`0420U`

What 0420U 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 0420U 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 0420U? These codes are bundled into it

0420U is a Column 1 code in 246 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	Modifier indicator
`0011M`	0 - no modifier bypass	Check pair
`0013M`	0 - no modifier bypass	Check pair
`0021U`	0 - no modifier bypass	Check pair
`0030U`	1 - modifier may bypass	Check pair
`0034U`	1 - modifier may bypass	Check pair
`0070U`	1 - modifier may bypass	Check pair
`0086U`	1 - modifier may bypass	Check pair
`0111U`	1 - modifier may bypass	Check pair
`0140U`	1 - modifier may bypass	Check pair
`0141U`	1 - modifier may bypass	Check pair
`0142U`	1 - modifier may bypass	Check pair
`0156U`	1 - modifier may bypass	Check pair
`0169U`	1 - modifier may bypass	Check pair
`0177U`	1 - modifier may bypass	Check pair
`0212U`	1 - modifier may bypass	Check pair
`0213U`	1 - modifier may bypass	Check pair
`0229U`	1 - modifier may bypass	Check pair
`0232U`	1 - modifier may bypass	Check pair
`0234U`	1 - modifier may bypass	Check pair
`0235U`	1 - modifier may bypass	Check pair
`0239U`	1 - modifier may bypass	Check pair
`0242U`	1 - modifier may bypass	Check pair
`0244U`	1 - modifier may bypass	Check pair
`0252U`	1 - modifier may bypass	Check pair
`0253U`	1 - modifier may bypass	Check pair
`0286U`	1 - modifier may bypass	Check pair
`0318U`	1 - modifier may bypass	Check pair
`0321U`	1 - modifier may bypass	Check pair
`0326U`	1 - modifier may bypass	Check pair
`0331U`	1 - modifier may bypass	Check pair

Showing 30 of 246 column 2 codes. Use the pair checker for any specific combination.

0420U is bundled into these codes

0420U appears as a Column 2 code in 29 active edits. Reported with one of these Column 1 codes on the same date of service, 0420U is the code that denies.

Column 1 code	Short description
`51020`	Cystotomy/cystostomy w/fulg	Check pair
`51525`	Removal of bladder lesion	Check pair
`51530`	Removal of bladder lesion	Check pair
`51535`	Repair of ureter lesion	Check pair
`51550`	Partial removal of bladder	Check pair
`51555`	Partial removal of bladder	Check pair
`51565`	Revise bladder & ureter(s)	Check pair
`51570`	Removal of bladder	Check pair
`51575`	Removal of bladder & nodes	Check pair
`51580`	Remove bladder/revise tract	Check pair
`51585`	Removal of bladder & nodes	Check pair
`51590`	Remove bladder/revise tract	Check pair
`51595`	Remove bladder/revise tract	Check pair
`51596`	Remove bladder/create pouch	Check pair
`51597`	Removal of pelvic structures	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.