CPT 98980
Global XXX ActiveRtm tx mgmt 1st 20 min
CPT 98980 Billing & Documentation Guide
CPT code 98980 (Rtm tx mgmt 1st 20 min) is classified under Medicine/E&M with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.62, a non-facility practice expense RVU of 0.97, and a malpractice RVU of 0.03, a total non-facility RVU of 1.62 and facility RVU of 0.77. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $55.8, though rates vary from $49.06 to $70.24 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 98980, 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 98980 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 98980 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 98980
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.62 | 0.62 |
| Practice Expense RVU | 0.97 | 0.12 |
| Malpractice RVU | 0.03 | 0.03 |
| Total RVU | 1.62 | 0.77 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 98980
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 | $60.33 | $26.74 | $57.11 - $70.24 | 29 |
| Florida | $55.17 | $26.68 | $53.19 - $56.97 | 3 |
| Georgia | $52.85 | $25.77 | $50.8 - $54.89 | 2 |
| Illinois | $54 | $26.57 | $51.85 - $55.9 | 4 |
| Michigan | $52.54 | $25.88 | $51.42 - $53.66 | 2 |
| North Carolina | $51.58 | $25.09 | $51.58 - $51.58 | 1 |
| New York | $59.2 | $27.52 | $52.19 - $62.42 | 5 |
| Ohio | $51.3 | $25.38 | $51.3 - $51.3 | 1 |
| Pennsylvania | $53.7 | $25.89 | $51.4 - $56 | 2 |
| Texas | $53.65 | $25.7 | $51.12 - $55.92 | 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 98980
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 98980 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0578T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 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 |
| 93294 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 93295 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 93297 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 93298 | 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 | Yes | CPT Manual or CMS manual coding instruction |
| 96523 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 97750 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 98980
What does CPT code 98980 mean? +
CPT code 98980 represents: Rtm tx mgmt 1st 20 min. It's in the Medicine/E&M category with a global period of XXX.
What is the Medicare reimbursement for CPT 98980? +
The 2026 Medicare national average non-facility payment for CPT 98980 is $55.8. Rates range from $49.06 to $70.24 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 98980? +
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 98980? +
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 June 1, 2026.
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