`0424U`

What 0424U 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 0424U 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 0424U? These codes are bundled into it

0424U is a Column 1 code in 281 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
`0005U`	0 - no modifier bypass	Check pair
`0011M`	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
`0046U`	1 - modifier may bypass	Check pair
`0047U`	0 - no modifier bypass	Check pair
`0049U`	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
`0113U`	0 - no modifier 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
`0228U`	0 - no modifier bypass	Check pair
`0229U`	1 - modifier may bypass	Check pair
`0230U`	1 - modifier may bypass	Check pair
`0231U`	1 - modifier may bypass	Check pair
`0232U`	1 - modifier may bypass	Check pair
`0233U`	1 - modifier may bypass	Check pair
`0234U`	1 - modifier may bypass	Check pair
`0235U`	1 - modifier may bypass	Check pair
`0236U`	1 - modifier may bypass	Check pair
`0239U`	1 - modifier may bypass	Check pair

Showing 30 of 281 column 2 codes. Use the pair checker for any specific combination.

0424U is bundled into these codes

0424U appears as a Column 2 code in 38 active edits. Reported with one of these Column 1 codes on the same date of service, 0424U is the code that denies.

Column 1 code	Short description	Modifier indicator
`0343U`		0	Check pair
`0359U`		0	Check pair
`0460U`		1	Check pair
`0461U`		1	Check pair
`0474U`		1	Check pair
`0475U`		1	Check pair
`0582T`	Trurl abltj mal prst8 tiss	1	Check pair
`0655T`	Tprnl focal abltj mal prst8	0	Check pair
`0738T`	Tx pln mag fld abltj prst8	0	Check pair
`0739T`	Abltj mal prst8 mag fld ndct	0	Check pair
`0898T`	N-invas prst8 cancer est map	0	Check pair
`55801`	Removal of prostate	1	Check pair
`55810`	Extensive prostate surgery	1	Check pair
`55812`	Extensive prostate surgery	1	Check pair
`55815`	Extensive prostate surgery	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.