Billing code 97026Medicare rate & RVUs in Oklahoma

Compare 97026 physician payment amounts across CMS localities, including office and facility settings.

CMS RVU26DEffective Oct 1, 20261 payment locality30.7K Medicare services in 2024

Medicare pays $6.14 for 97026 in the office in Oklahoma (Oklahoma). Which amount applies depends on the service address.

$6.14Office (non-facility)
—Hospital or facility

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

We’ll open 97026 for the payment locality that covers the ZIP.

On this page 5 sections
  1. Rate in Oklahoma
  2. By payment locality
  3. How it’s calculated
  4. Payment rules
  5. Sources

97026 in Oklahoma

97026 office and facility rates by payment locality
Payment localityOfficeFacility
Oklahoma$6.14Unavailable

How the 97026 rate is calculated

Each of 97026’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 · 97026

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 0.06Practice expense 0.13Malpractice 0.01

0.2000 adjusted RVUs×$33.4009 conversion factor=$6.68

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

Payment rules and modifiers for 97026

The CMS indicators that decide how 97026 is paid alongside other services.

CMS payment indicators · 97026

Code 97026

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures5Therapy reduction: practice expense of the second and later units is reduced.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical7Therapy service: the split doesn’t apply.

What modifiers do to the payment

Modifier CQ · payment effect

With and without the modifier

97026 without CQ · national office

$6.68

97026-CQ · Allowed amount unchanged

$6.68

Medicare cuts its own payment by 15% after the patient’s 20% coinsurance; the allowed amount stays the same. On $100 allowed: $20 coinsurance, then Medicare pays $68 instead of $80.

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
RVUs for 97026PPRRVU2026_Oct_nonQPP.csv, line 12,850 (RVU26D)
Geographic factors for OklahomaGPCI2026.csv, line 86 (RVU26D)

Open CMS sourceHow we calculate rates

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