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Medicare Physician Fee Schedule Effective CMS RVU20A Updated

HCPCS Q5105 Medicare payment status

HCPCS Q5105 has no published national rate. It carries status E (excluded) in the Q1 2020 release. A regulation removes this code from the fee schedule. When covered, it is paid under reasonable charge procedures instead. The blank amount means unpriced, not $0.

Excluded from PFS

Q5105 · PFS Q1 2020 · Historical

Status E is not separately payable under the PFS.

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View CMS source and method

CMS RVU20AJanuary 1 – March 31, 2020

HCPCS Q5105 has no published national rate. It carries status E (excluded) in the Q1 2020 release. A regulation removes this code from the fee schedule. When covered, it is paid under reasonable charge procedures instead. The blank amount means unpriced, not $0.

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PFS status evidence

Physician relative value file (Q1 2020) · rvu20a-updated-01312020.zip (PPRRVU20_Jan.csv row 4,082)
Inspect PFS status evidence
Code
Q5105
Release
Q1 2020, revision 1
Result
Excluded from PFS

Citations

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

    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 4,082 in rvu20a-updated-01312020.zip

    In the CMS file

    Loading rows 4,080–4,084 of PPRRVU20_Jan.csv…

    Download rvu20a-updated-01312020.zip from CMS File fingerprint 28d2c1e57daa957d1eef39cb96dc0e0f55fd4e6ab886473e117d9b4f43a9875d

Plain-text summary

Why is there no national PFS amount for Q5105?

Its status indicator is E (excluded). A regulation removes this code from the fee schedule. When covered, it is paid under reasonable charge procedures instead. Status E is not separately payable under the PFS.

About this code

Inj retacrit esrd on dialysi

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 Q5105 be denied or paid less?

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

  • Its status indicator is E (excluded)—A regulation removes this code from the fee schedule. When covered, it is paid under reasonable charge procedures instead. 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 Q5105'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 Q5105 →

How has it changed? Copy link

Rate history by release Copy link

National Office (non-facility) amount for Q5105 across quarterly releases.

Release Status Office Facility
Q4 2026 Oct 1, 2026 – present E — —
Q3 2026 Jul 1, 2026 – Sep 30, 2026 E — —
Q2 2026 Apr 1, 2026 – Jun 30, 2026 E — —
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 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. CMS owns the code description shown for HCPCS Level II codes. Our methodology explains sourcing, parsing, versioning, and how we cross-check claims before we publish them.

Physician relative value file (Q1 2020) · rvu20a-updated-01312020.zip (PPRRVU20_Jan.csv row 4,082)

Cite this rate

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

HCPCS Q5105 National PFS baseline: No national PFS rate (Q1 2020; participating; whole service; GPCI 1.000; sequestration excluded). CMS RVU20A, PPRRVU20_Jan.csv row 4,082. Localis. https://localishealth.com/hcpcs/Q5105/2020/A