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Billing code 43499Medicare rate & RVUs

Compare 43499 physician payment amounts across CMS localities, including office and facility settings.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.6K Medicare services in 2024

Medicare rate · 43499

Code 43499

Swap in your local Medicare rate.

Work RVUs
0
Total RVUs
0.00
Global days
YYY

National rate · 2026

—

Not priced in the facility setting.

See every locality for 43499 → · 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.

On this page 6 sections
  1. Medicare rate
  2. By payment locality
  3. Rate map
  4. How it’s calculated
  5. Payment rules
  6. Sources

Where 43499 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

43499 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
Alaska*UnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
AtlantaUnavailableUnavailable
AustinUnavailableUnavailable
BakersfieldUnavailableUnavailable
Baltimore/Surr. CntysUnavailableUnavailable
BeaumontUnavailableUnavailable
BrazoriaUnavailableUnavailable

43499 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
43499 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 43499 rate is calculated

Each of 43499’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 · 43499

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 0.00Practice expense 0.00Malpractice 0.00

0.0000 adjusted RVUs×$33.4009 conversion factor=$0.00

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 43499

The CMS indicators that decide how 43499 is paid alongside other services.

CMS payment indicators · 43499

Code 43499

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)1Not paid (statutory restriction).
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

43499 without 51 · national facility

$0.00

43499-51 · 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

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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Current Medicare rates for every code you bill at your locality, with what changed since last quarter.

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