CPT 99404
Excluded from PFS
99404 · PFS Q3 2024 · Historical
Status N: non-covered. Medicare covers no part of this service, so the PFS produces no payment amount.
CPT 99404 has no published national rate. It carries status N (non-covered) in the Q3 2024 release. Medicare covers no part of this service. The blank amount means unpriced, not $0.
PFS status evidence
Inspect PFS status evidence
- Code
- 99404
- Release
- Q3 2024, revision 1
- Result
- Excluded from PFS
Citations
-
Shows this code’s PFS status (N). Result: Excluded from PFS.
Physician relative value file (PPRRVU)Q3 2024 · revision 1
Latest revision of this release
Release period: July 1 – September 30, 2024
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
PPRRVU24_JUL.csv in rvu24c-updated-09-09-2024.zip (row 18,583)- hcpcs (col 1)
- 99404
- modifier (col 2)
- blank
- status_code (col 4)
- N
SHA-256: 63e2b9617ccd91e8ad68d5f23a0ae26a106d0cdfdf6390631fbac7b7e0513df1
Why is there no national PFS amount for 99404?
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: 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 99404 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.
Which billing rules and modifiers apply? Copy link
Global period: what 99404'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 99404 across quarterly releases.
| Release | Status | Office | Facility |
|---|---|---|---|
| Q4 2026 takes effect Oct 1, 2026 | N | — | — |
| Q3 2026 Jul 1, 2026 – Sep 30, 2026 | N | — | — |
| Q2 2026 Apr 1, 2026 – Jun 30, 2026 | N | — | — |
| Q1 2026 Jan 1, 2026 – Mar 31, 2026 | N | — | — |
| Q4 2025 Oct 1, 2025 – Dec 31, 2025 | N | — | — |
| Q3 2025 Jul 1, 2025 – Sep 30, 2025 | N | — | — |
| Q2 2025 Apr 1, 2025 – Jun 30, 2025 | N | — | — |
| Q1 2025 Jan 1, 2025 – Mar 31, 2025 | N | — | — |
| Q4 2024 Oct 1, 2024 – Dec 31, 2024 | N | — | — |
| Q3 2024 Jul 1, 2024 – Sep 30, 2024 | N | — | — |
| Q2 2024 Apr 1, 2024 – Jun 30, 2024 | N | — | — |
| Q1 2024 Mar 9, 2024 – Mar 31, 2024 | N | — | — |
| Q1 2024 Jan 1, 2024 – Mar 8, 2024 | N | — | — |
| Q4 2023 Oct 1, 2023 – Dec 31, 2023 | N | — | — |
| Q3 2023 Jul 1, 2023 – Sep 30, 2023 | N | — | — |
| Q2 2023 Apr 1, 2023 – Jun 30, 2023 | N | — | — |
| Q1 2023 Jan 1, 2023 – Mar 31, 2023 | N | — | — |
| Q4 2022 Oct 1, 2022 – Dec 31, 2022 | N | — | — |
| Q3 2022 Jul 1, 2022 – Sep 30, 2022 | N | — | — |
| Q2 2022 Apr 1, 2022 – Jun 30, 2022 | N | — | — |
| Q1 2022 Jan 1, 2022 – Mar 31, 2022 | N | — | — |
| Q4 2021 Oct 1, 2021 – Dec 31, 2021 | N | — | — |
| Q3 2021 Jul 1, 2021 – Sep 30, 2021 | N | — | — |
| Q2 2021 Apr 1, 2021 – Jun 30, 2021 | N | — | — |
| Q1 2021 Jan 1, 2021 – Mar 31, 2021 | N | — | — |
| Q4 2020 Oct 1, 2020 – Dec 31, 2020 | N | — | — |
| Q3 2020 Jul 1, 2020 – Sep 30, 2020 | N | — | — |
| Q2 2020 Apr 1, 2020 – Jun 30, 2020 | N | — | — |
| 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.
Sources: CMS Medicare Physician Fee Schedule Relative Value Files.
Usage and related codes Copy link
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Source & method
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This page uses CMS's Medicare Physician Fee Schedule Q3 2024 release (effective July 2024). 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 99404 National PFS baseline: No national PFS rate (Q3 2024; participating; whole service; GPCI 1.000; sequestration excluded). Localis. https://localishealth.com/cpt/99404/2024/C