CPT code 42808: Pharyngeal lesion treatment, excision or destruction2026 Medicare rate & RVUs in New Mexico
Excision or destruction of a pharyngeal lesion is reported when an otolaryngologist removes or ablates the lesion rather than obtaining a diagnostic sample alone.
In New Mexico, Medicare pays $224.68 for 42808 in the office and $145.66 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 42808 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 42808 covers
An otolaryngologist reports this service for operative removal or destruction of a lesion in the pharynx, such as a mucosal growth on a pharyngeal wall. The procedure may be performed in an operating room or another procedure setting, using the approach suited to the lesion’s location and the surgeon’s method. Tissue may be submitted for pathology when excision produces a specimen; destruction may leave no specimen.
Choose this code when the service treats the lesion by removing or destroying it, not when the service is limited to diagnostic tissue sampling. Document the lesion’s pharyngeal location, the treatment performed, and the extent of removal or destruction; include pathology details when tissue is sent. Related postoperative visits during the 10-day global period are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. 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 New Mexico compares for 42808
Across 109 of 109 payment localities, the office rate for 42808 runs from $208.18 in Arkansas to $302.13 in San Benito County, CA. New Mexico pays $224.68. The RVUs are the same everywhere; the geographic indexes change the dollars.
- New Mexico · this page$224.68
- Los Angeles, CA · California$260.45+$35.77
- Washington, DC area · District of Columbia$265.97+$41.29
- Miami, FL · Florida$258.35+$33.67
- Chicago, IL · Illinois$250.88+$26.20
- Manhattan, NY · New York$269.92+$45.24
- Alaska · Alaska$276.98+$52.30
Other areas in New Mexico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $211.11 | $135.71 |
| ArkansasArkansas | $208.18 | $134.15 |
| ArizonaArizona | $228.26 | $144.75 |
| Bakersfield, CACalifornia | $245.40 | $150.95 |
| Chico, CACalifornia | $244.39 | $149.95 |
| El Centro, CACalifornia | $244.45 | $150.01 |
| Fresno, CACalifornia | $244.39 | $149.95 |
| Hanford, CACalifornia | $244.39 | $149.95 |
| Madera, CACalifornia | $244.39 | $149.95 |
| Merced, CACalifornia | $244.39 | $149.95 |
| Modesto, CACalifornia | $244.39 | $149.95 |
| Napa, CACalifornia | $280.06 | $166.49 |
| Oxnard, CACalifornia | $258.83 | $156.98 |
| Redding, CACalifornia | $244.39 | $149.95 |
| Rest of CaliforniaCalifornia | $244.39 | $149.95 |
| Riverside, CACalifornia | $248.18 | $153.73 |
| Sacramento, CACalifornia | $255.65 | $155.43 |
| Salinas, CACalifornia | $254.68 | $154.81 |
| San Diego, CACalifornia | $260.09 | $157.02 |
| Marin County, CACalifornia | $295.40 | $173.89 |
| San Francisco, CACalifornia | $295.00 | $173.49 |
| San Benito County, CACalifornia | $302.13 | $177.86 |
| Santa Clara County, CACalifornia | $300.50 | $176.24 |
| San Luis Obispo, CACalifornia | $250.69 | $152.53 |
| Santa Cruz, CACalifornia | $262.11 | $157.41 |
| Santa Maria, CACalifornia | $255.48 | $155.00 |
| Santa Rosa, CACalifornia | $264.70 | $158.88 |
| Stockton, CACalifornia | $244.39 | $149.95 |
| Vallejo, CACalifornia | $279.49 | $165.91 |
| Visalia, CACalifornia | $244.39 | $149.95 |
| Yuba City, CACalifornia | $244.39 | $149.95 |
| ColoradoColorado | $242.19 | $150.51 |
| ConnecticutConnecticut | $249.72 | $156.91 |
| DelawareDelaware | $231.92 | $146.78 |
| Fort Lauderdale, FLFlorida | $245.82 | $158.53 |
| Rest of FloridaFlorida | $233.92 | $151.53 |
| Atlanta, GAGeorgia | $239.39 | $151.84 |
| Rest of GeorgiaGeorgia | $220.92 | $144.05 |
| Hawaii, Guam, HIHawaii | $249.60 | $151.62 |
| IowaIowa | $214.99 | $136.14 |
| IdahoIdaho | $216.61 | $137.33 |
| East St. Louis, ILIllinois | $234.62 | $155.34 |
| Rest of IllinoisIllinois | $228.33 | $149.65 |
| Suburban Chicago, ILIllinois | $247.98 | $159.48 |
| IndianaIndiana | $217.79 | $137.90 |
| KansasKansas | $214.63 | $136.73 |
| KentuckyKentucky | $217.24 | $140.63 |
| New Orleans, LALouisiana | $227.43 | $146.34 |
| Rest of LouisianaLouisiana | $217.16 | $140.90 |
| Metropolitan Boston, MAMassachusetts | $264.71 | $161.81 |
| Rest of MassachusettsMassachusetts | $241.08 | $150.34 |
| Baltimore area, MDMaryland | $249.15 | $156.68 |
| Rest of MarylandMaryland | $236.04 | $148.83 |
| Rest of MaineMaine | $218.35 | $139.07 |
| Southern Maine, MEMaine | $228.84 | $143.45 |
| Detroit, MIMichigan | $237.37 | $154.22 |
| Rest of MichiganMichigan | $223.25 | $144.58 |
| MinnesotaMinnesota | $230.49 | $141.81 |
| Metropolitan Kansas City, MOMissouri | $225.28 | $144.36 |
| Metropolitan St. Louis, MOMissouri | $227.48 | $145.44 |
| Rest of MissouriMissouri | $213.98 | $139.70 |
| MississippiMississippi | $211.09 | $136.89 |
| MontanaMontana | $234.45 | $148.28 |
| North CarolinaNorth Carolina | $220.45 | $140.05 |
| North DakotaNorth Dakota | $227.53 | $141.36 |
| NebraskaNebraska | $215.94 | $136.40 |
| New HampshireNew Hampshire | $239.01 | $149.30 |
| Northern New JerseyNew Jersey | $263.50 | $163.53 |
| Rest of New JerseyNew Jersey | $252.13 | $158.02 |
| NevadaNevada | $232.67 | $146.41 |
| NYC suburbs and Long Island, NYNew York | $277.04 | $174.58 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $254.27 | $159.91 |
| Queens, NYNew York | $271.16 | $169.30 |
| Rest of New YorkNew York | $223.69 | $141.82 |
| OhioOhio | $221.84 | $143.16 |
| OklahomaOklahoma | $216.21 | $139.26 |
| Portland, OROregon | $248.94 | $153.20 |
| Rest of OregonOregon | $230.42 | $144.59 |
| Metropolitan Philadelphia, PAPennsylvania | $244.11 | $154.40 |
| Rest of PennsylvaniaPennsylvania | $221.84 | $142.73 |
| Puerto RicoPuerto Rico | $235.91 | $148.79 |
| Rhode IslandRhode Island | $239.49 | $150.47 |
| South CarolinaSouth Carolina | $221.60 | $141.98 |
| South DakotaSouth Dakota | $226.71 | $140.54 |
| TennesseeTennessee | $215.75 | $137.42 |
| Austin, TXTexas | $241.78 | $150.61 |
| Beaumont, TXTexas | $220.48 | $142.06 |
| Brazoria, TXTexas | $231.20 | $145.80 |
| Dallas, TXTexas | $232.92 | $147.09 |
| Fort Worth, TXTexas | $231.61 | $146.64 |
| Galveston, TXTexas | $232.05 | $146.48 |
| Houston, TXTexas | $238.46 | $152.89 |
| Rest of TexasTexas | $225.88 | $144.10 |
| UtahUtah | $224.50 | $143.50 |
| VirginiaVirginia | $228.55 | $143.84 |
| Virgin Islands, VIUnited States Virgin Islands | $235.91 | $148.79 |
| VermontVermont | $227.24 | $141.92 |
| Rest of WashingtonWashington | $240.43 | $149.69 |
| King County, WAWashington | $269.37 | $163.63 |
| WisconsinWisconsin | $220.24 | $137.69 |
| West VirginiaWest Virginia | $220.35 | $145.46 |
| WyomingWyoming | $231.43 | $145.26 |
42808 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.
$208.18
$276.98
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 | $276.98 | 1 |
| AL | $211.11 | 1 |
| AR | $208.18 | 1 |
| AZ | $228.26 | 1 |
| CA | $244.39–$302.13 | 29 |
| CO | $242.19 | 1 |
| CT | $249.72 | 1 |
| DC | $265.97 | 1 |
| DE | $231.92 | 1 |
| FL | $233.92–$258.35 | 3 |
| GA | $220.92–$239.39 | 2 |
| GU | $249.60 | 1 |
| HI | $249.60 | 1 |
| IA | $214.99 | 1 |
| ID | $216.61 | 1 |
| IL | $228.33–$250.88 | 4 |
| IN | $217.79 | 1 |
| KS | $214.63 | 1 |
| KY | $217.24 | 1 |
| LA | $217.16–$227.43 | 2 |
| MA | $241.08–$264.71 | 2 |
| MD | $236.04–$265.97 | 3 |
| ME | $218.35–$228.84 | 2 |
| MI | $223.25–$237.37 | 2 |
| MN | $230.49 | 1 |
| MO | $213.98–$227.48 | 3 |
| MS | $211.09 | 1 |
| MT | $234.45 | 1 |
| NC | $220.45 | 1 |
| ND | $227.53 | 1 |
| NE | $215.94 | 1 |
| NH | $239.01 | 1 |
| NJ | $252.13–$263.50 | 2 |
| NM | $224.68 | 1 |
| NV | $232.67 | 1 |
| NY | $223.69–$277.04 | 5 |
| OH | $221.84 | 1 |
| OK | $216.21 | 1 |
| OR | $230.42–$248.94 | 2 |
| PA | $221.84–$244.11 | 2 |
| PR | $235.91 | 1 |
| RI | $239.49 | 1 |
| SC | $221.60 | 1 |
| SD | $226.71 | 1 |
| TN | $215.75 | 1 |
| TX | $220.48–$241.78 | 8 |
| UT | $224.50 | 1 |
| VA | $228.55–$265.97 | 2 |
| VI | $235.91 | 1 |
| VT | $227.24 | 1 |
| WA | $240.43–$269.37 | 2 |
| WI | $220.24 | 1 |
| WV | $220.35 | 1 |
| WY | $231.43 | 1 |
How the 42808 rate is calculated
Each of 42808’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 · 42808
RVUs × geographic indexes × conversion factor
Work2.29
2.29 RVUs× 1.000 GPCI
Practice expense4.38
4.38 RVUs× 1.000 GPCI
Malpractice0.35
0.35 RVUs× 1.000 GPCI
Adjusted RVUs
7.0200
Conversion factor
$33.4009
Medicare rate
$234.47
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact New Mexico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
5,074
- Code
- 42808
- Physician work
- 2.29
- Practice expense
- 4.38
- Malpractice
- 0.35
GPCI2026.csv
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.29 | × 1.000 | 2.2900 |
| Practice expense | 4.38 | × 0.917 | 4.0165 |
| Malpractice | 0.35 | × 1.201 | 0.4204 |
| Total RVUs | 6.7268 | ||
| Conversion factor | × 33.4009 | ||
Office rate, New Mexico$224.68
Office: (2.29 × 1 + 4.38 × 0.917 + 0.35 × 1.201) × $33.4009 = $224.68
Facility: (2.29 × 1 + 1.8 × 0.917 + 0.35 × 1.201) × $33.4009 = $145.66
Payment rules and modifiers for 42808
42808 has a 10-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 42808
Pharyngeal lesion treatment, excision or destruction
| 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 · 42808
Pharyngeal lesion treatment, excision or destruction
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
42808 without 51 · national office
$234.47
Pharyngeal lesion treatment, excision or destruction
42808-51 · Second procedure: 50%
$117.24
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 42808 has changed in New Mexico
42808 · Office / nonfacility
$224.68
Effective 2026-10-01
The base rate is $8.22 higher than on 2025-10-01, moving from $216.46 to $224.68 (3.8%).
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
$216.46changed to$224.68
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 2.35 changed to 2.29
- Practice expense RVU 4.33 changed to 4.38
- Practice expense GPCI 0.908 changed to 0.917
- Malpractice GPCI 1.172 changed to 1.201
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$222.97changed to$216.46
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 4.35 changed to 4.33
- Malpractice RVU 0.34 changed to 0.35
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$219.33changed to$222.97
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$225.46changed to$219.33
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 4.33 changed to 4.35
- Practice expense GPCI 0.902 changed to 0.908
- Malpractice GPCI 1.169 changed to 1.172
January 1, 2023
RVU23A
$225.80changed to$225.46
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 4.23 changed to 4.33
- Malpractice RVU 0.33 changed to 0.34
- Practice expense GPCI 0.896 changed to 0.902
- Malpractice GPCI 1.166 changed to 1.169
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$223.83changed to$225.80
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 4.12 changed to 4.23
- Malpractice RVU 0.32 changed to 0.33
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$225.24changed to$223.83
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 3.86 changed to 4.12
- Practice expense GPCI 0.908 changed to 0.896
- Malpractice GPCI 1.207 changed to 1.166
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$227.10changed to$225.24
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 3.83 changed to 3.86
- Malpractice RVU 0.34 changed to 0.32
- Practice expense GPCI 0.921 changed to 0.908
- Malpractice GPCI 1.247 changed to 1.207
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$223.75changed to$227.10
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 3.75 changed to 3.83
- Malpractice RVU 0.33 changed to 0.34
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$225.49changed to$223.75
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 3.83 changed to 3.75
- Malpractice RVU 0.34 changed to 0.33
- Practice expense GPCI 0.920 changed to 0.921
- Malpractice GPCI 1.204 changed to 1.247
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$226.93changed to$225.49
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 3.91 changed to 3.83
- Practice expense GPCI 0.919 changed to 0.920
- Malpractice GPCI 1.161 changed to 1.204
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$226.10changed to$226.93
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 3.86 changed to 3.91
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$224.97changed to$226.10
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$224.96changed to$224.97
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 3.94 changed to 3.86
- Malpractice RVU 0.29 changed to 0.34
- Practice expense GPCI 0.918 changed to 0.919
- Malpractice GPCI 1.079 changed to 1.161
Held through RVU15B.
January 1, 2014
RVU14A
$226.32changed to$224.96
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 4.37 changed to 3.94
- Malpractice RVU 0.30 changed to 0.29
- Practice expense GPCI 0.916 changed to 0.918
- Malpractice GPCI 0.997 changed to 1.079
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $226.32
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $224.68 | $145.66 | RVU26D |
| 2026-07-01 | $224.68 | $145.66 | RVU26C |
| 2026-04-01 | $224.68 | $145.66 | RVU26B |
| 2026-01-01 | $224.68 | $145.66 | RVU26A |
| 2025-10-01 | $216.46 | $158.89 | RVU25D |
| 2025-07-01 | $216.46 | $158.89 | RVU25C |
| 2025-04-01 | $216.46 | $158.89 | RVU25B |
| 2025-01-01 | $216.46 | $158.89 | RVU25A |
| 2024-10-01 | $222.97 | $162.22 | RVU24D |
| 2024-07-01 | $222.97 | $162.22 | RVU24C |
| 2024-04-01 | $222.97 | $162.22 | RVU24B |
| 2024-03-09 | $222.97 | $162.22 | RVU24AR |
| 2024-01-01 | $219.33 | $159.57 | RVU24A |
| 2023-10-01 | $225.46 | $163.71 | RVU23D |
| 2023-07-01 | $225.46 | $163.71 | RVU23C |
| 2023-04-01 | $225.46 | $163.71 | RVU23B |
| 2023-01-01 | $225.46 | $163.71 | RVU23A |
| 2022-10-01 | $225.80 | $163.17 | RVU22D |
| 2022-07-01 | $225.80 | $163.17 | RVU22C |
| 2022-04-01 | $225.80 | $163.17 | RVU22B |
| 2022-01-01 | $225.80 | $163.17 | RVU22A |
| 2021-10-01 | $223.83 | $160.67 | RVU21D |
| 2021-07-01 | $223.83 | $160.67 | RVU21C |
| 2021-04-01 | $223.83 | $160.67 | RVU21B |
| 2021-01-01 | $223.83 | $160.67 | RVU21A |
| 2020-10-01 | $225.24 | $163.96 | RVU20D |
| 2020-07-01 | $225.24 | $163.96 | RVU20C |
| 2020-04-01 | $225.24 | $163.96 | RVU20B |
| 2020-01-01 | $225.24 | $163.96 | RVU20A |
| 2019-10-01 | $227.10 | $165.69 | RVU19D |
| 2019-07-01 | $227.10 | $165.69 | RVU19C |
| 2019-04-01 | $227.10 | $165.69 | RVU19B |
| 2019-01-01 | $227.10 | $165.69 | RVU19A |
| 2018-10-01 | $223.75 | $163.74 | RVU18D |
| 2018-07-01 | $223.75 | $163.74 | RVU18C |
| 2018-04-01 | $223.75 | $163.74 | RVU18B |
| 2018-01-01 | $223.75 | $163.74 | RVU18AR1 |
| 2017-10-01 | $225.49 | $164.73 | RVU17D |
| 2017-07-01 | $225.49 | $164.73 | RVU17C |
| 2017-04-01 | $225.49 | $164.73 | RVU17B |
| 2017-01-01 | $225.49 | $164.73 | RVU17A |
| 2016-10-01 | $226.93 | $165.40 | RVU16D |
| 2016-07-01 | $226.93 | $165.40 | RVU16C |
| 2016-04-01 | $226.93 | $165.40 | RVU16B |
| 2016-01-01 | $226.93 | $165.40 | RVU16A |
| 2015-10-01 | $226.10 | $165.33 | RVU15D |
| 2015-07-01 | $226.10 | $165.33 | RVU15C |
| 2015-04-01 | $224.97 | $164.51 | RVU15B |
| 2015-01-01 | $224.97 | $164.51 | RVU15A |
| 2014-10-01 | $224.96 | $163.14 | RVU14D |
| 2014-07-01 | $224.96 | $163.14 | RVU14C |
| 2014-04-01 | $224.96 | $163.14 | RVU14B |
| 2014-01-01 | $224.96 | $163.14 | RVU14A |
| 2013-10-01 | $226.32 | $160.88 | RVU13D |
| 2013-07-01 | $226.32 | $160.88 | RVU13C |
| 2013-04-01 | $226.32 | $160.88 | RVU13B |
| 2013-01-01 | $226.32 | $160.88 | RVU13AR |
Where the New Mexico rate applies
New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.
- Abeytas
- Abiquiu
- Acomita Lake
- Adelino
- Agua Fria
- Alamillo
- Alamo
- Alamogordo
42808 billing questions
When should this code be used instead of a pharyngeal biopsy code?
Use this code when the lesion is removed or destroyed as treatment. A biopsy code describes diagnostic tissue sampling rather than lesion treatment.
Can pathology be billed separately when tissue is removed?
The surgeon’s lesion treatment and the pathologist’s examination of submitted tissue are distinct services. This code describes the procedure, not the laboratory examination.
Does modifier 50 apply if lesions are treated on both sides?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures in that session are subject to the standard 50% multiple-procedure reduction.
Are assistant surgeons or co-surgeons payable?
Medicare does not pay an assistant at surgery for this code. 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
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