CPT code 23525: Joint reduction, sternoclavicular with manipulation2026 Medicare rate & RVUs in Montana
Orthopedic closed reduction of a sternoclavicular dislocation with manipulation, reported when the joint is restored without open exposure or fixation.
In Montana, Medicare pays $446.18 for 23525 in the office and $367.02 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 23525 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 23525 covers
Code 23525 describes closed treatment of a sternoclavicular joint dislocation in which the clinician manipulates the clavicle and sternum to restore alignment without surgically exposing the joint. An orthopedic surgeon typically performs the reduction. Posterior displacement may require urgent attention because of the sternoclavicular joint’s proximity to mediastinal structures. This code is specific to the sternoclavicular articulation, not the acromioclavicular joint or a clavicle fracture.
Report 23525 when the record supports an actual closed reduction with manipulation, rather than closed treatment without manipulation (23520) or open treatment. Document the dislocation, side, reduction maneuver, and post-reduction alignment. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others at 50%; bilateral reporting with modifier 50 is paid at 150%. An assistant is payable only with documentation of medical necessity; co-surgeons and team surgery are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
How Montana compares for 23525
Across 109 of 109 payment localities, the office rate for 23525 runs from $391.66 in Arkansas to $578.54 in San Benito County, CA. Montana pays $446.18. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Montana · this page$446.18
- Los Angeles, CA · California$496.65+$50.47
- Washington, DC area · District of Columbia$508.63+$62.45
- Miami, FL · Florida$498.73+$52.55
- Chicago, IL · Illinois$482.75+$36.57
- Manhattan, NY · New York$517.60+$71.42
- Alaska · Alaska$515.44+$69.26
Other areas in Montana first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $397.75 | $328.49 |
| ArkansasArkansas | $391.66 | $323.67 |
| ArizonaArizona | $433.25 | $356.55 |
| Bakersfield, CACalifornia | $466.71 | $379.95 |
| Chico, CACalifornia | $464.54 | $377.78 |
| El Centro, CACalifornia | $464.67 | $377.91 |
| Fresno, CACalifornia | $464.54 | $377.78 |
| Hanford, CACalifornia | $464.54 | $377.78 |
| Madera, CACalifornia | $464.54 | $377.78 |
| Merced, CACalifornia | $464.54 | $377.78 |
| Modesto, CACalifornia | $464.54 | $377.78 |
| Napa, CACalifornia | $535.25 | $430.92 |
| Oxnard, CACalifornia | $493.67 | $400.10 |
| Redding, CACalifornia | $464.54 | $377.78 |
| Rest of CaliforniaCalifornia | $464.54 | $377.78 |
| Riverside, CACalifornia | $473.02 | $386.26 |
| Sacramento, CACalifornia | $486.73 | $394.67 |
| Salinas, CACalifornia | $484.93 | $393.18 |
| San Diego, CACalifornia | $495.93 | $401.25 |
| Marin County, CACalifornia | $565.17 | $453.55 |
| San Francisco, CACalifornia | $564.27 | $452.66 |
| San Benito County, CACalifornia | $578.54 | $464.39 |
| Santa Clara County, CACalifornia | $574.87 | $460.72 |
| San Luis Obispo, CACalifornia | $477.27 | $387.11 |
| Santa Cruz, CACalifornia | $500.29 | $404.11 |
| Santa Maria, CACalifornia | $486.63 | $394.33 |
| Santa Rosa, CACalifornia | $505.25 | $408.04 |
| Stockton, CACalifornia | $464.54 | $377.78 |
| Vallejo, CACalifornia | $533.96 | $429.63 |
| Visalia, CACalifornia | $464.54 | $377.78 |
| Yuba City, CACalifornia | $464.54 | $377.78 |
| ColoradoColorado | $460.90 | $376.67 |
| ConnecticutConnecticut | $477.06 | $391.81 |
| DelawareDelaware | $440.63 | $362.42 |
| Fort Lauderdale, FLFlorida | $471.41 | $391.22 |
| Rest of FloridaFlorida | $446.47 | $370.80 |
| Atlanta, GAGeorgia | $456.65 | $376.22 |
| Rest of GeorgiaGeorgia | $419.31 | $348.69 |
| Hawaii, Guam, HIHawaii | $475.72 | $385.71 |
| IowaIowa | $405.14 | $332.71 |
| IdahoIdaho | $408.63 | $335.80 |
| East St. Louis, ILIllinois | $449.29 | $376.46 |
| Rest of IllinoisIllinois | $435.32 | $363.04 |
| Suburban Chicago, ILIllinois | $475.47 | $394.17 |
| IndianaIndiana | $411.05 | $337.66 |
| KansasKansas | $404.71 | $333.15 |
| KentuckyKentucky | $411.11 | $340.73 |
| New Orleans, LALouisiana | $432.34 | $357.86 |
| Rest of LouisianaLouisiana | $411.06 | $341.00 |
| Metropolitan Boston, MAMassachusetts | $505.88 | $411.36 |
| Rest of MassachusettsMassachusetts | $458.56 | $375.20 |
| Baltimore area, MDMaryland | $476.09 | $391.16 |
| Rest of MarylandMaryland | $448.86 | $368.75 |
| Rest of MaineMaine | $412.56 | $339.73 |
| Southern Maine, MEMaine | $433.83 | $355.39 |
| Detroit, MIMichigan | $453.97 | $377.58 |
| Rest of MichiganMichigan | $423.86 | $351.59 |
| MinnesotaMinnesota | $436.25 | $354.80 |
| Metropolitan Kansas City, MOMissouri | $427.56 | $353.23 |
| Metropolitan St. Louis, MOMissouri | $432.07 | $356.71 |
| Rest of MissouriMissouri | $404.67 | $336.43 |
| MississippiMississippi | $398.17 | $330.01 |
| North CarolinaNorth Carolina | $416.86 | $343.00 |
| North DakotaNorth Dakota | $430.56 | $351.40 |
| NebraskaNebraska | $407.01 | $333.95 |
| New HampshireNew Hampshire | $455.08 | $372.68 |
| Northern New JerseyNew Jersey | $503.22 | $411.39 |
| Rest of New JerseyNew Jersey | $481.00 | $394.55 |
| New MexicoNew Mexico | $426.95 | $354.36 |
| NevadaNevada | $442.13 | $362.89 |
| NYC suburbs and Long Island, NYNew York | $532.75 | $438.63 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $485.48 | $398.80 |
| Queens, NYNew York | $519.73 | $426.16 |
| Rest of New YorkNew York | $423.59 | $348.38 |
| OhioOhio | $420.67 | $348.40 |
| OklahomaOklahoma | $408.65 | $337.96 |
| Portland, OROregon | $474.34 | $386.40 |
| Rest of OregonOregon | $437.21 | $358.37 |
| Metropolitan Philadelphia, PAPennsylvania | $465.70 | $383.29 |
| Rest of PennsylvaniaPennsylvania | $420.49 | $347.82 |
| Puerto RicoPuerto Rico | $449.10 | $369.07 |
| Rhode IslandRhode Island | $455.51 | $373.74 |
| South CarolinaSouth Carolina | $419.76 | $346.62 |
| South DakotaSouth Dakota | $428.72 | $349.56 |
| TennesseeTennessee | $407.06 | $335.10 |
| Austin, TXTexas | $460.66 | $376.91 |
| Beaumont, TXTexas | $417.70 | $345.66 |
| Brazoria, TXTexas | $438.75 | $360.31 |
| Dallas, TXTexas | $442.42 | $363.57 |
| Fort Worth, TXTexas | $439.80 | $361.74 |
| Galveston, TXTexas | $440.61 | $362.01 |
| Houston, TXTexas | $455.07 | $376.47 |
| Rest of TexasTexas | $428.57 | $353.44 |
| UtahUtah | $425.77 | $351.36 |
| VirginiaVirginia | $433.44 | $355.63 |
| Virgin Islands, VIUnited States Virgin Islands | $449.10 | $369.07 |
| VermontVermont | $430.24 | $351.87 |
| Rest of WashingtonWashington | $457.24 | $373.88 |
| King County, WAWashington | $514.84 | $417.71 |
| WisconsinWisconsin | $415.53 | $339.70 |
| West VirginiaWest Virginia | $418.80 | $350.01 |
| WyomingWyoming | $439.38 | $360.22 |
23525 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$391.66
$521.54
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $515.44 | 1 |
| AL | $397.75 | 1 |
| AR | $391.66 | 1 |
| AZ | $433.25 | 1 |
| CA | $464.54–$578.54 | 29 |
| CO | $460.90 | 1 |
| CT | $477.06 | 1 |
| DC | $508.63 | 1 |
| DE | $440.63 | 1 |
| FL | $446.47–$498.73 | 3 |
| GA | $419.31–$456.65 | 2 |
| GU | $475.72 | 1 |
| HI | $475.72 | 1 |
| IA | $405.14 | 1 |
| ID | $408.63 | 1 |
| IL | $435.32–$482.75 | 4 |
| IN | $411.05 | 1 |
| KS | $404.71 | 1 |
| KY | $411.11 | 1 |
| LA | $411.06–$432.34 | 2 |
| MA | $458.56–$505.88 | 2 |
| MD | $448.86–$508.63 | 3 |
| ME | $412.56–$433.83 | 2 |
| MI | $423.86–$453.97 | 2 |
| MN | $436.25 | 1 |
| MO | $404.67–$432.07 | 3 |
| MS | $398.17 | 1 |
| MT | $446.18 | 1 |
| NC | $416.86 | 1 |
| ND | $430.56 | 1 |
| NE | $407.01 | 1 |
| NH | $455.08 | 1 |
| NJ | $481.00–$503.22 | 2 |
| NM | $426.95 | 1 |
| NV | $442.13 | 1 |
| NY | $423.59–$532.75 | 5 |
| OH | $420.67 | 1 |
| OK | $408.65 | 1 |
| OR | $437.21–$474.34 | 2 |
| PA | $420.49–$465.70 | 2 |
| PR | $449.10 | 1 |
| RI | $455.51 | 1 |
| SC | $419.76 | 1 |
| SD | $428.72 | 1 |
| TN | $407.06 | 1 |
| TX | $417.70–$460.66 | 8 |
| UT | $425.77 | 1 |
| VA | $433.44–$508.63 | 2 |
| VI | $449.10 | 1 |
| VT | $430.24 | 1 |
| WA | $457.24–$514.84 | 2 |
| WI | $415.53 | 1 |
| WV | $418.80 | 1 |
| WY | $439.38 | 1 |
How the 23525 rate is calculated
Each of 23525’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 23525
RVUs × geographic indexes × conversion factor
Work3.70
3.70 RVUs× 1.000 GPCI
Practice expense8.87
8.87 RVUs× 1.000 GPCI
Malpractice0.79
0.79 RVUs× 1.000 GPCI
Adjusted RVUs
13.3600
Conversion factor
$33.4009
Medicare rate
$446.24
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Montana inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
2,222
- Code
- 23525
- Physician work
- 3.70
- Practice expense
- 8.87
- Malpractice
- 0.79
GPCI2026.csv
71
- Locality
- Montana
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.998
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.70 | × 1.000 | 3.7000 |
| Practice expense | 8.87 | × 1.000 | 8.8700 |
| Malpractice | 0.79 | × 0.998 | 0.7884 |
| Total RVUs | 13.3584 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Montana$446.18
Office: (3.7 × 1 + 8.87 × 1 + 0.79 × 0.998) × $33.4009 = $446.18
Facility: (3.7 × 1 + 6.5 × 1 + 0.79 × 0.998) × $33.4009 = $367.02
Payment rules and modifiers for 23525
23525 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 23525
Joint reduction, sternoclavicular with manipulation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 23525
Joint reduction, sternoclavicular with manipulation
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
23525 without 50 · national office
$446.24
Joint reduction, sternoclavicular with manipulation
23525-50 · Bilateral: 150%
$669.36
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
How 23525 has changed in Montana
23525 · Office / nonfacility
$446.18
Effective 2026-10-01
The base rate is $40.15 higher than on 2025-10-01, moving from $406.03 to $446.18 (9.9%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$406.03changed to$446.18
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 3.79 changed to 3.70
- Practice expense RVU 7.99 changed to 8.87
- Malpractice GPCI 0.978 changed to 0.998
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$412.53changed to$406.03
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 7.84 changed to 7.99
- Malpractice RVU 0.78 changed to 0.79
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$405.79changed to$412.53
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$412.19changed to$405.79
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 7.64 changed to 7.84
- Malpractice RVU 0.75 changed to 0.78
January 1, 2023
RVU23A
$411.55changed to$412.19
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 7.35 changed to 7.64
- Malpractice RVU 0.77 changed to 0.75
- Malpractice GPCI 0.977 changed to 0.978
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$408.00changed to$411.55
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 7.18 changed to 7.35
- Malpractice RVU 0.74 changed to 0.77
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$412.90changed to$408.00
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 6.66 changed to 7.18
- Malpractice RVU 0.76 changed to 0.74
- Malpractice GPCI 1.304 changed to 0.977
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$418.27changed to$412.90
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 6.56 changed to 6.66
- Malpractice RVU 0.77 changed to 0.76
- Malpractice GPCI 1.631 changed to 1.304
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$415.87changed to$418.27
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 6.49 changed to 6.56
- Malpractice RVU 0.78 changed to 0.77
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$391.40changed to$415.87
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 6.13 changed to 6.49
- Malpractice RVU 0.69 changed to 0.78
- Malpractice GPCI 1.429 changed to 1.631
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$389.81changed to$391.40
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 6.19 changed to 6.13
- Malpractice RVU 0.74 changed to 0.69
- Malpractice GPCI 1.226 changed to 1.429
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$402.12changed to$389.81
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 6.42 changed to 6.19
- Malpractice RVU 0.80 changed to 0.74
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$400.12changed to$402.12
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$392.10changed to$400.12
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 6.34 changed to 6.42
- Malpractice RVU 0.70 changed to 0.80
- Malpractice GPCI 1.165 changed to 1.226
Held through RVU15B.
January 1, 2014
RVU14A
$387.70changed to$392.10
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 6.80 changed to 6.34
- Malpractice RVU 0.73 changed to 0.70
- Malpractice GPCI 1.103 changed to 1.165
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $387.70
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $446.18 | $367.02 | RVU26D |
| 2026-07-01 | $446.18 | $367.02 | RVU26C |
| 2026-04-01 | $446.18 | $367.02 | RVU26B |
| 2026-01-01 | $446.18 | $367.02 | RVU26A |
| 2025-10-01 | $406.03 | $370.78 | RVU25D |
| 2025-07-01 | $406.03 | $370.78 | RVU25C |
| 2025-04-01 | $406.03 | $370.78 | RVU25B |
| 2025-01-01 | $406.03 | $370.78 | RVU25A |
| 2024-10-01 | $412.53 | $376.58 | RVU24D |
| 2024-07-01 | $412.53 | $376.58 | RVU24C |
| 2024-04-01 | $412.53 | $376.58 | RVU24B |
| 2024-03-09 | $412.53 | $376.58 | RVU24AR |
| 2024-01-01 | $405.79 | $370.43 | RVU24A |
| 2023-10-01 | $412.19 | $376.94 | RVU23D |
| 2023-07-01 | $412.19 | $376.94 | RVU23C |
| 2023-04-01 | $412.19 | $376.94 | RVU23B |
| 2023-01-01 | $412.19 | $376.94 | RVU23A |
| 2022-10-01 | $411.55 | $376.59 | RVU22D |
| 2022-07-01 | $411.55 | $376.59 | RVU22C |
| 2022-04-01 | $411.55 | $376.59 | RVU22B |
| 2022-01-01 | $411.55 | $376.59 | RVU22A |
| 2021-10-01 | $408.00 | $373.81 | RVU21D |
| 2021-07-01 | $408.00 | $373.81 | RVU21C |
| 2021-04-01 | $408.00 | $373.81 | RVU21B |
| 2021-01-01 | $408.00 | $373.81 | RVU21A |
| 2020-10-01 | $412.90 | $380.78 | RVU20D |
| 2020-07-01 | $412.90 | $380.78 | RVU20C |
| 2020-04-01 | $412.90 | $380.78 | RVU20B |
| 2020-01-01 | $412.90 | $380.78 | RVU20A |
| 2019-10-01 | $418.27 | $386.91 | RVU19D |
| 2019-07-01 | $418.27 | $386.91 | RVU19C |
| 2019-04-01 | $418.27 | $386.91 | RVU19B |
| 2019-01-01 | $418.27 | $386.91 | RVU19A |
| 2018-10-01 | $415.87 | $385.27 | RVU18D |
| 2018-07-01 | $415.87 | $385.27 | RVU18C |
| 2018-04-01 | $415.87 | $385.27 | RVU18B |
| 2018-01-01 | $415.87 | $385.27 | RVU18AR1 |
| 2017-10-01 | $391.40 | $363.41 | RVU17D |
| 2017-07-01 | $391.40 | $363.41 | RVU17C |
| 2017-04-01 | $391.40 | $363.41 | RVU17B |
| 2017-01-01 | $391.40 | $363.41 | RVU17A |
| 2016-10-01 | $389.81 | $361.17 | RVU16D |
| 2016-07-01 | $389.81 | $361.17 | RVU16C |
| 2016-04-01 | $389.81 | $361.17 | RVU16B |
| 2016-01-01 | $389.81 | $361.17 | RVU16A |
| 2015-10-01 | $402.12 | $372.66 | RVU15D |
| 2015-07-01 | $402.12 | $372.66 | RVU15C |
| 2015-04-01 | $400.12 | $370.80 | RVU15B |
| 2015-01-01 | $400.12 | $370.80 | RVU15A |
| 2014-10-01 | $392.10 | $363.44 | RVU14D |
| 2014-07-01 | $392.10 | $363.44 | RVU14C |
| 2014-04-01 | $392.10 | $363.44 | RVU14B |
| 2014-01-01 | $392.10 | $363.44 | RVU14A |
| 2013-10-01 | $387.70 | $358.44 | RVU13D |
| 2013-07-01 | $387.70 | $358.44 | RVU13C |
| 2013-04-01 | $387.70 | $358.44 | RVU13B |
| 2013-01-01 | $387.70 | $358.44 | RVU13AR |
Where the Montana rate applies
Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.
- Absarokee
- Acton
- Alberton
- Alder
- Alzada
- Amsterdam
- Anaconda-Deer Lodge County
- Antelope
23525 billing questions
When should 23525 be chosen over 23520?
Use 23525 when the clinician manipulates the dislocated sternoclavicular joint to restore alignment. Use 23520 for closed treatment without manipulation.
How does 23525 differ from 23530?
23525 describes closed treatment with manipulation. 23530 describes open treatment of a sternoclavicular dislocation.
Is manipulation separately reported?
The manipulation is part of the closed treatment represented by 23525; it is not separately reported as another reduction service for the same dislocation.
What documentation supports 23525?
Document the sternoclavicular dislocation, the affected side, the closed manipulation performed, and the resulting alignment. The record should make clear that the joint was treated by manipulation rather than open exposure.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. CMS also applies the standard multiple-procedure reduction when other procedures are performed in the same session.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. CMS does not permit co-surgeons or team surgery for this code.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
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