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You're viewing the Q1 2025 rate, effective January 2025 . See the current rate

CPT 98943

No national payment amount

Status N is not separately payable under the PFS.

Non-covered service. Not paid by Medicare.

Common questions

Why is there no payment amount for 98943?

Its status indicator is N (non-covered). Non-covered service. Not paid by Medicare. The blank is deliberate: the amount is unknown or paid another way, not zero.

When does this rate change?

CMS publishes a fee schedule release every quarter (January, April, July, October). Each release is versioned here, so past quarters stay lookupable — see what changed each release, or get an email when a new release moves rates.

Sources: CMS Medicare Physician Fee Schedule Relative Value Files.

Saw this code on your bill?

What is a 98943 visit in patient-friendly terms?

CPT 98943 is a billing code clinicians use to identify a specific service or procedure on a claim or explanation of benefits (EOB). We don't have a plain-language description on file for this exact code yet — ask your provider's billing office what service it represents, or bring it up at your next visit.

How this amount is computed

amount = (work RVU × work GPCI + PE RVU × PE GPCI + MP RVU × MP GPCI) × conversion factor. National amounts use GPCI = 1.000.

Release Q1 2025

Every rate combines three parts: work (the clinician’s time, skill and effort), practice expense (office overhead — higher when the service is done in a doctor’s own office), and malpractice (the share of liability-insurance cost). A value of blank means CMS publishes no national number for that part — which is not the same as zero.

Rate history by release

National non-facility amount for 98943 across quarterly releases. Up 5.9% since Q1 2025 · high $26.39 in Q1 2026

$26 $25 $23 $21 $19 Q1 2025 · $24.91 Q2 2025 · $24.91 (0.0%) Q3 2025 · $24.91 (0.0%) Q4 2025 · $24.91 (0.0%) Q1 2026 · $26.39 (+5.9%) Q2 2026 · $26.39 (0.0%) Q3 2026 · $26.39 (0.0%) Q1 2025 Q2 2025 Q3 2025 Q1 2026 Q2 2026 Q3 2026
Non-facility Facility
Release Status Non-facility Facility
Q3 2026 Jun 30, 2026 N $26.39 (0.0%) $19.37 (0.0%)
Q1 2026 Dec 29, 2025 N $26.39 (+5.9%) $19.37 (-10.6%)

Source & method

Computed from the CMS Medicare Physician Fee Schedule Q1 2025 release (schedule pfs, effective January 2025). National amounts apply a GPCI of 1.000 and exclude sequestration. Payability follows the status indicator, not RVU values — blank RVUs are never treated as zero. Releases are immutable; a rate retrieved for a past quarter always reflects that release.

Physician relative value file (Q1 2025) · 2025.zip (PPRRVU25_JAN.csv row 18,645)

Conversion factor $32.3465 read from the same file, row 11, column 25.

Use the (i) buttons next to each amount above for the exact row, columns, and math.