localis

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

Specialty rate rollup

General Surgery

Common general-surgery procedures, including appendectomy, cholecystectomy, hernia repair, and breast surgery.

This is a curated starter set for comparison. It doesn't claim that every specialty bills every code, and it isn't a utilization-weighted average.

At a glance

Q4 2026 compared with the prior available PFS release.

Conversion factor: 0.0% no change

Payable codes

7 / 7

Changed this release

0

Largest increase

None

Largest decrease

None

See the rates where you practice

Enter a ZIP code to apply that Medicare locality’s work, practice-expense, and malpractice adjustments to every row.

Current national rates Copy link

Q4 2026 release

Office (non-facility) and facility professional amounts, GPCI 1.000, before sequestration.

Code and service Status Office (non-facility) Facility
Visits and evaluation
99204 Long New Patient Office Visit Active
$177.36
8.6% increase · Q1 2026
$116.90
9.4% decrease · Q1 2026
99213 Routine Follow-Up Office Visit Active
$95.19
7.0% increase · Q1 2026
$57.45
9.8% decrease · Q1 2026
99214 Long Follow-Up Office Visit Active
$135.61
8.3% increase · Q1 2026
$84.50
9.9% decrease · Q1 2026
Surgical and endoscopic procedures
44950 Active
$605.56
3.6% decrease · Q1 2026
$605.56
3.6% decrease · Q1 2026
47562 Active
$631.95
2.6% decrease · Q1 2026
$631.95
2.6% decrease · Q1 2026
49505 Active
$508.03
1.5% decrease · Q1 2026
$508.03
1.5% decrease · Q1 2026
19301 Active
$632.61
2.3% decrease · Q1 2026
$632.61
2.3% decrease · Q1 2026

Every code links to its contracted-rate (% of Medicare) table and a full RVU breakdown, plus billing-policy context and rate history.

Download this fee schedule (CSV)—free, no account needed.

How often these codes appear in Medicare Copy link

Across Original Medicare nationally in CY2024, the covered codes on this page accounted for the activity below. It counts use by clinicians of every specialty, not just General Surgery, and CMS publishes it on a different cycle from the fee schedule.

Services

185.9M

Times these codes were billed

Allowed dollars

$20.1B

Across covered Medicare FFS services

Most used in this set

99214

103.7M services

Coverage: 7 of 7 displayed codes. HCPCS Level II and excluded drug codes may not appear in this utilization dataset.

What this specialty actually bills Medicare

Observed CY2024 Medicare fee-for-service billing by General Surgery clinicians, grouped by CMS rendering-provider specialty. That grouping differs from this page's General Surgery label, so treat it as context for the curated list above.

Top codes by allowed dollars Share of allowed Allowed
99213 4.8% $123.2M
99214 4.7% $122.1M
99204 3.7% $96.3M
37229 not in the list above 2.8% $72.9M
33533 not in the list above 2.3% $60.8M
99232 not in the list above 2.3% $59.6M
36465 not in the list above 2.2% $57.3M
37225 not in the list above 2.1% $54.1M
37227 not in the list above 1.9% $50.2M
99203 not in the list above 1.9% $50.0M
Top codes by services Share of services Services
99213 8.4% 1.5M
99214 5.8% 1.0M
Q9967 not in the list above 5.8% 995,920
99232 not in the list above 4.4% 764,838
99204 3.5% 603,991
Q9966 not in the list above 3.0% 526,596
99203 not in the list above 2.7% 473,090
93970 not in the list above 2.2% 386,929
93880 not in the list above 2.1% 362,963
99222 not in the list above 2.0% 350,345

Localis can price 74% of this cohort's observed services (91% of allowed dollars) under the Q4 2026 release. The rest is clinical lab, drugs, or services paid outside the PFS under other fee schedules, not $0.

Established patient office visits—Office (non-facility)

Visit levels as shares of the 2024 services observed in this family, across 18,937 clinicians.

99211
0%
99212
10%
99213
49%
99214
35%
99215
6%

New patient office visits—Office (non-facility)

Visit levels as shares of the 2024 services observed in this family, across 18,872 clinicians.

99202
4%
99203
36%
99204
45%
99205
14%

Also high-volume for this cohort (observed, not yet in the curated list above)

This is observed billing only. The curated table above is still this page's rate list.

CY2024 Medicare fee-for-service only. Codes billed by fewer than 30 observed clinicians in a single setting are not shown, so shares may not total 100%. CMS publishes only a facility vs non-facility split, not exact places of service. Observed use adds context to the curated table above. It doesn't weight or change any rate on this page.

Turn the list into contract math

Analyze a payer offer using these General Surgery codes

We’ll preload the code set in Contract Check. Add your annual volumes and ZIP to see the volume-weighted percentage of Medicare and annual-dollar difference.

Open in Contract Check

Get notified when General Surgery rates change

Medicare updates the fee schedule every quarter. We'll email you only when a release moves one of the 7 General Surgery codes on this page.

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Source & method Copy link

Amounts are computed from the CMS Medicare Physician Fee Schedule Q4 2026 release, GPCI 1.000, before the ~2% sequestration cut. The grouping by common clinical scenario is our own, not the AMA’s code-family taxonomy, and it’s a curated starter set, not a utilization-weighted specialty mix. A code with no amount is either not separately payable under the PFS or absent from the release. It never means $0.