CPT code 31626: Fiducial placement, bronchoscopic markers2026 Medicare rate & RVUs in North Carolina
Reports bronchoscopic placement of one or more fiducial markers near a lung target for image-guided radiation treatment or lesion localization.
In North Carolina, Medicare pays $815.38 for 31626 in the office and $170.30 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 31626 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 31626 covers
During flexible or rigid bronchoscopy, a pulmonologist or thoracic surgeon places one or more radiopaque fiducial markers in or near a pulmonary target. The markers provide a reference for later image-guided treatment, commonly stereotactic radiation, or for localizing a small lung lesion. The procedure is typically performed in a hospital bronchoscopy suite or operating room, often with imaging guidance and anesthesia support.
Report 31626 for marker placement, whether one or several markers are placed. Documentation should identify the target, marker number and locations, bronchoscopic approach, and clinical purpose. Navigation to a peripheral target or tissue sampling may also be performed and evaluated under the applicable bronchoscopy codes. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For multiple procedures in one session, the highest-valued procedure is paid in full and the others at 50%. Assistant-at-surgery payment requires documented 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 North Carolina compares for 31626
Across 109 of 109 payment localities, the office rate for 31626 runs from $759.72 in Arkansas to $1,198.15 in San Benito County, CA. North Carolina pays $815.38. The RVUs are the same everywhere; the geographic indexes change the dollars.
- North Carolina · this page$815.38
- Los Angeles, CA · California$1,002.83+$187.45
- Washington, DC area · District of Columbia$1,007.45+$192.07
- Miami, FL · Florida$921.72+$106.34
- Chicago, IL · Illinois$892.99+$77.61
- Manhattan, NY · New York$1,004.03+$188.65
- Alaska · Alaska$973.74+$158.36
Other areas in North Carolina first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $772.11 | $167.14 |
| ArkansasArkansas | $759.72 | $165.81 |
| ArizonaArizona | $844.76 | $174.79 |
| Bakersfield, CACalifornia | $935.93 | $178.16 |
| Chico, CACalifornia | $934.61 | $176.83 |
| El Centro, CACalifornia | $934.68 | $176.91 |
| Fresno, CACalifornia | $934.61 | $176.83 |
| Hanford, CACalifornia | $934.61 | $176.83 |
| Madera, CACalifornia | $934.61 | $176.83 |
| Merced, CACalifornia | $934.61 | $176.83 |
| Modesto, CACalifornia | $934.61 | $176.83 |
| Napa, CACalifornia | $1,101.55 | $190.28 |
| Oxnard, CACalifornia | $999.85 | $182.61 |
| Redding, CACalifornia | $934.61 | $176.83 |
| Rest of CaliforniaCalifornia | $934.61 | $176.83 |
| Riverside, CACalifornia | $939.39 | $181.62 |
| Sacramento, CACalifornia | $985.77 | $181.67 |
| Salinas, CACalifornia | $982.22 | $180.89 |
| San Diego, CACalifornia | $1,009.10 | $182.18 |
| Marin County, CACalifornia | $1,171.83 | $196.96 |
| San Francisco, CACalifornia | $1,171.33 | $196.46 |
| San Benito County, CACalifornia | $1,198.15 | $201.15 |
| Santa Clara County, CACalifornia | $1,196.10 | $199.11 |
| San Luis Obispo, CACalifornia | $965.89 | $178.39 |
| Santa Cruz, CACalifornia | $1,021.69 | $181.64 |
| Santa Maria, CACalifornia | $986.93 | $180.76 |
| Santa Rosa, CACalifornia | $1,032.29 | $183.25 |
| Stockton, CACalifornia | $934.61 | $176.83 |
| Vallejo, CACalifornia | $1,100.83 | $189.56 |
| Visalia, CACalifornia | $934.61 | $176.83 |
| Yuba City, CACalifornia | $934.61 | $176.83 |
| ColoradoColorado | $914.29 | $178.64 |
| ConnecticutConnecticut | $931.07 | $186.44 |
| DelawareDelaware | $859.85 | $176.75 |
| Fort Lauderdale, FLFlorida | $890.76 | $190.37 |
| Rest of FloridaFlorida | $844.81 | $183.83 |
| Atlanta, GAGeorgia | $884.40 | $181.94 |
| Rest of GeorgiaGeorgia | $793.68 | $176.95 |
| Hawaii, Guam, HIHawaii | $962.90 | $176.78 |
| IowaIowa | $798.73 | $166.10 |
| IdahoIdaho | $803.48 | $167.40 |
| East St. Louis, ILIllinois | $826.13 | $190.04 |
| Rest of IllinoisIllinois | $814.41 | $183.16 |
| Suburban Chicago, ILIllinois | $901.30 | $191.24 |
| IndianaIndiana | $808.77 | $167.84 |
| KansasKansas | $792.30 | $167.27 |
| KentuckyKentucky | $787.43 | $172.77 |
| New Orleans, LALouisiana | $828.50 | $177.90 |
| Rest of LouisianaLouisiana | $785.15 | $173.26 |
| Metropolitan Boston, MAMassachusetts | $1,014.16 | $188.63 |
| Rest of MassachusettsMassachusetts | $907.03 | $178.99 |
| Baltimore area, MDMaryland | $928.05 | $186.18 |
| Rest of MarylandMaryland | $878.22 | $178.53 |
| Rest of MaineMaine | $805.67 | $169.59 |
| Southern Maine, MEMaine | $857.46 | $172.28 |
| Detroit, MIMichigan | $854.05 | $186.85 |
| Rest of MichiganMichigan | $808.03 | $176.78 |
| MinnesotaMinnesota | $880.18 | $168.73 |
| Metropolitan Kansas City, MOMissouri | $824.71 | $175.49 |
| Metropolitan St. Louis, MOMissouri | $834.54 | $176.32 |
| Rest of MissouriMissouri | $768.65 | $172.67 |
| MississippiMississippi | $764.47 | $169.18 |
| MontanaMontana | $869.40 | $178.00 |
| North DakotaNorth Dakota | $860.70 | $169.30 |
| NebraskaNebraska | $804.27 | $166.11 |
| New HampshireNew Hampshire | $897.41 | $177.67 |
| Northern New JerseyNew Jersey | $994.84 | $192.82 |
| Rest of New JerseyNew Jersey | $942.87 | $187.86 |
| New MexicoNew Mexico | $812.00 | $177.99 |
| NevadaNevada | $867.70 | $175.61 |
| NYC suburbs and Long Island, NYNew York | $1,027.66 | $205.58 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $947.35 | $190.27 |
| Queens, NYNew York | $1,016.47 | $199.23 |
| Rest of New YorkNew York | $828.69 | $171.86 |
| OhioOhio | $806.25 | $175.01 |
| OklahomaOklahoma | $788.31 | $170.89 |
| Portland, OROregon | $948.45 | $180.30 |
| Rest of OregonOregon | $862.15 | $173.52 |
| Metropolitan Philadelphia, PAPennsylvania | $904.38 | $184.63 |
| Rest of PennsylvaniaPennsylvania | $808.96 | $174.26 |
| Puerto RicoPuerto Rico | $877.21 | $178.20 |
| Rhode IslandRhode Island | $894.26 | $180.05 |
| South CarolinaSouth Carolina | $811.93 | $173.08 |
| South DakotaSouth Dakota | $859.67 | $168.27 |
| TennesseeTennessee | $796.42 | $167.94 |
| Austin, TXTexas | $910.20 | $178.70 |
| Beaumont, TXTexas | $802.91 | $173.74 |
| Brazoria, TXTexas | $860.66 | $175.49 |
| Dallas, TXTexas | $865.57 | $176.94 |
| Fort Worth, TXTexas | $858.49 | $176.77 |
| Galveston, TXTexas | $862.82 | $176.26 |
| Houston, TXTexas | $870.88 | $184.32 |
| Rest of TexasTexas | $830.90 | $174.76 |
| UtahUtah | $824.28 | $174.36 |
| VirginiaVirginia | $852.74 | $173.09 |
| Virgin Islands, VIUnited States Virgin Islands | $877.21 | $178.20 |
| VermontVermont | $854.89 | $170.41 |
| Rest of WashingtonWashington | $906.12 | $178.08 |
| King County, WAWashington | $1,038.23 | $189.89 |
| WisconsinWisconsin | $828.70 | $166.34 |
| West VirginiaWest Virginia | $780.46 | $179.64 |
| WyomingWyoming | $865.60 | $174.21 |
31626 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.
$759.72
$1,066.38
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 | $973.74 | 1 |
| AL | $772.11 | 1 |
| AR | $759.72 | 1 |
| AZ | $844.76 | 1 |
| CA | $934.61–$1,198.15 | 29 |
| CO | $914.29 | 1 |
| CT | $931.07 | 1 |
| DC | $1,007.45 | 1 |
| DE | $859.85 | 1 |
| FL | $844.81–$921.72 | 3 |
| GA | $793.68–$884.40 | 2 |
| GU | $962.90 | 1 |
| HI | $962.90 | 1 |
| IA | $798.73 | 1 |
| ID | $803.48 | 1 |
| IL | $814.41–$901.30 | 4 |
| IN | $808.77 | 1 |
| KS | $792.30 | 1 |
| KY | $787.43 | 1 |
| LA | $785.15–$828.50 | 2 |
| MA | $907.03–$1,014.16 | 2 |
| MD | $878.22–$1,007.45 | 3 |
| ME | $805.67–$857.46 | 2 |
| MI | $808.03–$854.05 | 2 |
| MN | $880.18 | 1 |
| MO | $768.65–$834.54 | 3 |
| MS | $764.47 | 1 |
| MT | $869.40 | 1 |
| NC | $815.38 | 1 |
| ND | $860.70 | 1 |
| NE | $804.27 | 1 |
| NH | $897.41 | 1 |
| NJ | $942.87–$994.84 | 2 |
| NM | $812.00 | 1 |
| NV | $867.70 | 1 |
| NY | $828.69–$1,027.66 | 5 |
| OH | $806.25 | 1 |
| OK | $788.31 | 1 |
| OR | $862.15–$948.45 | 2 |
| PA | $808.96–$904.38 | 2 |
| PR | $877.21 | 1 |
| RI | $894.26 | 1 |
| SC | $811.93 | 1 |
| SD | $859.67 | 1 |
| TN | $796.42 | 1 |
| TX | $802.91–$910.20 | 8 |
| UT | $824.28 | 1 |
| VA | $852.74–$1,007.45 | 2 |
| VI | $877.21 | 1 |
| VT | $854.89 | 1 |
| WA | $906.12–$1,038.23 | 2 |
| WI | $828.70 | 1 |
| WV | $780.46 | 1 |
| WY | $865.60 | 1 |
How the 31626 rate is calculated
Each of 31626’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 · 31626
RVUs × geographic indexes × conversion factor
Work3.81
3.81 RVUs× 1.000 GPCI
Practice expense21.78
21.78 RVUs× 1.000 GPCI
Malpractice0.44
0.44 RVUs× 1.000 GPCI
Adjusted RVUs
26.0300
Conversion factor
$33.4009
Medicare rate
$869.43
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact North Carolina inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
3,635
- Code
- 31626
- Physician work
- 3.81
- Practice expense
- 21.78
- Malpractice
- 0.44
GPCI2026.csv
83
- Locality
- North Carolina
- Physician work
- 1.000
- Practice expense
- 0.933
- Malpractice
- 0.639
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.81 | × 1.000 | 3.8100 |
| Practice expense | 21.78 | × 0.933 | 20.3207 |
| Malpractice | 0.44 | × 0.639 | 0.2812 |
| Total RVUs | 24.4119 | ||
| Conversion factor | × 33.4009 | ||
Office rate, North Carolina$815.38
Office: (3.81 × 1 + 21.78 × 0.933 + 0.44 × 0.639) × $33.4009 = $815.38
Facility: (3.81 × 1 + 1.08 × 0.933 + 0.44 × 0.639) × $33.4009 = $170.30
Payment rules and modifiers for 31626
The CMS indicators that decide how 31626 is paid alongside other services.
CMS payment indicators · 31626
Fiducial placement, bronchoscopic markers
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
31626 without 51 · national office
$869.43
Fiducial placement, bronchoscopic markers
31626-51 · Second procedure: 50%
$434.72
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
How 31626 has changed in North Carolina
31626 · Office / nonfacility
$815.38
Effective 2026-10-01
The base rate is $125.65 higher than on 2025-10-01, moving from $689.73 to $815.38 (18.2%).
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
$689.73changed to$815.38
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 3.91 changed to 3.81
- Practice expense RVU 18.46 changed to 21.78
- Malpractice RVU 0.48 changed to 0.44
- Practice expense GPCI 0.926 changed to 0.933
- Malpractice GPCI 0.665 changed to 0.639
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$728.15changed to$689.73
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 19.07 changed to 18.46
- Malpractice RVU 0.46 changed to 0.48
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$716.27changed to$728.15
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$749.21changed to$716.27
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 19.28 changed to 19.07
- Malpractice RVU 0.44 changed to 0.46
- Practice expense GPCI 0.927 changed to 0.926
- Malpractice GPCI 0.742 changed to 0.665
January 1, 2023
RVU23A
$795.29changed to$749.21
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 20.18 changed to 19.28
- Malpractice RVU 0.42 changed to 0.44
- Practice expense GPCI 0.928 changed to 0.927
- Malpractice GPCI 0.819 changed to 0.742
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$829.04changed to$795.29
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 21.01 changed to 20.18
- Malpractice RVU 0.43 changed to 0.42
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$806.73changed to$829.04
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 19.49 changed to 21.01
- Malpractice RVU 0.42 changed to 0.43
- Practice expense GPCI 0.930 changed to 0.928
- Malpractice GPCI 0.757 changed to 0.819
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$809.23changed to$806.73
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 19.59 changed to 19.49
- Malpractice RVU 0.44 changed to 0.42
- Practice expense GPCI 0.931 changed to 0.930
- Malpractice GPCI 0.695 changed to 0.757
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$814.29changed to$809.23
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 19.76 changed to 19.59
- Malpractice RVU 0.45 changed to 0.44
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$805.76changed to$814.29
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 19.57 changed to 19.76
- Malpractice RVU 0.44 changed to 0.45
- Malpractice GPCI 0.732 changed to 0.695
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$869.79changed to$805.76
- Conversion factor 35.8043 changed to 35.8887
- Work RVU 4.16 changed to 3.91
- Practice expense RVU 21.26 changed to 19.57
- Malpractice RVU 0.47 changed to 0.44
- Practice expense GPCI 0.930 changed to 0.931
- Malpractice GPCI 0.768 changed to 0.732
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$434.09changed to$869.79
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 8.12 changed to 21.26
- Malpractice RVU 0.48 changed to 0.47
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$431.93changed to$434.09
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$426.45changed to$431.93
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 8.10 changed to 8.12
- Malpractice RVU 0.30 changed to 0.48
- Practice expense GPCI 0.929 changed to 0.930
- Malpractice GPCI 0.732 changed to 0.768
Held through RVU15B.
January 1, 2014
RVU14A
$438.40changed to$426.45
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 9.18 changed to 8.10
- Malpractice RVU 0.31 changed to 0.30
- Practice expense GPCI 0.927 changed to 0.929
- Malpractice GPCI 0.695 changed to 0.732
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $438.40
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $815.38 | $170.30 | RVU26D |
| 2026-07-01 | $815.38 | $170.30 | RVU26C |
| 2026-04-01 | $815.38 | $170.30 | RVU26B |
| 2026-01-01 | $815.38 | $170.30 | RVU26A |
| 2025-10-01 | $689.73 | $180.23 | RVU25D |
| 2025-07-01 | $689.73 | $180.23 | RVU25C |
| 2025-04-01 | $689.73 | $180.23 | RVU25B |
| 2025-01-01 | $689.73 | $180.23 | RVU25A |
| 2024-10-01 | $728.15 | $183.80 | RVU24D |
| 2024-07-01 | $728.15 | $183.80 | RVU24C |
| 2024-04-01 | $728.15 | $183.80 | RVU24B |
| 2024-03-09 | $728.15 | $183.80 | RVU24AR |
| 2024-01-01 | $716.27 | $180.80 | RVU24A |
| 2023-10-01 | $749.21 | $186.91 | RVU23D |
| 2023-07-01 | $749.21 | $186.91 | RVU23C |
| 2023-04-01 | $749.21 | $186.91 | RVU23B |
| 2023-01-01 | $749.21 | $186.91 | RVU23A |
| 2022-10-01 | $795.29 | $192.50 | RVU22D |
| 2022-07-01 | $795.29 | $192.50 | RVU22C |
| 2022-04-01 | $795.29 | $192.50 | RVU22B |
| 2022-01-01 | $795.29 | $192.50 | RVU22A |
| 2021-10-01 | $829.04 | $194.70 | RVU21D |
| 2021-07-01 | $829.04 | $194.70 | RVU21C |
| 2021-04-01 | $829.04 | $194.70 | RVU21B |
| 2021-01-01 | $829.04 | $194.70 | RVU21A |
| 2020-10-01 | $806.73 | $198.57 | RVU20D |
| 2020-07-01 | $806.73 | $198.57 | RVU20C |
| 2020-04-01 | $806.73 | $198.57 | RVU20B |
| 2020-01-01 | $806.73 | $198.57 | RVU20A |
| 2019-10-01 | $809.23 | $197.90 | RVU19D |
| 2019-07-01 | $809.23 | $197.90 | RVU19C |
| 2019-04-01 | $809.23 | $197.90 | RVU19B |
| 2019-01-01 | $809.23 | $197.90 | RVU19A |
| 2018-10-01 | $814.29 | $198.94 | RVU18D |
| 2018-07-01 | $814.29 | $198.94 | RVU18C |
| 2018-04-01 | $814.29 | $198.94 | RVU18B |
| 2018-01-01 | $814.29 | $198.94 | RVU18AR1 |
| 2017-10-01 | $805.76 | $199.00 | RVU17D |
| 2017-07-01 | $805.76 | $199.00 | RVU17C |
| 2017-04-01 | $805.76 | $199.00 | RVU17B |
| 2017-01-01 | $805.76 | $199.00 | RVU17A |
| 2016-10-01 | $869.79 | $210.82 | RVU16D |
| 2016-07-01 | $869.79 | $210.82 | RVU16C |
| 2016-04-01 | $869.79 | $210.82 | RVU16B |
| 2016-01-01 | $869.79 | $210.82 | RVU16A |
| 2015-10-01 | $434.09 | $212.86 | RVU15D |
| 2015-07-01 | $434.09 | $212.86 | RVU15C |
| 2015-04-01 | $431.93 | $211.80 | RVU15B |
| 2015-01-01 | $431.93 | $211.80 | RVU15A |
| 2014-10-01 | $426.45 | $206.48 | RVU14D |
| 2014-07-01 | $426.45 | $206.48 | RVU14C |
| 2014-04-01 | $426.45 | $206.48 | RVU14B |
| 2014-01-01 | $426.45 | $206.48 | RVU14A |
| 2013-10-01 | $438.40 | $200.91 | RVU13D |
| 2013-07-01 | $438.40 | $200.91 | RVU13C |
| 2013-04-01 | $438.40 | $200.91 | RVU13B |
| 2013-01-01 | $438.40 | $200.91 | RVU13AR |
Where the North Carolina rate applies
North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Advance
- Ahoskie
- Alamance
- Albemarle
- Alexis
- Alliance
- Altamahaw
31626 billing questions
Is 31626 reported once per marker?
No. The code includes placement of a single marker or multiple markers; document how many were placed and their locations.
How is 31626 different from navigational bronchoscopy?
31626 represents deployment of fiducial markers. 31627 represents navigational guidance to a bronchoscopic target; both services may be performed during the same procedure.
Can lung biopsy be reported with marker placement?
A distinct lung biopsy may be performed during the same bronchoscopy and considered under the applicable biopsy code. Document the tissue-sampling service separately from marker deployment.
Does the 0-day global period include same-day care?
Yes. Same-day preoperative and postoperative care is included in the procedure's 0-day global period.
How does Medicare pay when other procedures are performed in the same session?
The highest-valued procedure is paid in full, and the other procedures are paid at 50% under the standard multiple procedure reduction.
Can modifier 50 be used when markers are placed on both sides?
No. CMS identifies modifier 50 as inappropriate for this descriptor and anatomy.
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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