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0464U

What 0464U 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 0464U 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 0464U? These codes are bundled into it

0464U is a Column 1 code in 66 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
0091U0 - no modifier bypassCheck pair
0163U0 - no modifier bypassCheck pair
0229U1 - modifier may bypassCheck pair
0238U1 - modifier may bypassCheck pair
0453U0 - no modifier bypassCheck pair
0496U1 - modifier may bypassCheck pair
0501U0 - no modifier bypassCheck pair
36591Draw blood off venous device0 - no modifier bypassCheck pair
36592Collect blood from picc0 - no modifier bypassCheck pair
80503Path clin consltj sf 5-201 - modifier may bypassCheck pair
80504Path clin consltj mod 21-401 - modifier may bypassCheck pair
80505Path clin consltj high 41-601 - modifier may bypassCheck pair
81191Ntrk1 translocation analysis1 - modifier may bypassCheck pair
81192Ntrk2 translocation analysis1 - modifier may bypassCheck pair
81193Ntrk3 translocation analysis1 - modifier may bypassCheck pair
81194Ntrk translocation analysis1 - modifier may bypassCheck pair
81202Apc gene known fam variants1 - modifier may bypassCheck pair
81203Apc gene dup/delet variants1 - modifier may bypassCheck pair
81210Braf gene1 - modifier may bypassCheck pair
81275Kras gene variants exon 21 - modifier may bypassCheck pair
81276Kras gene addl variants1 - modifier may bypassCheck pair
81288Mlh1 gene1 - modifier may bypassCheck pair
81293Mlh1 gene known variants1 - modifier may bypassCheck pair
81294Mlh1 gene dup/delete variant1 - modifier may bypassCheck pair
81295Msh2 gene full seq1 - modifier may bypassCheck pair
81296Msh2 gene known variants1 - modifier may bypassCheck pair
81297Msh2 gene dup/delete variant1 - modifier may bypassCheck pair
81299Msh6 gene known variants1 - modifier may bypassCheck pair
81300Msh6 gene dup/delete variant1 - modifier may bypassCheck pair
81301Microsatellite instability1 - modifier may bypassCheck pair

Showing 30 of 66 column 2 codes. Use the pair checker for any specific combination.

0464U is bundled into these codes

0464U appears as a Column 2 code in 20 active edits. Reported with one of these Column 1 codes on the same date of service, 0464U is the code that denies.

Column 1 codeShort descriptionModifier indicator
0101U1Check pair
0111U0Check pair
0498U1Check pair
0499U1Check pair
81201Apc gene full sequence1Check pair
81292Mlh1 gene full seq1Check pair
81298Msh6 gene full seq1Check pair
81317Pms2 gene full seq analysis1Check pair
81321Pten gene full sequence1Check pair
81415Exome sequence analysis1Check pair
81425Genome sequence analysis1Check pair
81427Genome re-evaluation1Check pair
81435Hered colon ca-rlatd do 5+1Check pair
81445So neo gsap 5-50dna/dna&rna1Check pair
81449So neo gsap 5-50 rna alys1Check 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.