CPT codes, descriptors and other data are copyright 2020 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply. MPFS Status C Code Fee Updates Last Updated 8/11/2021 1 Jurisdiction E MPFS Status C Quarterly Fee Updates · April 2021 Updates · July 2021 Updates · August 2021 Updates April 2021 Updates Notes Indicators and Definitions # These amounts apply when service is performed in a facility setting. C The payment for the technical component is capped at the OPPS amount. Limiting charge applies to unassigned claims by non-participating providers. For Dates of Service on/after 1/1/2021 and processed on/after 1/5/2021 State CMS MPFS Locality Notes Procedure Code Modifier Par Fee NonPar Fee Limiting Charge CA 05 0055T $225.29 $214.03 $246.13 CA 06 0055T $225.29 $214.03 $246.13 CA 07 0055T $225.29 $214.03 $246.13 CA 09 0055T $227.67 $216.29 $248.73 CA 51 0055T $219.13 $208.17 $239.40 CA 52 0055T $224.46 $213.24 $245.22 CA 53 0055T $219.13 $208.17 $239.40 CA 54 0055T $214.71 $203.97 $234.57 CA 55 0055T $209.43 $198.96 $228.80 CA 56 0055T $209.43 $198.96 $228.80 CA 57 0055T $209.43 $198.96 $228.80 CA 58 0055T $209.43 $198.96 $228.80 CA 59 0055T $209.43 $198.96 $228.80 CA 60 0055T $209.43 $198.96 $228.80 CA 61 0055T $209.43 $198.96 $228.80 CA 62 0055T $220.71 $209.67 $241.13 CA 63 0055T $210.95 $200.40 $230.46 CA 64 0055T $215.14 $204.38 $235.04 CA 65 0055T $228.11 $216.70 $249.21 CA 66 0055T $216.72 $205.88 $236.77 CA 67 0055T $215.58 $204.80 $235.52 CA 68 0055T $209.43 $198.96 $228.80 CA 69 0055T $209.43 $198.96 $228.80 CA 70 0055T $209.43 $198.96 $228.80
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CPT codes, descriptors and other data are copyright 2020 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.MPFS Status C Code Fee Updates Last Updated 8/11/2021
1
Jurisdiction E MPFS Status C Quarterly Fee Updates· April 2021 Updates · July 2021 Updates · August 2021 Updates
April 2021 Updates
Notes Indicators and Definitions# These amounts apply when service is performed in a facility setting.C The payment for the technical component is capped at the OPPS amount.Limiting charge applies to unassigned claims by non-participating providers.
For Dates of Service on/after 1/1/2021 and processed on/after 1/5/2021
CPT codes, descriptors and other data are copyright 2020 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.MPFS Status C Code Fee Updates Last Updated 8/11/2021
For Dates of Service on/after 1/1/2021 and processed on/after 2/3/2021
State
CMS MPFS
Locality NotesProcedure
Code Modifier Par FeeNonPar
FeeLimiting Charge
CA 05 93241 $177.88 $168.99 $194.33 CA 05 93243 $102.82 $97.68 $112.33 CA 05 93245 $145.04 $137.79 $158.46 CA 05 93247 $105.14 $99.88 $114.87 CA 06 93241 $177.88 $168.99 $194.33 CA 06 93243 $102.82 $97.68 $112.33 CA 06 93245 $145.04 $137.79 $158.46 CA 06 93247 $105.14 $99.88 $114.87 CA 07 93241 $177.88 $168.99 $194.33 CA 07 93243 $102.82 $97.68 $112.33 CA 07 93245 $145.04 $137.79 $158.46 CA 07 93247 $105.14 $99.88 $114.87 CA 09 93241 $177.85 $168.96 $194.30 CA 09 93243 $106.89 $101.55 $116.78 CA 09 93245 $149.96 $142.46 $163.83 CA 09 93247 $109.30 $103.84 $119.41 CA 51 93241 $173.53 $164.85 $189.58 CA 51 93243 $94.53 $89.80 $103.27 CA 51 93245 $135.22 $128.46 $147.73 CA 51 93247 $96.66 $91.83 $105.60 CA 52 93241 $181.21 $172.15 $197.97 CA 52 93243 $101.52 $96.44 $110.91
CPT codes, descriptors and other data are copyright 2020 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.MPFS Status C Code Fee Updates Last Updated 8/11/2021
3
State
CMS MPFS
Locality NotesProcedure
Code Modifier Par FeeNonPar
FeeLimiting Charge
CA 52 93245 $143.46 $136.29 $156.73 CA 52 93247 $103.81 $98.62 $113.41 CA 53 93241 $173.53 $164.85 $189.58 CA 53 93243 $94.53 $89.80 $103.27 CA 53 93245 $135.22 $128.46 $147.73 CA 53 93247 $96.66 $91.83 $105.60 CA 54 93241 $182.55 $173.42 $199.44 CA 54 93243 $82.98 $78.83 $90.66 CA 54 93245 $122.81 $116.67 $134.17 CA 54 93247 $84.84 $80.60 $92.69 CA 55 93241 $171.03 $162.48 $186.85 CA 55 93243 $82.80 $78.66 $90.46 CA 55 93245 $122.35 $116.23 $133.67 CA 55 93247 $84.65 $80.42 $92.48 CA 56 93241 $171.03 $162.48 $186.85 CA 56 93243 $82.80 $78.66 $90.46 CA 56 93245 $122.35 $116.23 $133.67 CA 56 93247 $84.65 $80.42 $92.48 CA 57 93241 $171.03 $162.48 $186.85 CA 57 93243 $82.80 $78.66 $90.46 CA 57 93245 $122.35 $116.23 $133.67 CA 57 93247 $84.65 $80.42 $92.48 CA 58 93241 $171.03 $162.48 $186.85 CA 58 93243 $82.80 $78.66 $90.46 CA 58 93245 $122.35 $116.23 $133.67 CA 58 93247 $84.65 $80.42 $92.48 CA 59 93241 $171.03 $162.48 $186.85 CA 59 93243 $82.80 $78.66 $90.46 CA 59 93245 $122.35 $116.23 $133.67 CA 59 93247 $84.65 $80.42 $92.48 CA 60 93241 $171.03 $162.48 $186.85 CA 60 93243 $82.80 $78.66 $90.46 CA 60 93245 $122.35 $116.23 $133.67 CA 60 93247 $84.65 $80.42 $92.48 CA 61 93241 $171.03 $162.48 $186.85 CA 61 93243 $82.80 $78.66 $90.46 CA 61 93245 $122.35 $116.23 $133.67
CPT codes, descriptors and other data are copyright 2020 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.MPFS Status C Code Fee Updates Last Updated 8/11/2021
4
State
CMS MPFS
Locality NotesProcedure
Code Modifier Par FeeNonPar
FeeLimiting Charge
CA 61 93247 $84.65 $80.42 $92.48 CA 62 93241 $117.39 $111.52 $128.25 CA 62 93243 $81.91 $77.81 $89.49 CA 62 93245 $121.46 $115.39 $132.70 CA 62 93247 $83.77 $79.58 $91.52 CA 63 93241 $172.34 $163.72 $188.28 CA 63 93243 $83.87 $79.68 $91.63 CA 63 93245 $123.79 $117.60 $135.24 CA 63 93247 $85.75 $81.46 $93.68 CA 64 93241 $176.20 $167.39 $192.50 CA 64 93243 $87.17 $82.81 $95.23 CA 64 93245 $128.00 $121.60 $139.84 CA 64 93247 $89.13 $84.67 $97.37 CA 65 93241 $192.83 $183.19 $210.67 CA 65 93243 $103.14 $97.98 $112.68 CA 65 93245 $145.60 $138.32 $159.07 CA 65 93247 $105.46 $100.19 $115.22 CA 66 93241 $180.32 $171.30 $197.00 CA 66 93243 $91.70 $87.12 $100.18 CA 66 93245 $132.18 $125.57 $144.41 CA 66 93247 $93.76 $89.07 $102.43 CA 67 93241 $178.63 $169.70 $195.15 CA 67 93243 $90.01 $85.51 $98.34 CA 67 93245 $130.41 $123.89 $142.47 CA 67 93247 $92.03 $87.43 $100.54 CA 68 93241 $171.03 $162.48 $186.85 CA 68 93243 $82.80 $78.66 $90.46 CA 68 93245 $122.35 $116.23 $133.67 CA 68 93247 $84.65 $80.42 $92.48 CA 69 93241 $171.03 $162.48 $186.85 CA 69 93243 $82.80 $78.66 $90.46 CA 69 93245 $122.35 $116.23 $133.67 CA 69 93247 $84.65 $80.42 $92.48 CA 70 93241 $171.03 $162.48 $186.85 CA 70 93243 $82.80 $78.66 $90.46 CA 70 93245 $122.35 $116.23 $133.67 CA 70 93247 $84.65 $80.42 $92.48
CPT codes, descriptors and other data are copyright 2020 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.MPFS Status C Code Fee Updates Last Updated 8/11/2021
5
State
CMS MPFS
Locality NotesProcedure
Code Modifier Par FeeNonPar
FeeLimiting Charge
CA 75 93241 $171.03 $162.48 $186.85 CA 75 93243 $82.80 $78.66 $90.46 CA 75 93245 $122.35 $116.23 $133.67 CA 75 93247 $84.65 $80.42 $92.48 CA 17 93241 $193.42 $183.75 $211.31 CA 17 93243 $91.77 $87.18 $100.26 CA 17 93245 $131.72 $125.13 $143.90 CA 17 93247 $93.83 $89.14 $102.51 CA 18 93241 $196.93 $187.08 $215.15 CA 18 93243 $91.52 $86.94 $99.99 CA 18 93245 $132.19 $125.58 $144.42 CA 18 93247 $93.57 $88.89 $102.23 CA 26 93241 $196.93 $187.08 $215.15 CA 26 93243 $91.52 $86.94 $99.99 CA 26 93245 $132.19 $125.58 $144.42 CA 26 93247 $93.57 $88.89 $102.23 CA 71 93241 $173.04 $164.39 $189.05 CA 71 93243 $82.83 $78.69 $90.49 CA 71 93245 $122.38 $116.26 $133.70 CA 71 93247 $84.69 $80.46 $92.52 CA 72 93241 $179.39 $170.42 $195.98 CA 72 93243 $88.97 $84.52 $97.20 CA 72 93245 $129.08 $122.63 $141.02 CA 72 93247 $90.97 $86.42 $99.38 CA 73 93241 $172.57 $163.94 $188.53 CA 73 93243 $84.33 $80.11 $92.13 CA 73 93245 $123.95 $117.75 $135.42 CA 73 93247 $86.22 $81.91 $94.20 CA 74 93241 $178.38 $169.46 $194.88 CA 74 93243 $89.86 $85.37 $98.17 CA 74 93245 $130.11 $123.60 $142.15 CA 74 93247 $91.88 $87.29 $100.38 HI 01 93241 $184.83 $175.59 $201.93 HI 01 93243 $88.92 $84.47 $97.15 HI 01 93245 $128.15 $121.74 $140.00 HI 01 93247 $90.91 $86.36 $99.32 NV 00 93241 $245.20 $232.94 $267.88
CPT codes, descriptors and other data are copyright 2020 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.MPFS Status C Code Fee Updates Last Updated 8/11/2021
CPT codes, descriptors and other data are copyright 2020 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.MPFS Status C Code Fee Updates Last Updated 8/11/2021
CPT codes, descriptors and other data are copyright 2020 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.MPFS Status C Code Fee Updates Last Updated 8/11/2021
8
July 2021Updates
Notes Indicators and Definitions# These amounts apply when service is performed in a facility setting.C The payment for the technical component is capped at the OPPS amount.Limiting charge applies to unassigned claims by non-participating providers.
For Dates of Service on/after 4/8/2021 and processed on/after 4/19/2021
CPT codes, descriptors and other data are copyright 2020 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.MPFS Status C Code Fee Updates Last Updated 8/11/2021
CPT codes, descriptors and other data are copyright 2020 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.MPFS Status C Code Fee Updates Last Updated 8/11/2021
CPT codes, descriptors and other data are copyright 2020 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.MPFS Status C Code Fee Updates Last Updated 8/11/2021
CPT codes, descriptors and other data are copyright 2020 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.MPFS Status C Code Fee Updates Last Updated 8/11/2021
12
August 2021Updates
Notes Indicators and Definitions# These amounts apply when service is performed in a facility setting.C The payment for the technical component is capped at the OPPS amount.Limiting charge applies to unassigned claims by non-participating providers.
For Dates of Service on/after 1/1/2021 and processed on/after 8/4/2021
State
CMS MPFS
Locality NotesProcedure
Code Modifier Par FeeNonPar
FeeLimiting Charge
CA 05 78429 $1,614.44 $1,533.72 $1,763.78 CA 05 78429 TC $1,522.45 $1,446.33 $1,663.28 CA 05 78430 $1,471.01 $1,397.46 $1,607.08 CA 05 78430 TC $1,384.26 $1,315.05 $1,512.30 CA 05 78431 $2,453.95 $2,331.25 $2,680.94 CA 05 78431 TC $2,352.07 $2,234.47 $2,569.64 CA 05 78432 $2,161.85 $2,053.76 $2,361.82 CA 05 78432 TC $2,053.89 $1,951.20 $2,243.87 CA 05 78433 $2,746.34 $2,609.02 $3,000.38 CA 05 78433 TC $2,628.91 $2,497.46 $2,872.08 CA 05 78434 $174.40 $165.68 $190.53 CA 05 78434 TC $140.21 $133.20 $153.18 CA 05 78459 $1,273.06 $1,209.41 $1,390.82 CA 05 78459 TC $1,198.13 $1,138.22 $1,308.96 CA 05 78491 $1,162.20 $1,104.09 $1,269.70 CA 05 78491 TC $1,081.45 $1,027.38 $1,181.48 CA 05 78492 $1,934.06 $1,837.36 $2,112.96 CA 05 78492 TC $1,837.79 $1,745.90 $2,007.79 CA 06 78429 $1,614.44 $1,533.72 $1,763.78 CA 06 78429 TC $1,522.45 $1,446.33 $1,663.28 CA 06 78430 $1,471.01 $1,397.46 $1,607.08 CA 06 78430 TC $1,384.26 $1,315.05 $1,512.30 CA 06 78431 $2,453.95 $2,331.25 $2,680.94 CA 06 78431 TC $2,352.07 $2,234.47 $2,569.64 CA 06 78432 $2,161.85 $2,053.76 $2,361.82 CA 06 78432 TC $2,053.89 $1,951.20 $2,243.87 CA 06 78433 $2,746.34 $2,609.02 $3,000.38 CA 06 78433 TC $2,628.91 $2,497.46 $2,872.08 CA 06 78434 $174.40 $165.68 $190.53
CPT codes, descriptors and other data are copyright 2020 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.MPFS Status C Code Fee Updates Last Updated 8/11/2021
13
State
CMS MPFS
Locality NotesProcedure
Code Modifier Par FeeNonPar
FeeLimiting Charge
CA 06 78434 TC $140.21 $133.20 $153.18 CA 06 78459 $1,273.06 $1,209.41 $1,390.82 CA 06 78459 TC $1,198.13 $1,138.22 $1,308.96 CA 06 78491 $1,162.20 $1,104.09 $1,269.70 CA 06 78491 TC $1,081.45 $1,027.38 $1,181.48 CA 06 78492 $1,934.06 $1,837.36 $2,112.96 CA 06 78492 TC $1,837.79 $1,745.90 $2,007.79 CA 07 78429 $1,614.44 $1,533.72 $1,763.78 CA 07 78429 TC $1,522.45 $1,446.33 $1,663.28 CA 07 78430 $1,471.01 $1,397.46 $1,607.08 CA 07 78430 TC $1,384.26 $1,315.05 $1,512.30 CA 07 78431 $2,453.95 $2,331.25 $2,680.94 CA 07 78431 TC $2,352.07 $2,234.47 $2,569.64 CA 07 78432 $2,161.85 $2,053.76 $2,361.82 CA 07 78432 TC $2,053.89 $1,951.20 $2,243.87 CA 07 78433 $2,746.34 $2,609.02 $3,000.38 CA 07 78433 TC $2,628.91 $2,497.46 $2,872.08 CA 07 78434 $174.40 $165.68 $190.53 CA 07 78434 TC $140.21 $133.20 $153.18 CA 07 78459 $1,273.06 $1,209.41 $1,390.82 CA 07 78459 TC $1,198.13 $1,138.22 $1,308.96 CA 07 78491 $1,162.20 $1,104.09 $1,269.70 CA 07 78491 TC $1,081.45 $1,027.38 $1,181.48 CA 07 78492 $1,934.06 $1,837.36 $2,112.96 CA 07 78492 TC $1,837.79 $1,745.90 $2,007.79 CA 09 78429 $1,678.27 $1,594.36 $1,833.51 CA 09 78429 TC $1,584.18 $1,504.97 $1,730.72 CA 09 78430 $1,529.09 $1,452.64 $1,670.53 CA 09 78430 TC $1,440.38 $1,368.36 $1,573.62 CA 09 78431 $2,551.77 $2,424.18 $2,787.81 CA 09 78431 TC $2,447.50 $2,325.13 $2,673.89 CA 09 78432 $2,247.64 $2,135.26 $2,455.55 CA 09 78432 TC $2,137.21 $2,030.35 $2,334.90 CA 09 78433 $2,855.71 $2,712.92 $3,119.86 CA 09 78433 TC $2,735.60 $2,598.82 $2,988.64 CA 09 78434 $180.88 $171.84 $197.61 CA 09 78434 TC $145.88 $138.59 $159.37
CPT codes, descriptors and other data are copyright 2020 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.MPFS Status C Code Fee Updates Last Updated 8/11/2021
14
State
CMS MPFS
Locality NotesProcedure
Code Modifier Par FeeNonPar
FeeLimiting Charge
CA 09 78459 $1,323.15 $1,256.99 $1,445.54 CA 09 78459 TC $1,245.50 $1,183.22 $1,360.71 CA 09 78491 $1,207.84 $1,147.45 $1,319.57 CA 09 78491 TC $1,125.26 $1,069.00 $1,229.35 CA 09 78492 $2,010.85 $1,910.31 $2,196.85 CA 09 78492 TC $1,912.33 $1,816.71 $2,089.22 CA 51 78429 $1,485.74 $1,411.45 $1,623.17 CA 51 78429 TC $1,397.76 $1,327.87 $1,527.05 CA 51 78430 $1,353.91 $1,286.21 $1,479.15 CA 51 78430 TC $1,270.91 $1,207.36 $1,388.47 CA 51 78431 $2,256.67 $2,143.84 $2,465.41 CA 51 78431 TC $2,159.33 $2,051.36 $2,359.07 CA 51 78432 $1,988.89 $1,889.45 $2,172.86 CA 51 78432 TC $1,885.61 $1,791.33 $2,060.03 CA 51 78433 $2,525.80 $2,399.51 $2,759.44 CA 51 78433 TC $2,413.47 $2,292.80 $2,636.72 CA 51 78434 $161.40 $153.33 $176.33 CA 51 78434 TC $128.74 $122.30 $140.65 CA 51 78459 $1,172.08 $1,113.48 $1,280.50 CA 51 78459 TC $1,101.61 $1,046.53 $1,203.51 CA 51 78491 $1,070.22 $1,016.71 $1,169.22 CA 51 78491 TC $992.93 $943.28 $1,084.78 CA 51 78492 $1,779.23 $1,690.27 $1,943.81 CA 51 78492 TC $1,687.24 $1,602.88 $1,843.31 CA 52 78429 $1,593.30 $1,513.64 $1,740.68 CA 52 78429 TC $1,501.94 $1,426.84 $1,640.87 CA 52 78430 $1,451.78 $1,379.19 $1,586.07 CA 52 78430 TC $1,365.62 $1,297.34 $1,491.94 CA 52 78431 $2,421.48 $2,300.41 $2,645.47 CA 52 78431 TC $2,320.32 $2,204.30 $2,534.95 CA 52 78432 $2,133.41 $2,026.74 $2,330.75 CA 52 78432 TC $2,026.18 $1,924.87 $2,213.60 CA 52 78433 $2,710.04 $2,574.54 $2,960.72 CA 52 78433 TC $2,593.42 $2,463.75 $2,833.31 CA 52 78434 $172.28 $163.67 $188.22 CA 52 78434 TC $138.33 $131.41 $151.13 CA 52 78459 $1,256.50 $1,193.68 $1,372.73
CPT codes, descriptors and other data are copyright 2020 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.MPFS Status C Code Fee Updates Last Updated 8/11/2021
15
State
CMS MPFS
Locality NotesProcedure
Code Modifier Par FeeNonPar
FeeLimiting Charge
CA 52 78459 TC $1,182.99 $1,123.84 $1,292.42 CA 52 78491 $1,147.13 $1,089.77 $1,253.24 CA 52 78491 TC $1,066.91 $1,013.56 $1,165.60 CA 52 78492 $1,908.60 $1,813.17 $2,085.15 CA 52 78492 TC $1,813.01 $1,722.36 $1,980.71 CA 53 78429 $1,485.74 $1,411.45 $1,623.17 CA 53 78429 TC $1,397.76 $1,327.87 $1,527.05 CA 53 78430 $1,353.91 $1,286.21 $1,479.15 CA 53 78430 TC $1,270.91 $1,207.36 $1,388.47 CA 53 78431 $2,256.67 $2,143.84 $2,465.41 CA 53 78431 TC $2,159.33 $2,051.36 $2,359.07 CA 53 78432 $1,988.89 $1,889.45 $2,172.86 CA 53 78432 TC $1,885.61 $1,791.33 $2,060.03 CA 53 78433 $2,525.80 $2,399.51 $2,759.44 CA 53 78433 TC $2,413.47 $2,292.80 $2,636.72 CA 53 78434 $161.40 $153.33 $176.33 CA 53 78434 TC $128.74 $122.30 $140.65 CA 53 78459 $1,172.08 $1,113.48 $1,280.50 CA 53 78459 TC $1,101.61 $1,046.53 $1,203.51 CA 53 78491 $1,070.22 $1,016.71 $1,169.22 CA 53 78491 TC $992.93 $943.28 $1,084.78 CA 53 78492 $1,779.23 $1,690.27 $1,943.81 CA 53 78492 TC $1,687.24 $1,602.88 $1,843.31 CA 54 78429 $1,305.59 $1,240.31 $1,426.36 CA 54 78429 TC $1,220.73 $1,159.69 $1,333.65 CA 54 78430 $1,190.11 $1,130.60 $1,300.20 CA 54 78430 TC $1,109.99 $1,054.49 $1,212.66 CA 54 78431 $1,979.17 $1,880.21 $2,162.24 CA 54 78431 TC $1,885.54 $1,791.26 $2,059.95 CA 54 78432 $1,746.24 $1,658.93 $1,907.77 CA 54 78432 TC $1,646.60 $1,564.27 $1,798.91 CA 54 78433 $2,215.76 $2,104.97 $2,420.72 CA 54 78433 TC $2,107.40 $2,002.03 $2,302.33 CA 54 78434 $143.89 $136.70 $157.20 CA 54 78434 TC $112.47 $106.85 $122.87 CA 54 78459 $1,031.12 $979.56 $1,126.50 CA 54 78459 TC $967.18 $918.82 $1,056.64
CPT codes, descriptors and other data are copyright 2020 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.MPFS Status C Code Fee Updates Last Updated 8/11/2021
16
State
CMS MPFS
Locality NotesProcedure
Code Modifier Par FeeNonPar
FeeLimiting Charge
CA 54 78491 $941.99 $894.89 $1,029.12 CA 54 78491 TC $867.33 $823.96 $947.56 CA 54 78492 $1,561.96 $1,483.86 $1,706.44 CA 54 78492 TC $1,473.43 $1,399.76 $1,609.72 CA 55 78429 $1,304.69 $1,239.46 $1,425.37 CA 55 78429 TC $1,220.51 $1,159.48 $1,333.41 CA 55 78430 $1,189.23 $1,129.77 $1,299.23 CA 55 78430 TC $1,109.77 $1,054.28 $1,212.42 CA 55 78431 $1,978.23 $1,879.32 $2,161.22 CA 55 78431 TC $1,885.32 $1,791.05 $2,059.71 CA 55 78432 $1,745.21 $1,657.95 $1,906.64 CA 55 78432 TC $1,646.37 $1,564.05 $1,798.66 CA 55 78433 $2,214.68 $2,103.95 $2,419.54 CA 55 78433 TC $2,107.17 $2,001.81 $2,302.08 CA 55 78434 $143.60 $136.42 $156.88 CA 55 78434 TC $112.43 $106.81 $122.83 CA 55 78459 $1,030.26 $978.75 $1,125.56 CA 55 78459 TC $964.94 $916.69 $1,054.20 CA 55 78491 $941.14 $894.08 $1,028.20 CA 55 78491 TC $867.10 $823.75 $947.31 CA 55 78492 $1,561.04 $1,482.99 $1,705.44 CA 55 78492 TC $1,473.20 $1,399.54 $1,609.47 CA 56 78429 $1,304.69 $1,239.46 $1,425.37 CA 56 78429 TC $1,220.51 $1,159.48 $1,333.41 CA 56 78430 $1,189.23 $1,129.77 $1,299.23 CA 56 78430 TC $1,109.77 $1,054.28 $1,212.42 CA 56 78431 $1,978.23 $1,879.32 $2,161.22 CA 56 78431 TC $1,885.32 $1,791.05 $2,059.71 CA 56 78432 $1,745.21 $1,657.95 $1,906.64 CA 56 78432 TC $1,646.37 $1,564.05 $1,798.66 CA 56 78433 $2,214.68 $2,103.95 $2,419.54 CA 56 78433 TC $2,107.17 $2,001.81 $2,302.08 CA 56 78434 $143.60 $136.42 $156.88 CA 56 78434 TC $112.43 $106.81 $122.83 CA 56 78459 $1,030.26 $978.75 $1,125.56 CA 56 78459 TC $964.94 $916.69 $1,054.20 CA 56 78491 $941.14 $894.08 $1,028.20
CPT codes, descriptors and other data are copyright 2020 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.MPFS Status C Code Fee Updates Last Updated 8/11/2021
17
State
CMS MPFS
Locality NotesProcedure
Code Modifier Par FeeNonPar
FeeLimiting Charge
CA 56 78491 TC $867.10 $823.75 $947.31 CA 56 78492 $1,561.04 $1,482.99 $1,705.44 CA 56 78492 TC $1,473.20 $1,399.54 $1,609.47 CA 57 78429 $1,304.69 $1,239.46 $1,425.37 CA 57 78429 TC $1,220.51 $1,159.48 $1,333.41 CA 57 78430 $1,189.23 $1,129.77 $1,299.23 CA 57 78430 TC $1,109.77 $1,054.28 $1,212.42 CA 57 78431 $1,978.23 $1,879.32 $2,161.22 CA 57 78431 TC $1,885.32 $1,791.05 $2,059.71 CA 57 78432 $1,745.21 $1,657.95 $1,906.64 CA 57 78432 TC $1,646.37 $1,564.05 $1,798.66 CA 57 78433 $2,214.68 $2,103.95 $2,419.54 CA 57 78433 TC $2,107.17 $2,001.81 $2,302.08 CA 57 78434 $143.60 $136.42 $156.88 CA 57 78434 TC $112.43 $106.81 $122.83 CA 57 78459 $1,030.26 $978.75 $1,125.56 CA 57 78459 TC $964.94 $916.69 $1,054.20 CA 57 78491 $941.14 $894.08 $1,028.20 CA 57 78491 TC $867.10 $823.75 $947.31 CA 57 78492 $1,561.04 $1,482.99 $1,705.44 CA 57 78492 TC $1,473.20 $1,399.54 $1,609.47 CA 58 78429 $1,304.69 $1,239.46 $1,425.37 CA 58 78429 TC $1,220.51 $1,159.48 $1,333.41 CA 58 78430 $1,189.23 $1,129.77 $1,299.23 CA 58 78430 TC $1,109.77 $1,054.28 $1,212.42 CA 58 78431 $1,978.23 $1,879.32 $2,161.22 CA 58 78431 TC $1,885.32 $1,791.05 $2,059.71 CA 58 78432 $1,745.21 $1,657.95 $1,906.64 CA 58 78432 TC $1,646.37 $1,564.05 $1,798.66 CA 58 78433 $2,214.68 $2,103.95 $2,419.54 CA 58 78433 TC $2,107.17 $2,001.81 $2,302.08 CA 58 78434 $143.60 $136.42 $156.88 CA 58 78434 TC $112.43 $106.81 $122.83 CA 58 78459 $1,030.26 $978.75 $1,125.56 CA 58 78459 TC $964.94 $916.69 $1,054.20 CA 58 78491 $941.14 $894.08 $1,028.20 CA 58 78491 TC $867.10 $823.75 $947.31
CPT codes, descriptors and other data are copyright 2020 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.MPFS Status C Code Fee Updates Last Updated 8/11/2021
18
State
CMS MPFS
Locality NotesProcedure
Code Modifier Par FeeNonPar
FeeLimiting Charge
CA 58 78492 $1,561.04 $1,482.99 $1,705.44 CA 58 78492 TC $1,473.20 $1,399.54 $1,609.47 CA 59 78429 $1,304.69 $1,239.46 $1,425.37 CA 59 78429 TC $1,220.51 $1,159.48 $1,333.41 CA 59 78430 $1,189.23 $1,129.77 $1,299.23 CA 59 78430 TC $1,109.77 $1,054.28 $1,212.42 CA 59 78431 $1,978.23 $1,879.32 $2,161.22 CA 59 78431 TC $1,885.32 $1,791.05 $2,059.71 CA 59 78432 $1,745.21 $1,657.95 $1,906.64 CA 59 78432 TC $1,646.37 $1,564.05 $1,798.66 CA 59 78433 $2,214.68 $2,103.95 $2,419.54 CA 59 78433 TC $2,107.17 $2,001.81 $2,302.08 CA 59 78434 $143.60 $136.42 $156.88 CA 59 78434 TC $112.43 $106.81 $122.83 CA 59 78459 $1,030.26 $978.75 $1,125.56 CA 59 78459 TC $964.94 $916.69 $1,054.20 CA 59 78491 $941.14 $894.08 $1,028.20 CA 59 78491 TC $867.10 $823.75 $947.31 CA 59 78492 $1,561.04 $1,482.99 $1,705.44 CA 59 78492 TC $1,473.20 $1,399.54 $1,609.47 CA 60 78429 $1,304.69 $1,239.46 $1,425.37 CA 60 78429 TC $1,220.51 $1,159.48 $1,333.41 CA 60 78430 $1,189.23 $1,129.77 $1,299.23 CA 60 78430 TC $1,109.77 $1,054.28 $1,212.42 CA 60 78431 $1,978.23 $1,879.32 $2,161.22 CA 60 78431 TC $1,885.32 $1,791.05 $2,059.71 CA 60 78432 $1,745.21 $1,657.95 $1,906.64 CA 60 78432 TC $1,646.37 $1,564.05 $1,798.66 CA 60 78433 $2,214.68 $2,103.95 $2,419.54 CA 60 78433 TC $2,107.17 $2,001.81 $2,302.08 CA 60 78434 $143.60 $136.42 $156.88 CA 60 78434 TC $112.43 $106.81 $122.83 CA 60 78459 $1,030.26 $978.75 $1,125.56 CA 60 78459 TC $964.94 $916.69 $1,054.20 CA 60 78491 $941.14 $894.08 $1,028.20 CA 60 78491 TC $867.10 $823.75 $947.31 CA 60 78492 $1,561.04 $1,482.99 $1,705.44
CPT codes, descriptors and other data are copyright 2020 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.MPFS Status C Code Fee Updates Last Updated 8/11/2021
19
State
CMS MPFS
Locality NotesProcedure
Code Modifier Par FeeNonPar
FeeLimiting Charge
CA 60 78492 TC $1,473.20 $1,399.54 $1,609.47 CA 61 78429 $1,304.69 $1,239.46 $1,425.37 CA 61 78429 TC $1,220.51 $1,159.48 $1,333.41 CA 61 78430 $1,189.23 $1,129.77 $1,299.23 CA 61 78430 TC $1,109.77 $1,054.28 $1,212.42 CA 61 78431 $1,978.23 $1,879.32 $2,161.22 CA 61 78431 TC $1,885.32 $1,791.05 $2,059.71 CA 61 78432 $1,745.21 $1,657.95 $1,906.64 CA 61 78432 TC $1,646.37 $1,564.05 $1,798.66 CA 61 78433 $2,214.68 $2,103.95 $2,419.54 CA 61 78433 TC $2,107.17 $2,001.81 $2,302.08 CA 61 78434 $143.60 $136.42 $156.88 CA 61 78434 TC $112.43 $106.81 $122.83 CA 61 78459 $1,030.26 $978.75 $1,125.56 CA 61 78459 TC $964.94 $916.69 $1,054.20 CA 61 78491 $941.14 $894.08 $1,028.20 CA 61 78491 TC $867.10 $823.75 $947.31 CA 61 78492 $1,561.04 $1,482.99 $1,705.44 CA 61 78492 TC $1,473.20 $1,399.54 $1,609.47 CA 62 78429 $1,302.74 $1,237.60 $1,423.24 CA 62 78429 TC $1,219.44 $1,158.47 $1,332.24 CA 62 78430 $1,187.29 $1,127.93 $1,297.11 CA 62 78430 TC $1,108.70 $1,053.27 $1,211.25 CA 62 78431 $1,976.28 $1,877.47 $2,159.09 CA 62 78431 TC $1,884.26 $1,790.05 $2,058.55 CA 62 78432 $1,743.09 $1,655.94 $1,904.33 CA 62 78432 TC $1,645.31 $1,563.04 $1,797.50 CA 62 78433 $2,212.55 $2,101.92 $2,417.21 CA 62 78433 TC $2,106.11 $2,000.80 $2,300.93 CA 62 78434 $143.07 $135.92 $156.30 CA 62 78434 TC $112.26 $106.65 $122.64 CA 62 78459 $1,028.32 $976.90 $1,123.44 CA 62 78459 TC $954.32 $906.60 $1,042.59 CA 62 78491 $939.20 $892.24 $1,026.08 CA 62 78491 TC $866.04 $822.74 $946.15 CA 62 78492 $1,559.10 $1,481.14 $1,703.32 CA 62 78492 TC $1,472.14 $1,398.53 $1,608.31
CPT codes, descriptors and other data are copyright 2020 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.MPFS Status C Code Fee Updates Last Updated 8/11/2021
20
State
CMS MPFS
Locality NotesProcedure
Code Modifier Par FeeNonPar
FeeLimiting Charge
CA 63 78429 $1,321.53 $1,255.45 $1,443.77 CA 63 78429 TC $1,236.54 $1,174.71 $1,350.92 CA 63 78430 $1,204.57 $1,144.34 $1,315.99 CA 63 78430 TC $1,124.34 $1,068.12 $1,228.34 CA 63 78431 $2,003.91 $1,903.71 $2,189.27 CA 63 78431 TC $1,910.09 $1,814.59 $2,086.77 CA 63 78432 $1,767.80 $1,679.41 $1,931.32 CA 63 78432 TC $1,668.00 $1,584.60 $1,822.29 CA 63 78433 $2,243.40 $2,131.23 $2,450.91 CA 63 78433 TC $2,134.86 $2,028.12 $2,332.33 CA 63 78434 $145.38 $138.11 $158.83 CA 63 78434 TC $113.91 $108.21 $124.45 CA 63 78459 $1,043.52 $991.34 $1,140.05 CA 63 78459 TC $977.46 $928.59 $1,067.88 CA 63 78491 $953.24 $905.58 $1,041.41 CA 63 78491 TC $878.49 $834.57 $959.75 CA 63 78492 $1,581.25 $1,502.19 $1,727.52 CA 63 78492 TC $1,492.55 $1,417.92 $1,630.61 CA 64 78429 $1,372.92 $1,304.27 $1,499.92 CA 64 78429 TC $1,285.76 $1,221.47 $1,404.69 CA 64 78430 $1,251.36 $1,188.79 $1,367.11 CA 64 78430 TC $1,169.10 $1,110.64 $1,277.24 CA 64 78431 $2,082.40 $1,978.28 $2,275.02 CA 64 78431 TC $1,986.16 $1,886.85 $2,169.88 CA 64 78432 $1,836.76 $1,744.92 $2,006.66 CA 64 78432 TC $1,734.42 $1,647.70 $1,894.85 CA 64 78433 $2,331.19 $2,214.63 $2,546.83 CA 64 78433 TC $2,219.88 $2,108.89 $2,425.22 CA 64 78434 $150.73 $143.19 $164.67 CA 64 78434 TC $118.44 $112.52 $129.40 CA 64 78459 $1,083.94 $1,029.74 $1,184.20 CA 64 78459 TC $1,015.91 $965.11 $1,109.88 CA 64 78491 $990.09 $940.59 $1,081.67 CA 64 78491 TC $913.45 $867.78 $997.94 CA 64 78492 $1,642.97 $1,560.82 $1,794.94 CA 64 78492 TC $1,551.98 $1,474.38 $1,695.54 CA 65 78429 $1,616.56 $1,535.73 $1,766.09
CPT codes, descriptors and other data are copyright 2020 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.MPFS Status C Code Fee Updates Last Updated 8/11/2021
21
State
CMS MPFS
Locality NotesProcedure
Code Modifier Par FeeNonPar
FeeLimiting Charge
CA 65 78429 TC $1,523.89 $1,447.70 $1,664.85 CA 65 78430 $1,473.01 $1,399.36 $1,609.26 CA 65 78430 TC $1,385.60 $1,316.32 $1,513.77 CA 65 78431 $2,456.73 $2,333.89 $2,683.98 CA 65 78431 TC $2,354.13 $2,236.42 $2,571.89 CA 65 78432 $2,164.51 $2,056.28 $2,364.73 CA 65 78432 TC $2,055.72 $1,952.93 $2,245.87 CA 65 78433 $2,749.47 $2,612.00 $3,003.80 CA 65 78433 TC $2,631.18 $2,499.62 $2,874.56 CA 65 78434 $174.82 $166.08 $190.99 CA 65 78434 TC $140.36 $133.34 $153.34 CA 65 78459 $1,274.90 $1,211.16 $1,392.83 CA 65 78459 TC $1,201.93 $1,141.83 $1,313.11 CA 65 78491 $1,163.95 $1,105.75 $1,271.62 CA 65 78491 TC $1,082.55 $1,028.42 $1,182.69 CA 65 78492 $1,936.43 $1,839.61 $2,115.55 CA 65 78492 TC $1,839.46 $1,747.49 $2,009.61 CA 66 78429 $1,440.59 $1,368.56 $1,573.84 CA 66 78429 TC $1,353.31 $1,285.64 $1,478.49 CA 66 78430 $1,312.87 $1,247.23 $1,434.31 CA 66 78430 TC $1,230.51 $1,168.98 $1,344.33 CA 66 78431 $2,187.03 $2,077.68 $2,389.33 CA 66 78431 TC $2,090.53 $1,986.00 $2,283.90 CA 66 78432 $1,928.03 $1,831.63 $2,106.37 CA 66 78432 TC $1,825.56 $1,734.28 $1,994.42 CA 66 78433 $2,447.99 $2,325.59 $2,674.43 CA 66 78433 TC $2,336.55 $2,219.72 $2,552.68 CA 66 78434 $157.05 $149.20 $171.58 CA 66 78434 TC $124.66 $118.43 $136.19 CA 66 78459 $1,136.79 $1,079.95 $1,241.94 CA 66 78459 TC $1,068.68 $1,015.25 $1,167.53 CA 66 78491 $1,038.13 $986.22 $1,134.16 CA 66 78491 TC $961.41 $913.34 $1,050.34 CA 66 78492 $1,724.74 $1,638.50 $1,884.28 CA 66 78492 TC $1,633.53 $1,551.85 $1,784.63 CA 67 78429 $1,414.99 $1,344.24 $1,545.88 CA 67 78429 TC $1,328.12 $1,261.71 $1,450.97
CPT codes, descriptors and other data are copyright 2020 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.MPFS Status C Code Fee Updates Last Updated 8/11/2021
22
State
CMS MPFS
Locality NotesProcedure
Code Modifier Par FeeNonPar
FeeLimiting Charge
CA 67 78430 $1,289.59 $1,225.11 $1,408.88 CA 67 78430 TC $1,207.61 $1,147.23 $1,319.31 CA 67 78431 $2,147.62 $2,040.24 $2,346.27 CA 67 78431 TC $2,051.61 $1,949.03 $2,241.38 CA 67 78432 $1,893.57 $1,798.89 $2,068.73 CA 67 78432 TC $1,791.58 $1,702.00 $1,957.30 CA 67 78433 $2,403.97 $2,283.77 $2,626.34 CA 67 78433 TC $2,293.05 $2,178.40 $2,505.16 CA 67 78434 $154.56 $146.83 $168.86 CA 67 78434 TC $122.34 $116.22 $133.66 CA 67 78459 $1,116.75 $1,060.91 $1,220.05 CA 67 78459 TC $1,049.00 $996.55 $1,146.03 CA 67 78491 $1,019.89 $968.90 $1,114.23 CA 67 78491 TC $943.53 $896.35 $1,030.81 CA 67 78492 $1,693.87 $1,609.18 $1,850.55 CA 67 78492 TC $1,603.12 $1,522.96 $1,751.41 CA 68 78429 $1,304.69 $1,239.46 $1,425.37 CA 68 78429 TC $1,220.51 $1,159.48 $1,333.41 CA 68 78430 $1,189.23 $1,129.77 $1,299.23 CA 68 78430 TC $1,109.77 $1,054.28 $1,212.42 CA 68 78431 $1,978.23 $1,879.32 $2,161.22 CA 68 78431 TC $1,885.32 $1,791.05 $2,059.71 CA 68 78432 $1,745.21 $1,657.95 $1,906.64 CA 68 78432 TC $1,646.37 $1,564.05 $1,798.66 CA 68 78433 $2,214.68 $2,103.95 $2,419.54 CA 68 78433 TC $2,107.17 $2,001.81 $2,302.08 CA 68 78434 $143.60 $136.42 $156.88 CA 68 78434 TC $112.43 $106.81 $122.83 CA 68 78459 $1,030.26 $978.75 $1,125.56 CA 68 78459 TC $964.94 $916.69 $1,054.20 CA 68 78491 $941.14 $894.08 $1,028.20 CA 68 78491 TC $867.10 $823.75 $947.31 CA 68 78492 $1,561.04 $1,482.99 $1,705.44 CA 68 78492 TC $1,473.20 $1,399.54 $1,609.47 CA 69 78429 $1,304.69 $1,239.46 $1,425.37 CA 69 78429 TC $1,220.51 $1,159.48 $1,333.41 CA 69 78430 $1,189.23 $1,129.77 $1,299.23
CPT codes, descriptors and other data are copyright 2020 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.MPFS Status C Code Fee Updates Last Updated 8/11/2021
23
State
CMS MPFS
Locality NotesProcedure
Code Modifier Par FeeNonPar
FeeLimiting Charge
CA 69 78430 TC $1,109.77 $1,054.28 $1,212.42 CA 69 78431 $1,978.23 $1,879.32 $2,161.22 CA 69 78431 TC $1,885.32 $1,791.05 $2,059.71 CA 69 78432 $1,745.21 $1,657.95 $1,906.64 CA 69 78432 TC $1,646.37 $1,564.05 $1,798.66 CA 69 78433 $2,214.68 $2,103.95 $2,419.54 CA 69 78433 TC $2,107.17 $2,001.81 $2,302.08 CA 69 78434 $143.60 $136.42 $156.88 CA 69 78434 TC $112.43 $106.81 $122.83 CA 69 78459 $1,030.26 $978.75 $1,125.56 CA 69 78459 TC $964.94 $916.69 $1,054.20 CA 69 78491 $941.14 $894.08 $1,028.20 CA 69 78491 TC $867.10 $823.75 $947.31 CA 69 78492 $1,561.04 $1,482.99 $1,705.44 CA 69 78492 TC $1,473.20 $1,399.54 $1,609.47 CA 70 78429 $1,304.69 $1,239.46 $1,425.37 CA 70 78429 TC $1,220.51 $1,159.48 $1,333.41 CA 70 78430 $1,189.23 $1,129.77 $1,299.23 CA 70 78430 TC $1,109.77 $1,054.28 $1,212.42 CA 70 78431 $1,978.23 $1,879.32 $2,161.22 CA 70 78431 TC $1,885.32 $1,791.05 $2,059.71 CA 70 78432 $1,745.21 $1,657.95 $1,906.64 CA 70 78432 TC $1,646.37 $1,564.05 $1,798.66 CA 70 78433 $2,214.68 $2,103.95 $2,419.54 CA 70 78433 TC $2,107.17 $2,001.81 $2,302.08 CA 70 78434 $143.60 $136.42 $156.88 CA 70 78434 TC $112.43 $106.81 $122.83 CA 70 78459 $1,030.26 $978.75 $1,125.56 CA 70 78459 TC $964.94 $916.69 $1,054.20 CA 70 78491 $941.14 $894.08 $1,028.20 CA 70 78491 TC $867.10 $823.75 $947.31 CA 70 78492 $1,561.04 $1,482.99 $1,705.44 CA 70 78492 TC $1,473.20 $1,399.54 $1,609.47 CA 75 78429 $1,304.69 $1,239.46 $1,425.37 CA 75 78429 TC $1,220.51 $1,159.48 $1,333.41 CA 75 78430 $1,189.23 $1,129.77 $1,299.23 CA 75 78430 TC $1,109.77 $1,054.28 $1,212.42
CPT codes, descriptors and other data are copyright 2020 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.MPFS Status C Code Fee Updates Last Updated 8/11/2021
24
State
CMS MPFS
Locality NotesProcedure
Code Modifier Par FeeNonPar
FeeLimiting Charge
CA 75 78431 $1,978.23 $1,879.32 $2,161.22 CA 75 78431 TC $1,885.32 $1,791.05 $2,059.71 CA 75 78432 $1,745.21 $1,657.95 $1,906.64 CA 75 78432 TC $1,646.37 $1,564.05 $1,798.66 CA 75 78433 $2,214.68 $2,103.95 $2,419.54 CA 75 78433 TC $2,107.17 $2,001.81 $2,302.08 CA 75 78434 $143.60 $136.42 $156.88 CA 75 78434 TC $112.43 $106.81 $122.83 CA 75 78459 $1,030.26 $978.75 $1,125.56 CA 75 78459 TC $964.94 $916.69 $1,054.20 CA 75 78491 $941.14 $894.08 $1,028.20 CA 75 78491 TC $867.10 $823.75 $947.31 CA 75 78492 $1,561.04 $1,482.99 $1,705.44 CA 75 78492 TC $1,473.20 $1,399.54 $1,609.47 CA 17 78429 $1,437.84 $1,365.95 $1,570.84 CA 17 78429 TC $1,351.29 $1,283.73 $1,476.28 CA 17 78430 $1,310.38 $1,244.86 $1,431.59 CA 17 78430 TC $1,228.70 $1,167.27 $1,342.35 CA 17 78431 $2,182.95 $2,073.80 $2,384.87 CA 17 78431 TC $2,087.27 $1,982.91 $2,280.34 CA 17 78432 $1,924.36 $1,828.14 $2,102.36 CA 17 78432 TC $1,822.74 $1,731.60 $1,991.34 CA 17 78433 $2,443.35 $2,321.18 $2,669.36 CA 17 78433 TC $2,332.87 $2,216.23 $2,548.66 CA 17 78434 $156.63 $148.80 $171.12 CA 17 78434 TC $124.49 $118.27 $136.01 CA 17 78459 $1,134.62 $1,077.89 $1,239.57 CA 17 78459 TC $1,069.59 $1,016.11 $1,168.53 CA 17 78491 $1,036.15 $984.34 $1,131.99 CA 17 78491 TC $960.06 $912.06 $1,048.87 CA 17 78492 $1,721.49 $1,635.42 $1,880.73 CA 17 78492 TC $1,631.03 $1,549.48 $1,781.90 CA 18 78429 $1,434.59 $1,362.86 $1,567.29 CA 18 78429 TC $1,346.77 $1,279.43 $1,471.35 CA 18 78430 $1,307.49 $1,242.12 $1,428.43 CA 18 78430 TC $1,224.60 $1,163.37 $1,337.88 CA 18 78431 $2,177.29 $2,068.43 $2,378.69
CPT codes, descriptors and other data are copyright 2020 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.MPFS Status C Code Fee Updates Last Updated 8/11/2021
25
State
CMS MPFS
Locality NotesProcedure
Code Modifier Par FeeNonPar
FeeLimiting Charge
CA 18 78431 TC $2,080.25 $1,976.24 $2,272.67 CA 18 78432 $1,919.74 $1,823.75 $2,097.32 CA 18 78432 TC $1,816.63 $1,725.80 $1,984.67 CA 18 78433 $2,437.13 $2,315.27 $2,662.56 CA 18 78433 TC $2,325.02 $2,208.77 $2,540.08 CA 18 78434 $156.67 $148.84 $171.16 CA 18 78434 TC $124.08 $117.88 $135.56 CA 18 78459 $1,132.27 $1,075.66 $1,237.00 CA 18 78459 TC $1,066.66 $1,013.33 $1,165.33 CA 18 78491 $1,034.10 $982.39 $1,129.75 CA 18 78491 TC $956.87 $909.03 $1,045.38 CA 18 78492 $1,717.31 $1,631.44 $1,876.16 CA 18 78492 TC $1,625.57 $1,544.29 $1,775.94 CA 26 78429 $1,434.59 $1,362.86 $1,567.29 CA 26 78429 TC $1,346.77 $1,279.43 $1,471.35 CA 26 78430 $1,307.49 $1,242.12 $1,428.43 CA 26 78430 TC $1,224.60 $1,163.37 $1,337.88 CA 26 78431 $2,177.29 $2,068.43 $2,378.69 CA 26 78431 TC $2,080.25 $1,976.24 $2,272.67 CA 26 78432 $1,919.74 $1,823.75 $2,097.32 CA 26 78432 TC $1,816.63 $1,725.80 $1,984.67 CA 26 78433 $2,437.13 $2,315.27 $2,662.56 CA 26 78433 TC $2,325.02 $2,208.77 $2,540.08 CA 26 78434 $156.67 $148.84 $171.16 CA 26 78434 TC $124.08 $117.88 $135.56 CA 26 78459 $1,132.27 $1,075.66 $1,237.00 CA 26 78459 TC $1,066.66 $1,013.33 $1,165.33 CA 26 78491 $1,034.10 $982.39 $1,129.75 CA 26 78491 TC $956.87 $909.03 $1,045.38 CA 26 78492 $1,717.31 $1,631.44 $1,876.16 CA 26 78492 TC $1,625.57 $1,544.29 $1,775.94 CA 71 78429 $1,304.76 $1,239.52 $1,425.45 CA 71 78429 TC $1,220.55 $1,159.52 $1,333.45 CA 71 78430 $1,189.31 $1,129.84 $1,299.32 CA 71 78430 TC $1,109.81 $1,054.32 $1,212.47 CA 71 78431 $1,978.30 $1,879.38 $2,161.29 CA 71 78431 TC $1,885.36 $1,791.09 $2,059.76
CPT codes, descriptors and other data are copyright 2020 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.MPFS Status C Code Fee Updates Last Updated 8/11/2021
26
State
CMS MPFS
Locality NotesProcedure
Code Modifier Par FeeNonPar
FeeLimiting Charge
CA 71 78432 $1,745.29 $1,658.03 $1,906.73 CA 71 78432 TC $1,646.41 $1,564.09 $1,798.70 CA 71 78433 $2,214.76 $2,104.02 $2,419.63 CA 71 78433 TC $2,107.21 $2,001.85 $2,302.13 CA 71 78434 $143.62 $136.44 $156.90 CA 71 78434 TC $112.44 $106.82 $122.84 CA 71 78459 $1,030.34 $978.82 $1,125.65 CA 71 78459 TC $965.34 $917.07 $1,054.63 CA 71 78491 $941.22 $894.16 $1,028.28 CA 71 78491 TC $867.14 $823.78 $947.35 CA 71 78492 $1,561.12 $1,483.06 $1,705.52 CA 71 78492 TC $1,473.24 $1,399.58 $1,609.51 CA 72 78429 $1,398.34 $1,328.42 $1,527.69 CA 72 78429 TC $1,312.13 $1,246.52 $1,433.50 CA 72 78430 $1,274.44 $1,210.72 $1,392.33 CA 72 78430 TC $1,193.08 $1,133.43 $1,303.44 CA 72 78431 $2,122.15 $2,016.04 $2,318.45 CA 72 78431 TC $2,026.89 $1,925.55 $2,214.38 CA 72 78432 $1,871.21 $1,777.65 $2,044.30 CA 72 78432 TC $1,769.99 $1,681.49 $1,933.71 CA 72 78433 $2,375.48 $2,256.71 $2,595.21 CA 72 78433 TC $2,265.40 $2,152.13 $2,474.95 CA 72 78434 $152.84 $145.20 $166.98 CA 72 78434 TC $120.87 $114.83 $132.05 CA 72 78459 $1,103.67 $1,048.49 $1,205.76 CA 72 78459 TC $1,036.88 $985.04 $1,132.79 CA 72 78491 $1,007.98 $957.58 $1,101.22 CA 72 78491 TC $932.19 $885.58 $1,018.42 CA 72 78492 $1,673.86 $1,590.17 $1,828.69 CA 72 78492 TC $1,583.81 $1,504.62 $1,730.31 CA 73 78429 $1,327.96 $1,261.56 $1,450.80 CA 73 78429 TC $1,243.40 $1,181.23 $1,358.41 CA 73 78430 $1,210.40 $1,149.88 $1,322.36 CA 73 78430 TC $1,130.58 $1,074.05 $1,235.16 CA 73 78431 $2,014.06 $1,913.36 $2,200.36 CA 73 78431 TC $1,920.70 $1,824.67 $2,098.36 CA 73 78432 $1,776.55 $1,687.72 $1,940.88
CPT codes, descriptors and other data are copyright 2020 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.MPFS Status C Code Fee Updates Last Updated 8/11/2021
27
State
CMS MPFS
Locality NotesProcedure
Code Modifier Par FeeNonPar
FeeLimiting Charge
CA 73 78432 TC $1,677.27 $1,593.41 $1,832.42 CA 73 78433 $2,254.70 $2,141.96 $2,463.26 CA 73 78433 TC $2,146.72 $2,039.38 $2,345.29 CA 73 78434 $145.86 $138.57 $159.35 CA 73 78434 TC $114.54 $108.81 $125.13 CA 73 78459 $1,048.48 $996.06 $1,145.46 CA 73 78459 TC $982.83 $933.69 $1,073.74 CA 73 78491 $957.72 $909.83 $1,046.31 CA 73 78491 TC $883.36 $839.19 $965.07 CA 73 78492 $1,589.11 $1,509.65 $1,736.10 CA 73 78492 TC $1,500.85 $1,425.81 $1,639.68 CA 74 78429 $1,412.42 $1,341.80 $1,543.07 CA 74 78429 TC $1,325.83 $1,259.54 $1,448.47 CA 74 78430 $1,287.24 $1,222.88 $1,406.31 CA 74 78430 TC $1,205.53 $1,145.25 $1,317.04 CA 74 78431 $2,143.77 $2,036.58 $2,342.07 CA 74 78431 TC $2,048.08 $1,945.68 $2,237.53 CA 74 78432 $1,890.15 $1,795.64 $2,064.99 CA 74 78432 TC $1,788.49 $1,699.07 $1,953.93 CA 74 78433 $2,399.65 $2,279.67 $2,621.62 CA 74 78433 TC $2,289.09 $2,174.64 $2,500.83 CA 74 78434 $154.25 $146.54 $168.52 CA 74 78434 TC $122.13 $116.02 $133.43 CA 74 78459 $1,114.70 $1,058.96 $1,217.81 CA 74 78459 TC $1,047.22 $994.86 $1,144.09 CA 74 78491 $1,018.02 $967.12 $1,112.19 CA 74 78491 TC $941.90 $894.81 $1,029.03 CA 74 78492 $1,690.82 $1,606.28 $1,847.22 CA 74 78492 TC $1,600.36 $1,520.34 $1,748.39 HI 01 78429 $1,394.71 $1,324.97 $1,523.72 HI 01 78429 TC $1,309.97 $1,244.47 $1,431.14 HI 01 78430 $1,271.09 $1,207.54 $1,388.67 HI 01 78430 TC $1,191.12 $1,131.56 $1,301.30 HI 01 78431 $2,117.13 $2,011.27 $2,312.96 HI 01 78431 TC $2,023.47 $1,922.30 $2,210.64 HI 01 78432 $1,866.52 $1,773.19 $2,039.17 HI 01 78432 TC $1,767.03 $1,678.68 $1,930.48
CPT codes, descriptors and other data are copyright 2020 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.MPFS Status C Code Fee Updates Last Updated 8/11/2021