CPT 98001
Global XXXSynch audio-video new low 30
CPT 98001 Billing & Documentation Guide
CPT code 98001 (Synch audio-video new low 30) is classified under Medicine/E&M with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.6, a non-facility practice expense RVU of 0.92, and a malpractice RVU of 0.09, a total non-facility RVU of 2.61 and facility RVU of 2.04. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $89.18, though rates vary from $81.39 to $114.54 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 98001, 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 98001 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 98001 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 98001
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.6 | 1.6 |
| Practice Expense RVU | 0.92 | 0.35 |
| Malpractice RVU | 0.09 | 0.09 |
| Total RVU | 2.61 | 2.04 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 98001
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 | $93.35 | $70.82 | $89.64 - $105.24 | 29 |
| Florida | $90.12 | $71.02 | $87.34 - $93.03 | 3 |
| Georgia | $86.43 | $68.27 | $84.43 - $88.43 | 2 |
| Illinois | $89.07 | $70.67 | $86.2 - $91.6 | 4 |
| Michigan | $86.53 | $68.65 | $84.89 - $88.16 | 2 |
| North Carolina | $84.03 | $66.27 | $84.03 - $84.03 | 1 |
| New York | $94.34 | $73.1 | $84.75 - $98.98 | 5 |
| Ohio | $84.53 | $67.14 | $84.53 - $84.53 | 1 |
| Pennsylvania | $87.24 | $68.59 | $84.49 - $89.98 | 2 |
| Texas | $86.78 | $68.04 | $84.2 - $88.72 | 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 98001
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 98001 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 98001
What does CPT code 98001 mean? +
CPT code 98001 represents: Synch audio-video new low 30. It's in the Medicine/E&M category with a global period of XXX.
What is the Medicare reimbursement for CPT 98001? +
The 2026 Medicare national average non-facility payment for CPT 98001 is $89.18. Rates range from $81.39 to $114.54 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 98001? +
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 98001? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team