`0407U`

What 0407U 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 0407U 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 0407U? These codes are bundled into it

0407U is a Column 1 code in 31 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
`0105U`		0 - no modifier bypass	Check pair
`0384U`		1 - modifier may bypass	Check pair
`0500U`		1 - modifier may 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
`81105`	Hpa-1 genotyping	1 - modifier may bypass	Check pair
`81106`	Hpa-2 genotyping	1 - modifier may bypass	Check pair
`81107`	Hpa-3 genotyping	1 - modifier may bypass	Check pair
`81108`	Hpa-4 genotyping	1 - modifier may bypass	Check pair
`81109`	Hpa-5 genotyping	1 - modifier may bypass	Check pair
`81110`	Hpa-6 genotyping	1 - modifier may bypass	Check pair
`81111`	Hpa-9 genotyping	1 - modifier may bypass	Check pair
`81112`	Hpa-15 genotyping	1 - modifier may bypass	Check pair
`81400`	Mopath procedure level 1	1 - modifier may bypass	Check pair
`81401`	Mopath procedure level 2	1 - modifier may bypass	Check pair
`81402`	Mopath procedure level 3	1 - modifier may bypass	Check pair
`81403`	Mopath procedure level 4	1 - modifier may bypass	Check pair
`81404`	Mopath procedure level 5	1 - modifier may bypass	Check pair
`81405`	Mopath procedure level 6	1 - modifier may bypass	Check pair
`81406`	Mopath procedure level 7	1 - modifier may bypass	Check pair
`81407`	Mopath procedure level 8	1 - modifier may bypass	Check pair
`81417`	Exome re-evaluation	1 - modifier may bypass	Check pair
`81465`	Whole mitochondrial genome	1 - modifier may bypass	Check pair
`81479`	Unlisted molecular pathology	1 - modifier may bypass	Check pair
`82172`	Assay of apolipoprotein	1 - modifier may bypass	Check pair
`83001`	Assay of gonadotropin (fsh)	1 - modifier may bypass	Check pair
`84466`	Assay of transferrin	1 - modifier may bypass	Check pair
`86304`	Immunoassay tumor ca 125	1 - modifier may bypass	Check pair
`86305`	Human epididymis protein 4	1 - modifier may bypass	Check pair

Showing 30 of 31 column 2 codes. Use the pair checker for any specific combination.

0407U is bundled into these codes

0407U appears as a Column 2 code in 29 active edits. Reported with one of these Column 1 codes on the same date of service, 0407U is the code that denies.

Column 1 code	Short description	Modifier indicator
`0036U`		1	Check pair
`0094U`		1	Check pair
`0489U`		1	Check pair
`81408`	Mopath procedure level 9	1	Check pair
`81415`	Exome sequence analysis	1	Check pair
`81425`	Genome sequence analysis	1	Check pair
`81427`	Genome re-evaluation	1	Check pair
`81443`	Genetic tstg severe inh cond	1	Check pair
`90951`	Esrd serv 4 visits p mo <2yr	1	Check pair
`90952`	Esrd serv 2-3 vsts p mo <2yr	1	Check pair
`90953`	Esrd serv 1 visit p mo <2yrs	1	Check pair
`90954`	Esrd serv 4 vsts p mo 2-11	1	Check pair
`90955`	Esrd srv 2-3 vsts p mo 2-11	1	Check pair
`90956`	Esrd srv 1 visit p mo 2-11	1	Check pair
`90957`	Esrd srv 4 vsts p mo 12-19	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.