CPT 98000
Global XXXSynch audio-video new sf 15
CPT 98000 Billing & Documentation Guide
CPT code 98000 (Synch audio-video new sf 15) is classified under Medicine/E&M with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.93, a non-facility practice expense RVU of 0.61, and a malpractice RVU of 0.06, a total non-facility RVU of 1.6 and facility RVU of 1.2. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $54.68, though rates vary from $49.6 to $69.4 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 98000, 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 98000 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Invalid for Medicare; not separately payable
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 98000 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 98000
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.93 | 0.93 |
| Practice Expense RVU | 0.61 | 0.21 |
| Malpractice RVU | 0.06 | 0.06 |
| Total RVU | 1.6 | 1.2 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 98000
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 | $57.37 | $41.56 | $55 - $64.93 | 29 |
| Florida | $55.41 | $42 | $53.55 - $57.34 | 3 |
| Georgia | $52.95 | $40.2 | $51.63 - $54.26 | 2 |
| Illinois | $54.69 | $41.78 | $52.8 - $56.36 | 4 |
| Michigan | $53.02 | $40.47 | $51.93 - $54.1 | 2 |
| North Carolina | $51.35 | $38.89 | $51.35 - $51.35 | 1 |
| New York | $57.99 | $43.09 | $51.83 - $61 | 5 |
| Ohio | $51.68 | $39.49 | $51.68 - $51.68 | 1 |
| Pennsylvania | $53.44 | $40.36 | $51.66 - $55.22 | 2 |
| Texas | $53.16 | $40 | $51.47 - $54.46 | 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 98000
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 98000 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0362T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0373T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0469T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 93792 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 93793 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 94002 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 94003 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 94004 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 98000
What does CPT code 98000 mean? +
CPT code 98000 represents: Synch audio-video new sf 15. It's in the Medicine/E&M category with a global period of XXX.
What is the Medicare reimbursement for CPT 98000? +
The 2026 Medicare national average non-facility payment for CPT 98000 is $54.68. Rates range from $49.6 to $69.4 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 98000? +
Medicine section spans a wide range: therapy services use GP/GO/GN (PT/OT/SLP plans of care) and KX (above cap with documentation). Drug administration uses JW (waste) and JZ (no waste). Professional/technical split applies to some diagnostic codes.
What bundling edits apply to CPT 98000? +
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 May 31, 2026.
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