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CPT code 39499: Mediastinal procedure, unlisted procedure2026 Medicare rate & RVUs

Reports an unlisted surgical procedure involving the mediastinum when no specific CPT code describes the service performed.

CMS RVU26DEffective Oct 1, 2026109 payment localities36 Medicare services in 2024

Medicare rate · 39499

Mediastinal procedure, unlisted procedure

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
YYY

National rate · 2026

—

Not priced in the facility setting.

See every locality for 39499 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 39499 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 39499 covers

CPT 39499 represents an unlisted surgical procedure involving the mediastinum, the central compartment of the chest between the lungs. It is selected when no listed CPT code specifically describes the mediastinal service performed. It should not replace a listed code that accurately describes the procedure, such as mediastinoscopy with biopsy or mediastinoscopy with lymph node biopsy. The code identifies an unlisted service rather than a particular named operation.

Medicare assigns status C, or carrier priced: CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim. The contractor also sets the global period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the other procedures are subject to the standard 50% reduction. Report the code for the unlisted mediastinal procedure performed.

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.

Where 39499 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

39499 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

39499 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

View every state and territory as a table
39499 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 39499 rate is calculated

Each of 39499’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 · 39499

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense0.00

0.00 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

0.0000

Conversion factor

$33.4009

Medicare rate

$0.00

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 39499

The CMS indicators that decide how 39499 is paid alongside other services.

CMS payment indicators · 39499

Mediastinal procedure, unlisted procedure

RuleCMS valueWhat it means
Global periodYYYThe Medicare contractor sets the global period.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)1Permitted with supporting documentation.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

39499 without 51 · national facility

$0.00

Mediastinal procedure, unlisted procedure

39499-51 · Second procedure: 50%

$0.00

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%).

When to use modifier 51

39499 compared with similar codes

Compare codes · National

39499 vs 39401 vs 39402: Medicare rates

Office or facility?

  • 39499

    Mediastinal procedure, unlisted procedure0 wRVU

    Not priced

  • 39401

    Mediastinoscopy, mediastinal tissue biopsy5.3 wRVU

    Not priced

  • 39402

    Mediastinoscopy, lymph node biopsy7.07 wRVU

    Not priced

How to choose

39401MediastinoscopyMediastinal tissue biopsy
39401 describes mediastinoscopy with biopsy. Use 39499 only when the mediastinal procedure performed is not described by a listed code.
39402MediastinoscopyLymph node biopsy
39402 describes mediastinoscopy with lymph node biopsy. A different mediastinal procedure without a matching listed code may be reported with 39499.

Codes related to 39499

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 39499
CodeHow it relatesNational office range
Used instead
39401Mediastinoscopy, mediastinal tissue biopsyUse for mediastinoscopy with biopsy when that specific procedure describes the service.No office rate
39402Mediastinoscopy, lymph node biopsyUse for mediastinoscopy with lymph node biopsy when that specific procedure describes the service.No office rate

39499 billing questions

When should 39499 be used instead of a listed mediastinal code?

Use it when no specific CPT code describes the mediastinal procedure performed. If a listed code accurately describes the service, report that code instead.

How does 39499 differ from 39401 and 39402?

Those codes describe specific mediastinoscopy procedures with biopsy. Use 39499 only when the procedure performed is not described by a listed code.

What should documentation describe for 39499?

Describe the procedure performed, the mediastinal anatomy involved, the approach, and the work done so the unlisted service is clear.

How does Medicare price 39499?

Medicare assigns status C, so CMS publishes no national payment and the Medicare Administrative Contractor sets payment for each claim.

Who sets the global period for 39499?

The Medicare Administrative Contractor sets the global period.

What happens when 39499 is performed with another procedure in the same session?

The highest-valued procedure is paid in full, and the other procedures are subject to the standard 50% reduction.

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

Open CMS sourceHow we calculate rates

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