CPT code 51720: Bladder instillation, antineoplastic agent2026 Medicare rate & RVUs in Vermont
Report this service when a clinician delivers an antineoplastic agent into the bladder through a catheter for intravesical treatment, such as BCG therapy.
In Vermont, Medicare pays $89.44 for 51720 in the office and $36.20 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 51720 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 51720 covers
A urologist or other qualified clinician places a catheter and delivers an antineoplastic agent into the bladder, commonly in an office or outpatient setting. Intravesical BCG and chemotherapy are typical treatments for bladder cancer, including treatment after tumor resection or for carcinoma in situ. The service covers the drug’s delivery and retention in the bladder; it is distinct from endoscopic biopsy, lesion destruction, or simple bladder irrigation.
Select 51720 for the therapeutic instillation, not for catheter placement alone. Document the agent and administration details, including the retention instructions when available. The drug may be reported separately with the applicable drug code; catheter placement integral to the instillation is not separately reported as 51701. The 0-day global includes same-day preoperative and postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, 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 Vermont compares for 51720
Across 109 of 109 payment localities, the office rate for 51720 runs from $81.64 in Arkansas to $119.70 in San Benito County, CA. Vermont pays $89.44. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Vermont · this page$89.44
- Los Angeles, CA · California$102.72+$13.28
- Washington, DC area · District of Columbia$104.44+$15.00
- Miami, FL · Florida$99.92+$10.48
- Chicago, IL · Illinois$97.11+$7.67
- Manhattan, NY · New York$105.51+$16.07
- Alaska · Alaska$108.28+$18.84
Other areas in Vermont first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $82.78 | $35.73 |
| ArkansasArkansas | $81.64 | $35.45 |
| ArizonaArizona | $89.47 | $37.36 |
| Bakersfield, CACalifornia | $96.69 | $37.76 |
| Chico, CACalifornia | $96.37 | $37.43 |
| El Centro, CACalifornia | $96.39 | $37.45 |
| Fresno, CACalifornia | $96.37 | $37.43 |
| Hanford, CACalifornia | $96.37 | $37.43 |
| Madera, CACalifornia | $96.37 | $37.43 |
| Merced, CACalifornia | $96.37 | $37.43 |
| Modesto, CACalifornia | $96.37 | $37.43 |
| Napa, CACalifornia | $110.85 | $39.97 |
| Oxnard, CACalifornia | $102.14 | $38.58 |
| Redding, CACalifornia | $96.37 | $37.43 |
| Rest of CaliforniaCalifornia | $96.37 | $37.43 |
| Riverside, CACalifornia | $97.56 | $38.63 |
| Sacramento, CACalifornia | $100.92 | $38.37 |
| Salinas, CACalifornia | $100.53 | $38.21 |
| San Diego, CACalifornia | $102.74 | $38.42 |
| Marin County, CACalifornia | $117.07 | $41.25 |
| San Francisco, CACalifornia | $116.95 | $41.13 |
| San Benito County, CACalifornia | $119.70 | $42.15 |
| Santa Clara County, CACalifornia | $119.19 | $41.64 |
| San Luis Obispo, CACalifornia | $98.94 | $37.69 |
| Santa Cruz, CACalifornia | $103.60 | $38.26 |
| Santa Maria, CACalifornia | $100.87 | $38.17 |
| Santa Rosa, CACalifornia | $104.63 | $38.59 |
| Stockton, CACalifornia | $96.37 | $37.43 |
| Vallejo, CACalifornia | $110.67 | $39.79 |
| Visalia, CACalifornia | $96.37 | $37.43 |
| Yuba City, CACalifornia | $96.37 | $37.43 |
| ColoradoColorado | $95.21 | $38.00 |
| ConnecticutConnecticut | $97.80 | $39.88 |
| DelawareDelaware | $90.91 | $37.78 |
| Fort Lauderdale, FLFlorida | $95.60 | $41.12 |
| Rest of FloridaFlorida | $91.07 | $39.66 |
| Atlanta, GAGeorgia | $93.63 | $39.00 |
| Rest of GeorgiaGeorgia | $86.10 | $38.13 |
| Hawaii, Guam, HIHawaii | $98.50 | $37.35 |
| IowaIowa | $84.56 | $35.35 |
| IdahoIdaho | $85.13 | $35.66 |
| East St. Louis, ILIllinois | $90.80 | $41.32 |
| Rest of IllinoisIllinois | $88.72 | $39.62 |
| Suburban Chicago, ILIllinois | $96.50 | $41.27 |
| IndianaIndiana | $85.60 | $35.75 |
| KansasKansas | $84.29 | $35.68 |
| KentuckyKentucky | $84.90 | $37.10 |
| New Orleans, LALouisiana | $88.82 | $38.22 |
| Rest of LouisianaLouisiana | $84.82 | $37.23 |
| Metropolitan Boston, MAMassachusetts | $104.21 | $40.00 |
| Rest of MassachusettsMassachusetts | $94.73 | $38.10 |
| Baltimore area, MDMaryland | $97.54 | $39.84 |
| Rest of MarylandMaryland | $92.55 | $38.13 |
| Rest of MaineMaine | $85.68 | $36.21 |
| Southern Maine, MEMaine | $89.96 | $36.67 |
| Detroit, MIMichigan | $92.28 | $40.39 |
| Rest of MichiganMichigan | $87.12 | $38.03 |
| MinnesotaMinnesota | $91.00 | $35.66 |
| Metropolitan Kansas City, MOMissouri | $88.12 | $37.63 |
| Metropolitan St. Louis, MOMissouri | $88.99 | $37.80 |
| Rest of MissouriMissouri | $83.51 | $37.15 |
| MississippiMississippi | $82.58 | $36.28 |
| MontanaMontana | $91.85 | $38.07 |
| North CarolinaNorth Carolina | $86.52 | $36.35 |
| North DakotaNorth Dakota | $89.67 | $35.89 |
| NebraskaNebraska | $84.96 | $35.33 |
| New HampshireNew Hampshire | $93.84 | $37.86 |
| Northern New JerseyNew Jersey | $103.46 | $41.08 |
| Rest of New JerseyNew Jersey | $98.84 | $40.12 |
| New MexicoNew Mexico | $87.63 | $38.32 |
| NevadaNevada | $91.30 | $37.47 |
| NYC suburbs and Long Island, NYNew York | $108.12 | $44.18 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $99.58 | $40.70 |
| Queens, NYNew York | $106.17 | $42.61 |
| Rest of New YorkNew York | $87.77 | $36.69 |
| OhioOhio | $86.68 | $37.58 |
| OklahomaOklahoma | $84.64 | $36.61 |
| Portland, OROregon | $98.00 | $38.26 |
| Rest of OregonOregon | $90.52 | $36.96 |
| Metropolitan Philadelphia, PAPennsylvania | $95.52 | $39.54 |
| Rest of PennsylvaniaPennsylvania | $86.75 | $37.38 |
| Puerto RicoPuerto Rico | $92.46 | $38.09 |
| Rhode IslandRhode Island | $93.97 | $38.42 |
| South CarolinaSouth Carolina | $86.76 | $37.07 |
| South DakotaSouth Dakota | $89.41 | $35.64 |
| TennesseeTennessee | $84.71 | $35.83 |
| Austin, TXTexas | $94.96 | $38.06 |
| Beaumont, TXTexas | $86.21 | $37.28 |
| Brazoria, TXTexas | $90.73 | $37.44 |
| Dallas, TXTexas | $91.35 | $37.79 |
| Fort Worth, TXTexas | $90.80 | $37.77 |
| Galveston, TXTexas | $91.03 | $37.63 |
| Houston, TXTexas | $93.04 | $39.64 |
| Rest of TexasTexas | $88.45 | $37.41 |
| UtahUtah | $87.89 | $37.34 |
| VirginiaVirginia | $89.76 | $36.89 |
| Virgin Islands, VIUnited States Virgin Islands | $92.46 | $38.09 |
| Rest of WashingtonWashington | $94.51 | $37.89 |
| King County, WAWashington | $106.17 | $40.19 |
| WisconsinWisconsin | $86.80 | $35.28 |
| West VirginiaWest Virginia | $85.60 | $38.87 |
| WyomingWyoming | $90.90 | $37.12 |
51720 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.
$81.64
$108.28
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 | $108.28 | 1 |
| AL | $82.78 | 1 |
| AR | $81.64 | 1 |
| AZ | $89.47 | 1 |
| CA | $96.37–$119.70 | 29 |
| CO | $95.21 | 1 |
| CT | $97.80 | 1 |
| DC | $104.44 | 1 |
| DE | $90.91 | 1 |
| FL | $91.07–$99.92 | 3 |
| GA | $86.10–$93.63 | 2 |
| GU | $98.50 | 1 |
| HI | $98.50 | 1 |
| IA | $84.56 | 1 |
| ID | $85.13 | 1 |
| IL | $88.72–$97.11 | 4 |
| IN | $85.60 | 1 |
| KS | $84.29 | 1 |
| KY | $84.90 | 1 |
| LA | $84.82–$88.82 | 2 |
| MA | $94.73–$104.21 | 2 |
| MD | $92.55–$104.44 | 3 |
| ME | $85.68–$89.96 | 2 |
| MI | $87.12–$92.28 | 2 |
| MN | $91.00 | 1 |
| MO | $83.51–$88.99 | 3 |
| MS | $82.58 | 1 |
| MT | $91.85 | 1 |
| NC | $86.52 | 1 |
| ND | $89.67 | 1 |
| NE | $84.96 | 1 |
| NH | $93.84 | 1 |
| NJ | $98.84–$103.46 | 2 |
| NM | $87.63 | 1 |
| NV | $91.30 | 1 |
| NY | $87.77–$108.12 | 5 |
| OH | $86.68 | 1 |
| OK | $84.64 | 1 |
| OR | $90.52–$98.00 | 2 |
| PA | $86.75–$95.52 | 2 |
| PR | $92.46 | 1 |
| RI | $93.97 | 1 |
| SC | $86.76 | 1 |
| SD | $89.41 | 1 |
| TN | $84.71 | 1 |
| TX | $86.21–$94.96 | 8 |
| UT | $87.89 | 1 |
| VA | $89.76–$104.44 | 2 |
| VI | $92.46 | 1 |
| VT | $89.44 | 1 |
| WA | $94.51–$106.17 | 2 |
| WI | $86.80 | 1 |
| WV | $85.60 | 1 |
| WY | $90.90 | 1 |
How the 51720 rate is calculated
Each of 51720’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 · 51720
RVUs × geographic indexes × conversion factor
Work0.85
0.85 RVUs× 1.000 GPCI
Practice expense1.79
1.79 RVUs× 1.000 GPCI
Malpractice0.11
0.11 RVUs× 1.000 GPCI
Adjusted RVUs
2.7500
Conversion factor
$33.4009
Medicare rate
$91.85
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Vermont inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
6,052
- Code
- 51720
- Physician work
- 0.85
- Practice expense
- 1.79
- Malpractice
- 0.11
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.85 | × 1.000 | 0.8500 |
| Practice expense | 1.79 | × 0.990 | 1.7721 |
| Malpractice | 0.11 | × 0.506 | 0.0557 |
| Total RVUs | 2.6778 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Vermont$89.44
Office: (0.85 × 1 + 1.79 × 0.99 + 0.11 × 0.506) × $33.4009 = $89.44
Facility: (0.85 × 1 + 0.18 × 0.99 + 0.11 × 0.506) × $33.4009 = $36.20
Payment rules and modifiers for 51720
The CMS indicators that decide how 51720 is paid alongside other services.
CMS payment indicators · 51720
Bladder instillation, antineoplastic agent
| 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) | 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. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
51720 without 51 · national office
$91.85
Bladder instillation, antineoplastic agent
51720-51 · Second procedure: 50%
$45.93
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 51720 has changed in Vermont
51720 · Office / nonfacility
$89.44
Effective 2026-10-01
The base rate is $5.33 higher than on 2025-10-01, moving from $84.11 to $89.44 (6.3%).
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
$84.11changed to$89.44
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.87 changed to 0.85
- Practice expense RVU 1.68 changed to 1.79
- Malpractice RVU 0.12 changed to 0.11
- Practice expense GPCI 0.993 changed to 0.990
- Malpractice GPCI 0.518 changed to 0.506
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$86.39changed to$84.11
- Conversion factor 33.2875 changed to 32.3465
- Malpractice RVU 0.11 changed to 0.12
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$84.98changed to$86.39
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$86.91changed to$84.98
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 1.64 changed to 1.68
- Practice expense GPCI 0.997 changed to 0.993
- Malpractice GPCI 0.543 changed to 0.518
January 1, 2023
RVU23A
$88.19changed to$86.91
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 1.62 changed to 1.64
- Malpractice RVU 0.10 changed to 0.11
- Practice expense GPCI 1.001 changed to 0.997
- Malpractice GPCI 0.569 changed to 0.543
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$89.62changed to$88.19
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 1.64 changed to 1.62
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$84.95changed to$89.62
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 1.42 changed to 1.64
- Malpractice RVU 0.09 changed to 0.10
- Practice expense GPCI 1.008 changed to 1.001
- Malpractice GPCI 0.582 changed to 0.569
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$85.96changed to$84.95
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 1.44 changed to 1.42
- Practice expense GPCI 1.015 changed to 1.008
- Malpractice GPCI 0.595 changed to 0.582
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$86.23changed to$85.96
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 1.45 changed to 1.44
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$89.47changed to$86.23
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 1.55 changed to 1.45
- Practice expense GPCI 1.010 changed to 1.015
- Malpractice GPCI 0.639 changed to 0.595
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$109.38changed to$89.47
- Conversion factor 35.8043 changed to 35.8887
- Work RVU 1.50 changed to 0.87
- Practice expense RVU 1.44 changed to 1.55
- Malpractice RVU 0.16 changed to 0.09
- Practice expense GPCI 1.004 changed to 1.010
- Malpractice GPCI 0.682 changed to 0.639
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$109.77changed to$109.38
- Conversion factor 35.9335 changed to 35.8043
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$109.23changed to$109.77
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$107.79changed to$109.23
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 1.42 changed to 1.44
- Malpractice RVU 0.13 changed to 0.16
- Practice expense GPCI 1.006 changed to 1.004
- Malpractice GPCI 0.618 changed to 0.682
Held through RVU15B.
January 1, 2014
RVU14A
No ratechanged to$107.79
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $89.44 | $36.20 | RVU26D |
| 2026-07-01 | $89.44 | $36.20 | RVU26C |
| 2026-04-01 | $89.44 | $36.20 | RVU26B |
| 2026-01-01 | $89.44 | $36.20 | RVU26A |
| 2025-10-01 | $84.11 | $40.43 | RVU25D |
| 2025-07-01 | $84.11 | $40.43 | RVU25C |
| 2025-04-01 | $84.11 | $40.43 | RVU25B |
| 2025-01-01 | $84.11 | $40.43 | RVU25A |
| 2024-10-01 | $86.39 | $41.10 | RVU24D |
| 2024-07-01 | $86.39 | $41.10 | RVU24C |
| 2024-04-01 | $86.39 | $41.10 | RVU24B |
| 2024-03-09 | $86.39 | $41.10 | RVU24AR |
| 2024-01-01 | $84.98 | $40.43 | RVU24A |
| 2023-10-01 | $86.91 | $41.98 | RVU23D |
| 2023-07-01 | $86.91 | $41.98 | RVU23C |
| 2023-04-01 | $86.91 | $41.98 | RVU23B |
| 2023-01-01 | $86.91 | $41.98 | RVU23A |
| 2022-10-01 | $88.19 | $42.47 | RVU22D |
| 2022-07-01 | $88.19 | $42.47 | RVU22C |
| 2022-04-01 | $88.19 | $42.47 | RVU22B |
| 2022-01-01 | $88.19 | $42.47 | RVU22A |
| 2021-10-01 | $89.62 | $42.82 | RVU21D |
| 2021-07-01 | $89.62 | $42.82 | RVU21C |
| 2021-04-01 | $89.62 | $42.82 | RVU21B |
| 2021-01-01 | $89.62 | $42.82 | RVU21A |
| 2020-10-01 | $84.95 | $44.20 | RVU20D |
| 2020-07-01 | $84.95 | $44.20 | RVU20C |
| 2020-04-01 | $84.95 | $44.20 | RVU20B |
| 2020-01-01 | $84.95 | $44.20 | RVU20A |
| 2019-10-01 | $85.96 | $44.62 | RVU19D |
| 2019-07-01 | $85.96 | $44.62 | RVU19C |
| 2019-04-01 | $85.96 | $44.62 | RVU19B |
| 2019-01-01 | $85.96 | $44.62 | RVU19A |
| 2018-10-01 | $86.23 | $53.34 | RVU18D |
| 2018-07-01 | $86.23 | $53.34 | RVU18C |
| 2018-04-01 | $86.23 | $53.34 | RVU18B |
| 2018-01-01 | $86.23 | $53.34 | RVU18AR1 |
| 2017-10-01 | $89.47 | $65.91 | RVU17D |
| 2017-07-01 | $89.47 | $65.91 | RVU17C |
| 2017-04-01 | $89.47 | $65.91 | RVU17B |
| 2017-01-01 | $89.47 | $65.91 | RVU17A |
| 2016-10-01 | $109.38 | $80.62 | RVU16D |
| 2016-07-01 | $109.38 | $80.62 | RVU16C |
| 2016-04-01 | $109.38 | $80.62 | RVU16B |
| 2016-01-01 | $109.38 | $80.62 | RVU16A |
| 2015-10-01 | $109.77 | $80.91 | RVU15D |
| 2015-07-01 | $109.77 | $80.91 | RVU15C |
| 2015-04-01 | $109.23 | $80.51 | RVU15B |
| 2015-01-01 | $109.23 | $80.51 | RVU15A |
| 2014-10-01 | $107.79 | $79.68 | RVU14D |
| 2014-07-01 | $107.79 | $79.68 | RVU14C |
| 2014-04-01 | $107.79 | $79.68 | RVU14B |
| 2014-01-01 | $107.79 | $79.68 | RVU14A |
| 2013-10-01 | Rate data unavailable | Rate data unavailable | 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 Vermont rate applies
Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.
- Albany
- Alburgh
- Algiers
- Arlington
- Ascutney
- Bakersfield
- Barnet
- Barre
51720 billing questions
How is 51720 different from bladder irrigation or catheter insertion?
51720 represents therapeutic delivery of an antineoplastic agent into the bladder. Irrigation alone or catheter placement without that treatment does not meet the service; do not separately report 51701 for catheter placement integral to the instillation.
Can the drug be billed separately?
The drug may be reported separately with its applicable HCPCS drug code when the drug was supplied and billing requirements are met. 51720 represents the instillation service.
Should modifier 50 be appended for treatment of both sides?
No. Modifier 50 is inappropriate for this bladder service.
How does Medicare handle 51720 with another procedure in the same session?
The highest-valued procedure is paid in full, and other procedures in that session are subject to the standard multiple-procedure reduction. Same-day preoperative and postoperative care is included in the 0-day global period.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 51720. 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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