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0461U

What 0461U is

This code appears in the Medicare NCCI edit tables. It has no RVUs in the CY2026 Physician Fee Schedule file.

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Medically Unlikely Edit (MUE)

Medicare caps 0461U 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 0461U? These codes are bundled into it

0461U is a Column 1 code in 67 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 codeShort descriptionModifier indicator
0005U1 - modifier may bypassCheck pair
0006M1 - modifier may bypassCheck pair
0007M1 - modifier may bypassCheck pair
0009U1 - modifier may bypassCheck pair
0011M1 - modifier may bypassCheck pair
0012M1 - modifier may bypassCheck pair
0013M1 - modifier may bypassCheck pair
0021U1 - modifier may bypassCheck pair
0069U1 - modifier may bypassCheck pair
0089U1 - modifier may bypassCheck pair
0091U1 - modifier may bypassCheck pair
0111U1 - modifier may bypassCheck pair
0113U1 - modifier may bypassCheck pair
0155U1 - modifier may bypassCheck pair
0177U1 - modifier may bypassCheck pair
0228U1 - modifier may bypassCheck pair
0229U1 - modifier may bypassCheck pair
0238U1 - modifier may bypassCheck pair
0286U1 - modifier may bypassCheck pair
0343U1 - modifier may bypassCheck pair
0348U1 - modifier may bypassCheck pair
0359U1 - modifier may bypassCheck pair
0363U1 - modifier may bypassCheck pair
0368U1 - modifier may bypassCheck pair
0403U1 - modifier may bypassCheck pair
0406U1 - modifier may bypassCheck pair
0421U1 - modifier may bypassCheck pair
0424U1 - modifier may bypassCheck pair
0433U1 - modifier may bypassCheck pair
0453U1 - modifier may bypassCheck pair

Showing 30 of 67 column 2 codes. Use the pair checker for any specific combination.

0461U is bundled into these codes

0461U appears as a Column 2 code in 62 active edits. Reported with one of these Column 1 codes on the same date of service, 0461U is the code that denies.

Column 1 codeShort descriptionModifier indicator
0016M1Check pair
0020M1Check pair
0036U1Check pair
0037U1Check pair
0045U1Check pair
0047U1Check pair
0048U1Check pair
0050U1Check pair
0090U1Check pair
0101U1Check pair
0102U1Check pair
0103U1Check pair
0108U1Check pair
0120U1Check pair
0129U1Check 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.