`0436U`

What 0436U 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 0436U 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 0436U? These codes are bundled into it

0436U is a Column 1 code in 11 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
`0080U`		0 - no modifier bypass	Check pair
`0092U`		0 - no modifier bypass	Check pair
`0360U`		0 - no modifier bypass	Check pair
`0406U`		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
`83789`	Mass spectrometry qual/quan	1 - modifier may bypass	Check pair
`88291`	Cyto/molecular report	1 - modifier may bypass	Check pair
`96523`	Irrig drug delivery device	0 - no modifier bypass	Check pair
`G0452`	Molecular pathology interpr	1 - modifier may bypass	Check pair

0436U is bundled into these codes

0436U appears as a Column 2 code in 3 active edits. Reported with one of these Column 1 codes on the same date of service, 0436U is the code that denies.

Column 1 code	Short description	Modifier indicator
`0288U`		0	Check pair
`0388U`		0	Check pair
`0395U`		0	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.