`0209U`

What 0209U is

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

Medically Unlikely Edit (MUE)

Medicare caps 0209U at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 0209U? These codes are bundled into it

0209U is a Column 1 code in 9 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 code	Short description	Modifier indicator
`0232U`		0 - no modifier bypass	Check pair
`0253U`		0 - no modifier bypass	Check pair
`0425U`		1 - modifier may bypass	Check pair
`0426U`		0 - no modifier bypass	Check pair
`80503`	Path clin consltj sf 5-20	1 - modifier may bypass	Check pair
`80504`	Path clin consltj mod 21-40	1 - modifier may bypass	Check pair
`80505`	Path clin consltj high 41-60	1 - modifier may bypass	Check pair
`80506`	Path clin consltj prolng svc	1 - modifier may bypass	Check pair
`81425`	Genome sequence analysis	0 - no modifier bypass	Check pair

0209U is bundled into these codes

0209U appears as a Column 2 code in 3 active edits. Reported with one of these Column 1 codes on the same date of service, 0209U is the code that denies.

Column 1 code	Modifier indicator
`0417U`	1	Check pair
`0454U`	1	Check pair
`0469U`	1	Check 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.