CPT code 42100: Palate biopsy, tissue sampling2026 Medicare rate & RVUs in Wisconsin
Report this service when a clinician takes a tissue sample from the roof of the mouth for evaluation of a suspicious oral lesion.
In Wisconsin, Medicare pays $141.63 for 42100 in the office and $95.23 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 42100 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 42100 covers
This service covers taking a tissue sample from the palate, the roof of the mouth, for diagnostic examination. Otolaryngologists and oral and maxillofacial surgeons commonly perform it in an office, procedure room, or operating room when assessing a suspicious ulcer, patch, or mass. The work is sampling tissue for diagnosis, rather than removing a palate lesion as definitive treatment.
Select the code when the documented service is a palatal biopsy; record the sampled site, the finding or concern prompting the procedure, and the tissue submitted. CMS assigns a 10-day minor-procedure global period, so related postoperative visits during that interval are included. If multiple procedures subject to the standard reduction are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Palatal anatomy makes modifier 50 inappropriate. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery billing 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 Wisconsin compares for 42100
Across 109 of 109 payment localities, the office rate for 42100 runs from $133.02 in Arkansas to $196.06 in San Benito County, CA. Wisconsin pays $141.63. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Wisconsin · this page$141.63
- Los Angeles, CA · California$167.99+$26.36
- Washington, DC area · District of Columbia$170.77+$29.14
- Miami, FL · Florida$163.24+$21.61
- Chicago, IL · Illinois$158.56+$16.93
- Manhattan, NY · New York$172.46+$30.83
- Alaska · Alaska$175.95+$34.32
Other areas in Wisconsin first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $134.92 | $92.54 |
| ArkansasArkansas | $133.02 | $91.42 |
| ArizonaArizona | $146.02 | $99.09 |
| Bakersfield, CACalifornia | $158.02 | $104.94 |
| Chico, CACalifornia | $157.49 | $104.41 |
| El Centro, CACalifornia | $157.52 | $104.44 |
| Fresno, CACalifornia | $157.49 | $104.41 |
| Hanford, CACalifornia | $157.49 | $104.41 |
| Madera, CACalifornia | $157.49 | $104.41 |
| Merced, CACalifornia | $157.49 | $104.41 |
| Modesto, CACalifornia | $157.49 | $104.41 |
| Napa, CACalifornia | $181.46 | $117.63 |
| Oxnard, CACalifornia | $167.06 | $109.82 |
| Redding, CACalifornia | $157.49 | $104.41 |
| Rest of CaliforniaCalifornia | $157.49 | $104.41 |
| Riverside, CACalifornia | $159.44 | $106.36 |
| Sacramento, CACalifornia | $165.00 | $108.68 |
| Salinas, CACalifornia | $164.38 | $108.25 |
| San Diego, CACalifornia | $168.06 | $110.13 |
| Marin County, CACalifornia | $191.75 | $123.46 |
| San Francisco, CACalifornia | $191.54 | $123.25 |
| San Benito County, CACalifornia | $196.06 | $126.22 |
| Santa Clara County, CACalifornia | $195.23 | $125.39 |
| San Luis Obispo, CACalifornia | $161.77 | $106.61 |
| Santa Cruz, CACalifornia | $169.51 | $110.67 |
| Santa Maria, CACalifornia | $164.95 | $108.48 |
| Santa Rosa, CACalifornia | $171.21 | $111.73 |
| Stockton, CACalifornia | $157.49 | $104.41 |
| Vallejo, CACalifornia | $181.17 | $117.34 |
| Visalia, CACalifornia | $157.49 | $104.41 |
| Yuba City, CACalifornia | $157.49 | $104.41 |
| ColoradoColorado | $155.56 | $104.03 |
| ConnecticutConnecticut | $159.79 | $107.62 |
| DelawareDelaware | $148.39 | $100.54 |
| Fort Lauderdale, FLFlorida | $156.12 | $107.06 |
| Rest of FloridaFlorida | $148.61 | $102.31 |
| Atlanta, GAGeorgia | $152.90 | $103.70 |
| Rest of GeorgiaGeorgia | $140.37 | $97.17 |
| Hawaii, Guam, HIHawaii | $161.08 | $106.01 |
| IowaIowa | $137.88 | $93.57 |
| IdahoIdaho | $138.84 | $94.28 |
| East St. Louis, ILIllinois | $148.10 | $103.55 |
| Rest of IllinoisIllinois | $144.70 | $100.48 |
| Suburban Chicago, ILIllinois | $157.61 | $107.87 |
| IndianaIndiana | $139.61 | $94.72 |
| KansasKansas | $137.43 | $93.65 |
| KentuckyKentucky | $138.41 | $95.36 |
| New Orleans, LALouisiana | $144.92 | $99.34 |
| Rest of LouisianaLouisiana | $138.27 | $95.41 |
| Metropolitan Boston, MAMassachusetts | $170.44 | $112.61 |
| Rest of MassachusettsMassachusetts | $154.74 | $103.74 |
| Baltimore area, MDMaryland | $159.37 | $107.40 |
| Rest of MarylandMaryland | $151.12 | $102.10 |
| Rest of MaineMaine | $139.73 | $95.18 |
| Southern Maine, MEMaine | $146.86 | $98.86 |
| Detroit, MIMichigan | $150.61 | $103.87 |
| Rest of MichiganMichigan | $142.09 | $97.87 |
| MinnesotaMinnesota | $148.62 | $98.79 |
| Metropolitan Kansas City, MOMissouri | $143.76 | $98.28 |
| Metropolitan St. Louis, MOMissouri | $145.20 | $99.10 |
| Rest of MissouriMissouri | $136.08 | $94.33 |
| MississippiMississippi | $134.57 | $92.87 |
| MontanaMontana | $149.96 | $101.53 |
| North CarolinaNorth Carolina | $141.13 | $95.94 |
| North DakotaNorth Dakota | $146.40 | $97.97 |
| NebraskaNebraska | $138.57 | $93.86 |
| New HampshireNew Hampshire | $153.30 | $102.88 |
| Northern New JerseyNew Jersey | $169.10 | $112.92 |
| Rest of New JerseyNew Jersey | $161.49 | $108.60 |
| New MexicoNew Mexico | $142.92 | $98.51 |
| NevadaNevada | $149.07 | $100.59 |
| NYC suburbs and Long Island, NYNew York | $176.78 | $119.19 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $162.69 | $109.66 |
| Queens, NYNew York | $173.59 | $116.34 |
| Rest of New YorkNew York | $143.21 | $97.20 |
| OhioOhio | $141.36 | $97.14 |
| OklahomaOklahoma | $137.98 | $94.73 |
| Portland, OROregon | $160.19 | $106.38 |
| Rest of OregonOregon | $147.79 | $99.55 |
| Metropolitan Philadelphia, PAPennsylvania | $156.01 | $105.59 |
| Rest of PennsylvaniaPennsylvania | $141.48 | $97.02 |
| Puerto RicoPuerto Rico | $150.97 | $102.01 |
| Rhode IslandRhode Island | $153.45 | $103.42 |
| South CarolinaSouth Carolina | $141.50 | $96.75 |
| South DakotaSouth Dakota | $145.98 | $97.55 |
| TennesseeTennessee | $138.13 | $94.10 |
| Austin, TXTexas | $155.15 | $103.91 |
| Beaumont, TXTexas | $140.59 | $96.51 |
| Brazoria, TXTexas | $148.11 | $100.11 |
| Dallas, TXTexas | $149.12 | $100.88 |
| Fort Worth, TXTexas | $148.20 | $100.45 |
| Galveston, TXTexas | $148.59 | $100.50 |
| Houston, TXTexas | $151.89 | $103.80 |
| Rest of TexasTexas | $144.31 | $98.35 |
| UtahUtah | $143.38 | $97.86 |
| VirginiaVirginia | $146.51 | $98.90 |
| Virgin Islands, VIUnited States Virgin Islands | $150.97 | $102.01 |
| VermontVermont | $146.00 | $98.06 |
| Rest of WashingtonWashington | $154.39 | $103.39 |
| King County, WAWashington | $173.69 | $114.26 |
| West VirginiaWest Virginia | $139.52 | $97.44 |
| WyomingWyoming | $148.41 | $99.98 |
42100 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.
$133.02
$176.78
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 | $175.95 | 1 |
| AL | $134.92 | 1 |
| AR | $133.02 | 1 |
| AZ | $146.02 | 1 |
| CA | $157.49–$196.06 | 29 |
| CO | $155.56 | 1 |
| CT | $159.79 | 1 |
| DC | $170.77 | 1 |
| DE | $148.39 | 1 |
| FL | $148.61–$163.24 | 3 |
| GA | $140.37–$152.90 | 2 |
| GU | $161.08 | 1 |
| HI | $161.08 | 1 |
| IA | $137.88 | 1 |
| ID | $138.84 | 1 |
| IL | $144.70–$158.56 | 4 |
| IN | $139.61 | 1 |
| KS | $137.43 | 1 |
| KY | $138.41 | 1 |
| LA | $138.27–$144.92 | 2 |
| MA | $154.74–$170.44 | 2 |
| MD | $151.12–$170.77 | 3 |
| ME | $139.73–$146.86 | 2 |
| MI | $142.09–$150.61 | 2 |
| MN | $148.62 | 1 |
| MO | $136.08–$145.20 | 3 |
| MS | $134.57 | 1 |
| MT | $149.96 | 1 |
| NC | $141.13 | 1 |
| ND | $146.40 | 1 |
| NE | $138.57 | 1 |
| NH | $153.30 | 1 |
| NJ | $161.49–$169.10 | 2 |
| NM | $142.92 | 1 |
| NV | $149.07 | 1 |
| NY | $143.21–$176.78 | 5 |
| OH | $141.36 | 1 |
| OK | $137.98 | 1 |
| OR | $147.79–$160.19 | 2 |
| PA | $141.48–$156.01 | 2 |
| PR | $150.97 | 1 |
| RI | $153.45 | 1 |
| SC | $141.50 | 1 |
| SD | $145.98 | 1 |
| TN | $138.13 | 1 |
| TX | $140.59–$155.15 | 8 |
| UT | $143.38 | 1 |
| VA | $146.51–$170.77 | 2 |
| VI | $150.97 | 1 |
| VT | $146.00 | 1 |
| WA | $154.39–$173.69 | 2 |
| WI | $141.63 | 1 |
| WV | $139.52 | 1 |
| WY | $148.41 | 1 |
How the 42100 rate is calculated
Each of 42100’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 · 42100
RVUs × geographic indexes × conversion factor
Work1.33
1.33 RVUs× 1.000 GPCI
Practice expense2.98
2.98 RVUs× 1.000 GPCI
Malpractice0.18
0.18 RVUs× 1.000 GPCI
Adjusted RVUs
4.4900
Conversion factor
$33.4009
Medicare rate
$149.97
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Wisconsin inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
4,993
- Code
- 42100
- Physician work
- 1.33
- Practice expense
- 2.98
- Malpractice
- 0.18
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.33 | × 1.000 | 1.3300 |
| Practice expense | 2.98 | × 0.958 | 2.8548 |
| Malpractice | 0.18 | × 0.308 | 0.0554 |
| Total RVUs | 4.2403 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Wisconsin$141.63
Office: (1.33 × 1 + 2.98 × 0.958 + 0.18 × 0.308) × $33.4009 = $141.63
Facility: (1.33 × 1 + 1.53 × 0.958 + 0.18 × 0.308) × $33.4009 = $95.23
Payment rules and modifiers for 42100
42100 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 42100
Palate biopsy, tissue sampling
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 010 | Minor procedure: the day of the procedure plus 10 days after are 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) | 1 | Not paid (statutory restriction). |
| 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) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 42100
Palate biopsy, tissue sampling
10-day global period ends
Oct 11, 2026
Covers Oct 1, 2026 through Oct 11, 2026 (11 days).
Visit on Oct 31, 2026
After the global period ends: visits and procedures are billed normally.
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
42100 without 51 · national office
$149.97
Palate biopsy, tissue sampling
42100-51 · Second procedure: 50%
$74.99
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 42100 has changed in Wisconsin
42100 · Office / nonfacility
$141.63
Effective 2026-10-01
The base rate is $7.70 higher than on 2025-10-01, moving from $133.93 to $141.63 (5.7%).
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
$133.93changed to$141.63
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 1.36 changed to 1.33
- Practice expense RVU 2.85 changed to 2.98
- Malpractice RVU 0.16 changed to 0.18
- Practice expense GPCI 0.957 changed to 0.958
- Malpractice GPCI 0.331 changed to 0.308
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$138.68changed to$133.93
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 2.87 changed to 2.85
- Malpractice RVU 0.18 changed to 0.16
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$136.42changed to$138.68
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$140.72changed to$136.42
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 2.88 changed to 2.87
- Practice expense GPCI 0.950 changed to 0.957
- Malpractice GPCI 0.314 changed to 0.331
January 1, 2023
RVU23A
$142.14changed to$140.72
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 2.86 changed to 2.88
- Practice expense GPCI 0.942 changed to 0.950
- Malpractice GPCI 0.296 changed to 0.314
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$142.46changed to$142.14
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 2.84 changed to 2.86
- Malpractice RVU 0.16 changed to 0.18
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$143.41changed to$142.46
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 2.70 changed to 2.84
- Practice expense GPCI 0.949 changed to 0.942
- Malpractice GPCI 0.322 changed to 0.296
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$145.11changed to$143.41
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 2.71 changed to 2.70
- Malpractice RVU 0.21 changed to 0.16
- Practice expense GPCI 0.957 changed to 0.949
- Malpractice GPCI 0.347 changed to 0.322
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$145.29changed to$145.11
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 2.72 changed to 2.71
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$147.29changed to$145.29
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 2.77 changed to 2.72
- Practice expense GPCI 0.956 changed to 0.957
- Malpractice GPCI 0.457 changed to 0.347
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$149.03changed to$147.29
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 2.81 changed to 2.77
- Practice expense GPCI 0.955 changed to 0.956
- Malpractice GPCI 0.566 changed to 0.457
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$149.57changed to$149.03
- Conversion factor 35.9335 changed to 35.8043
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$148.83changed to$149.57
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$148.89changed to$148.83
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 2.82 changed to 2.81
- Malpractice RVU 0.17 changed to 0.21
- Practice expense GPCI 0.958 changed to 0.955
- Malpractice GPCI 0.557 changed to 0.566
Held through RVU15B.
January 1, 2014
RVU14A
$150.87changed to$148.89
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 3.10 changed to 2.82
- Malpractice RVU 0.18 changed to 0.17
- Practice expense GPCI 0.960 changed to 0.958
- Malpractice GPCI 0.547 changed to 0.557
Held through RVU14B, RVU14C, RVU14D.
October 1, 2013
RVU13D
No ratechanged to$150.87
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $141.63 | $95.23 | RVU26D |
| 2026-07-01 | $141.63 | $95.23 | RVU26C |
| 2026-04-01 | $141.63 | $95.23 | RVU26B |
| 2026-01-01 | $141.63 | $95.23 | RVU26A |
| 2025-10-01 | $133.93 | $102.35 | RVU25D |
| 2025-07-01 | $133.93 | $102.35 | RVU25C |
| 2025-04-01 | $133.93 | $102.35 | RVU25B |
| 2025-01-01 | $133.93 | $102.35 | RVU25A |
| 2024-10-01 | $138.68 | $104.28 | RVU24D |
| 2024-07-01 | $138.68 | $104.28 | RVU24C |
| 2024-04-01 | $138.68 | $104.28 | RVU24B |
| 2024-03-09 | $138.68 | $104.28 | RVU24AR |
| 2024-01-01 | $136.42 | $102.57 | RVU24A |
| 2023-10-01 | $140.72 | $104.66 | RVU23D |
| 2023-07-01 | $140.72 | $104.66 | RVU23C |
| 2023-04-01 | $140.72 | $104.66 | RVU23B |
| 2023-01-01 | $140.72 | $104.66 | RVU23A |
| 2022-10-01 | $142.14 | $104.00 | RVU22D |
| 2022-07-01 | $142.14 | $104.00 | RVU22C |
| 2022-04-01 | $142.14 | $104.00 | RVU22B |
| 2022-01-01 | $142.14 | $104.00 | RVU22A |
| 2021-10-01 | $142.46 | $102.68 | RVU21D |
| 2021-07-01 | $142.46 | $102.68 | RVU21C |
| 2021-04-01 | $142.46 | $102.68 | RVU21B |
| 2021-01-01 | $142.46 | $102.68 | RVU21A |
| 2020-10-01 | $143.41 | $104.37 | RVU20D |
| 2020-07-01 | $143.41 | $104.37 | RVU20C |
| 2020-04-01 | $143.41 | $104.37 | RVU20B |
| 2020-01-01 | $143.41 | $104.37 | RVU20A |
| 2019-10-01 | $145.11 | $105.79 | RVU19D |
| 2019-07-01 | $145.11 | $105.79 | RVU19C |
| 2019-04-01 | $145.11 | $105.79 | RVU19B |
| 2019-01-01 | $145.11 | $105.79 | RVU19A |
| 2018-10-01 | $145.29 | $106.36 | RVU18D |
| 2018-07-01 | $145.29 | $106.36 | RVU18C |
| 2018-04-01 | $145.29 | $106.36 | RVU18B |
| 2018-01-01 | $145.29 | $106.36 | RVU18AR1 |
| 2017-10-01 | $147.29 | $107.49 | RVU17D |
| 2017-07-01 | $147.29 | $107.49 | RVU17C |
| 2017-04-01 | $147.29 | $107.49 | RVU17B |
| 2017-01-01 | $147.29 | $107.49 | RVU17A |
| 2016-10-01 | $149.03 | $109.37 | RVU16D |
| 2016-07-01 | $149.03 | $109.37 | RVU16C |
| 2016-04-01 | $149.03 | $109.37 | RVU16B |
| 2016-01-01 | $149.03 | $109.37 | RVU16A |
| 2015-10-01 | $149.57 | $109.42 | RVU15D |
| 2015-07-01 | $149.57 | $109.42 | RVU15C |
| 2015-04-01 | $148.83 | $108.88 | RVU15B |
| 2015-01-01 | $148.83 | $108.88 | RVU15A |
| 2014-10-01 | $148.89 | $109.08 | RVU14D |
| 2014-07-01 | $148.89 | $109.08 | RVU14C |
| 2014-04-01 | $148.89 | $109.08 | RVU14B |
| 2014-01-01 | $148.89 | $109.08 | RVU14A |
| 2013-10-01 | $150.87 | $108.74 | RVU13D |
| 2013-07-01 | Rate data unavailable | Rate data unavailable | RVU13C |
| 2013-04-01 | Rate data unavailable | Rate data unavailable | RVU13B |
| 2013-01-01 | Rate data unavailable | Rate data unavailable | RVU13AR |
Where the Wisconsin rate applies
Wisconsin is a Medicare payment area, not a city. Our Census mapping connects it to 807 cities and communities in Wisconsin. Some span more than one payment area; confirm with the service ZIP.
- Abbotsford
- Abrams
- Adams
- Adell
- Albany
- Algoma
- Allens Grove
- Allenton
42100 billing questions
When should this code be chosen instead of a palate excision code?
Use this code when the service is tissue sampling for diagnosis. When the procedure removes a palate lesion, consider the applicable excision code instead.
Can modifier 50 be reported for biopsies on both sides of the palate?
No. CMS identifies bilateral adjustment as inappropriate for this code because of the descriptor or anatomy.
Are related postoperative visits separately reported during the global period?
Related postoperative visits during the 10-day global period are included in the procedure.
What documentation supports reporting a palatal biopsy?
Document the palate site sampled, the clinical finding or concern that prompted sampling, and that tissue was obtained for diagnostic evaluation.
Can an assistant surgeon or co-surgeon be billed?
Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing are not permitted.
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
Show the CMS file lines behind this rate
Fee sheets
Put 42100 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Build my fee sheet