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0115U

What 0115U is

This code appears in the Medicare NCCI edit tables. It has no RVUs in the CY2026 Physician Fee Schedule file.

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Medically Unlikely Edit (MUE)

Medicare caps 0115U at 1 unit per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 0115U? These codes are bundled into it

0115U is a Column 1 code in 27 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 codeShort descriptionModifier indicator
80503Path clin consltj sf 5-201 - modifier may bypassCheck pair
80504Path clin consltj mod 21-401 - modifier may bypassCheck pair
80505Path clin consltj high 41-601 - modifier may bypassCheck pair
80506Path clin consltj prolng svc1 - modifier may bypassCheck pair
87260Adenovirus ag if0 - no modifier bypassCheck pair
87275Influenza b ag if0 - no modifier bypassCheck pair
87276Influenza a ag if0 - no modifier bypassCheck pair
87279Parainfluenza ag if0 - no modifier bypassCheck pair
87280Respiratory syncytial ag if0 - no modifier bypassCheck pair
87301Adenovirus ag ia0 - no modifier bypassCheck pair
87400Influenza a/b each ag ia0 - no modifier bypassCheck pair
87420Resp syncytial virus ag ia0 - no modifier bypassCheck pair
87428Sarscov & inf vir a&b ag ia0 - no modifier bypassCheck pair
87501Influenza dna amp prob 1+0 - no modifier bypassCheck pair
87502Influenza dna amp probe1 - modifier may bypassCheck pair
87503Influenza dna amp prob addl1 - modifier may bypassCheck pair
87631Resp virus 3-5 targets0 - no modifier bypassCheck pair
87632Resp virus 6-11 targets0 - no modifier bypassCheck pair
87634Rsv dna/rna amp probe1 - modifier may bypassCheck pair
87636Sarscov2 & inf a&b amp prb1 - modifier may bypassCheck pair
87637Sarscov2&inf a&b&rsv amp prb1 - modifier may bypassCheck pair
87801Detect agnt mult dna ampli1 - modifier may bypassCheck pair
87804Influenza assay w/optic1 - modifier may bypassCheck pair
87807Rsv assay w/optic1 - modifier may bypassCheck pair
87809Adenovirus assay w/optic1 - modifier may bypassCheck pair
87811Sars-cov-2 covid19 w/optic1 - modifier may bypassCheck pair
96523Irrig drug delivery device0 - no modifier bypassCheck pair

0115U is bundled into these codes

0115U appears as a Column 2 code in 260 active edits. Reported with one of these Column 1 codes on the same date of service, 0115U is the code that denies.

Column 1 codeShort descriptionModifier indicator
0008U1Check pair
0010U1Check pair
0016U1Check pair
0017U1Check pair
0027U1Check pair
0030U1Check pair
0034U1Check pair
0040U1Check pair
0046U1Check pair
0049U1Check pair
0070U1Check pair
0071U1Check pair
0072U1Check pair
0073U1Check pair
0074U1Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.