0397T Ercp w/optical endomicroscpy

What 0397T is

CMS fee schedule short descriptor: Ercp w/optical endomicroscpy.

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 0397T (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.

Medically Unlikely Edit (MUE)

Medicare caps 0397T 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 0397T? These codes are bundled into it

0397T is a Column 1 code in 239 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.

Showing 30 of 239 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.