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0165T Revise lumb artif disc addl

What 0165T is

CMS fee schedule short descriptor: Revise lumb artif disc addl.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 0165T (CY2026)

This code has no Physician Fee Schedule rate: Carrier-priced - the Medicare contractor sets the price. It may be paid under a different fee schedule (clinical laboratory, DMEPOS, anesthesia) or not paid at all - check the relevant CMS schedule.

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Medically Unlikely Edit (MUE)

Medicare caps 0165T at 4 units per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Anatomic Consideration. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 0165T? These codes are bundled into it

0165T is a Column 1 code in 33 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
11000Dbrdmt ecz/infected skin<10%1 - modifier may bypassCheck pair
11001Dbrdmt ecz/infct skn ea addl1 - modifier may bypassCheck pair
11004Dbrdmt skin xtrnl gent&per1 - modifier may bypassCheck pair
11005Dbrdmt skin abdominal wall1 - modifier may bypassCheck pair
11006Dbrdmt skin xtrnl gent per1 - modifier may bypassCheck pair
11042Dbrdmt subq tis 1st 20sqcm/<1 - modifier may bypassCheck pair
11043Dbrdmt musc&/fsca 1st 20/<1 - modifier may bypassCheck pair
11044Dbrdmt bone 1st 20 sq cm/<1 - modifier may bypassCheck pair
11045Dbrdmt subq tiss each addl1 - modifier may bypassCheck pair
11046Dbrdmt musc&/fsca ea addl1 - modifier may bypassCheck pair
11047Dbrdmt bone each addl1 - modifier may bypassCheck pair
22853Insj biomechanical device1 - modifier may bypassCheck pair
22854Insj biomechanical device1 - modifier may bypassCheck pair
22859Insj biomechanical device1 - modifier may bypassCheck pair
36591Draw blood off venous device0 - no modifier bypassCheck pair
36592Collect blood from picc0 - no modifier bypassCheck pair
38220Dx bone marrow aspirations1 - modifier may bypassCheck pair
38222Dx bone marrow bx & aspir1 - modifier may bypassCheck pair
38230Bone marrow harvest allogen0 - no modifier bypassCheck pair
38232Bone marrow harvest autolog0 - no modifier bypassCheck pair
49010Exploration behind abdomen0 - no modifier bypassCheck pair
63707Repair spinal fluid leakage1 - modifier may bypassCheck pair
63709Repair spinal fluid leakage1 - modifier may bypassCheck pair
96523Irrig drug delivery device0 - no modifier bypassCheck pair
97597Dbrdmt opn wnd 1st 20 cm/<1 - modifier may bypassCheck pair
97598Dbrdmt opn wnd addl 20cm/<1 - modifier may bypassCheck pair
97602Wound(s) care non-selective1 - modifier may bypassCheck pair
99446Ntrprof ph1/ntrnet/ehr 5-100 - no modifier bypassCheck pair
99447Ntrprof ph1/ntrnet/ehr 11-200 - no modifier bypassCheck pair
99448Ntrprof ph1/ntrnet/ehr 21-300 - no modifier bypassCheck pair

Showing 30 of 33 column 2 codes. Use the pair checker for any specific combination.

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.