fe38620fee5aff0fbba61f50983de3a9733e23acc7373c453261da6f0cd7

Plain-text summary

Why is there no national PFS amount for 99360?

Its status indicator is X (statutory exclusion). The statutory definition of physician services does not include this item. Status X 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 fee-schedule routing Applies
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, NCCI same-day edits: Not determined, MUE behavior: Not determined, Contractor pricing: Does not apply.

Why would a Medicare claim for 99360 be denied or paid less?

These come from CMS indicators on this page, not general billing advice.

  • Its status indicator is X (statutory exclusion)—The statutory definition of physician services does not include this item. 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 99360 line may not pay separately Copy link

CMS publishes no separately payable amount for 99360 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.
  • Check the place of service: CMS publishes no Office (non-facility) practice-expense amount for this code, so it prices in a Facility setting only.
  • 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 Q2 2023 amounts at GPCI 1.000. A blank means this schedule does not publish a payable PFS amount.

None of the comparison codes are in this release.

Check an actual payment Model this code in a contract

Sources: CMS Medicare Physician Fee Schedule Relative Value Files; CMS Medicare Physician Fee Schedule Relative Value Files (status indicator field); CMS Practice Expense methodology (cms.gov).

Which billing rules and modifiers apply? Copy link

Global period: what 99360'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 99360 →

How has it changed? Copy link

Rate history by release Copy link

National Office (non-facility) amount for 99360 across quarterly releases.

Release Status Office Facility
Q4 2026 Oct 1, 2026 – present X — —
Q3 2026 Jul 1, 2026 – Sep 30, 2026 X — —
Q2 2026 Apr 1, 2026 – Jun 30, 2026 X — —
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.

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Source & method

Show sources

This page uses CMS's Medicare Physician Fee Schedule Q2 2023 release (effective April 2023). 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 2023) · rvu23b-updated-02-27-2023.zip (PPRRVU23_APR.csv row 17,930)

Cite this rate

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

CPT 99360 National PFS baseline: No national PFS rate (Q2 2023; participating; whole service; GPCI 1.000; sequestration excluded). CMS RVU23B, PPRRVU23_APR.csv row 17,930. Localis. https://localishealth.com/cpt/99360/2023/B