FeeBase
Log inGet started
Menu

Medicare · Multiple procedure payment reduction

One visit. Several units. What changes?

For eligible therapy services, Medicare pays one unit’s practice expense in full and reduces the rest by 50%. Compare the base fees with the reduced amount for your payment locality.

Enter all eligible therapy services furnished to the same patient, by the same provider or group, on the same day. Office/nonfacility PFS rates only, for available dates in 2025–2026. No patient details are needed.

Build the therapy visit

Enter billable units, not minutes. This calculator does not decide which services or units may be billed.

Therapy MPPR codes only (CMS indicator 5). CQ/CO assistant adjustments, other modifiers, bundling and coverage rules are not calculated.

Worked example · live CMS rates

What MPPR changes

Chicago · 2026-10-05 · Non-QP · Office / nonfacility

Before MPPR

$95.05

After MPPR

$81.27

The practice-expense reduction lowers this example by $13.78. Work and malpractice components remain unchanged.

  1. 97110 × 2 units

    $45.56

    No full-rate units + 2 reduced units at $22.78 each.

    Only the practice-expense component is reduced.

    Source rows

    PPRRVU2026_Oct_nonQPP.csv · row 12859
    GPCI2026.csv · row 48

  2. 97530 × 1 unit

    $35.71

    1 full-rate unit at $35.71.

    This line has a unit with the highest practice-expense amount.

    Source rows

    PPRRVU2026_Oct_nonQPP.csv · row 12889
    GPCI2026.csv · row 48

RVU26D · Effective 2026-10-01. CMS rate source →

Amounts precede assistant adjustments, patient cost sharing and sequestration. They are not a coverage or claim-payment determination.

The largest fee is not necessarily first

The unit with the highest practice-expense amount keeps its full rate. Ranking by the total fee can give the wrong answer when the work components differ.

One code can still have reduced units

Three units of one eligible code receive one full-rate unit and two reduced units. Splitting those units over multiple rows does not create extra full-rate units.

Rounded rates, then unit totals

Each full or reduced unit is calculated from the component RVUs, geographic indices and conversion factor, then rounded to cents. Those unit amounts are multiplied and added.

Sources and scope

This is a therapy MPPR estimate, not a full claim adjudicator. It requires every line to have a supported base rate and therapy indicator. If any line is unresolved, totals are withheld rather than treating it as zero. Tied practice-expense amounts use the first entered unit.

CMS therapy payment policy →Browse therapy rates →How FeeBase calculates rates →

Need this code list in a reusable fee sheet? Explore early access →