CPT 34820
Global ZZZ ActiveOpn iliac art expos
CPT 34820 Billing & Documentation Guide
CPT code 34820 (Opn iliac art expos) is classified under Surgery (Respiratory/Cardiovascular) with a global period indicator of ZZZ. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 6.83, a non-facility practice expense RVU of 0.54, and a malpractice RVU of 1.74, a total non-facility RVU of 9.11 and facility RVU of 9.11. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $301.36, though rates vary from $263.31 to $393.88 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 34820, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 34820 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Add-on code (global concept does not apply)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 34820 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 34820
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 6.83 | 6.83 |
| Practice Expense RVU | 0.54 | 0.54 |
| Malpractice RVU | 1.74 | 1.74 |
| Total RVU | 9.11 | 9.11 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 34820
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $289.17 | $289.17 | $282.93 - $310.38 | 29 |
| Florida | $359.36 | $359.36 | $332.72 - $393.88 | 3 |
| Georgia | $315.22 | $315.22 | $313.49 - $316.94 | 2 |
| Illinois | $357.42 | $357.42 | $335.43 - $381.23 | 4 |
| Michigan | $326.87 | $326.87 | $310.21 - $343.52 | 2 |
| North Carolina | $282.09 | $282.09 | $282.09 - $282.09 | 1 |
| New York | $338.08 | $338.08 | $286.12 - $372.1 | 5 |
| Ohio | $303.18 | $303.18 | $303.18 - $303.18 | 1 |
| Pennsylvania | $309.98 | $309.98 | $299.61 - $320.34 | 2 |
| Texas | $301.12 | $301.12 | $293.16 - $327.83 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 34820
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 34820 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 01926 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 12001 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 34820
What does CPT code 34820 mean? +
CPT code 34820 represents: Opn iliac art expos. It's in the Surgery (Respiratory/Cardiovascular) category with a global period of ZZZ.
What is the Medicare reimbursement for CPT 34820? +
The 2026 Medicare national average non-facility payment for CPT 34820 is $301.36. Rates range from $263.31 to $393.88 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 34820? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 34820? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on April 21, 2026.
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