CPT code 970262026 Medicare rate & RVUs in Rhode Island
CPT 97026 pays $6.83 in the office in Rhode Island under the 2026 Medicare fee schedule, 2% above the national rate. Locality math, rate history and payer benchmarks.
Medicare pays $6.83 for 97026 in the office in Rhode Island (Rhode Island). Which amount applies depends on the service address.
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 5 sections
97026 in Rhode Island
| Payment locality | Office | Facility |
|---|---|---|
| Rhode Island | $6.83 | Unavailable |
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
Work0.06
0.06 RVUs× 1.000 GPCI
Practice expense0.13
0.13 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
0.2000
Conversion factor
$33.4009
Medicare rate
$6.68
Every GPCI starts 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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 5 | Therapy reduction: practice expense of the second and later units is reduced. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 7 | Therapy 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
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