`0467U`

What 0467U 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 0467U 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 0467U? These codes are bundled into it

0467U is a Column 1 code in 116 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
`0012M`		1 - modifier may bypass	Check pair
`0013M`		1 - modifier may bypass	Check pair
`0169U`		1 - modifier may bypass	Check pair
`0235U`		1 - modifier may bypass	Check pair
`0286U`		1 - modifier may bypass	Check pair
`0365U`		0 - no modifier bypass	Check pair
`0452U`		0 - no modifier bypass	Check pair
`0523U`		1 - modifier may bypass	Check pair
`36591`	Draw blood off venous device	0 - no modifier bypass	Check pair
`36592`	Collect blood from picc	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
`81170`	Abl1 gene	1 - modifier may bypass	Check pair
`81191`	Ntrk1 translocation analysis	1 - modifier may bypass	Check pair
`81192`	Ntrk2 translocation analysis	1 - modifier may bypass	Check pair
`81193`	Ntrk3 translocation analysis	1 - modifier may bypass	Check pair
`81194`	Ntrk translocation analysis	1 - modifier may bypass	Check pair
`81212`	Brca1&2 185&5385&6174 vrnt	1 - modifier may bypass	Check pair
`81215`	Brca1 gene known famil vrnt	1 - modifier may bypass	Check pair
`81216`	Brca2 gene full seq alys	1 - modifier may bypass	Check pair
`81217`	Brca2 gene known famil vrnt	1 - modifier may bypass	Check pair
`81235`	Egfr gene com variants	1 - modifier may bypass	Check pair
`81245`	Flt3 gene	1 - modifier may bypass	Check pair
`81246`	Flt3 gene analysis	1 - modifier may bypass	Check pair
`81261`	Igh gene rearrange amp meth	1 - modifier may bypass	Check pair
`81262`	Igh gene rearrang dir probe	1 - modifier may bypass	Check pair
`81263`	Igh vari regional mutation	1 - modifier may bypass	Check pair
`81264`	Igk rearrangeabn clonal pop	1 - modifier may bypass	Check pair
`81272`	Kit gene targeted seq analys	1 - modifier may bypass	Check pair

Showing 30 of 116 column 2 codes. Use the pair checker for any specific combination.

0467U is bundled into these codes

0467U appears as a Column 2 code in 9 active edits. Reported with one of these Column 1 codes on the same date of service, 0467U is the code that denies.

Column 1 code	Short description	Modifier indicator
`0239U`		1	Check pair
`0242U`		1	Check pair
`0244U`		1	Check pair
`0326U`		1	Check pair
`0422U`		1	Check pair
`81408`	Mopath procedure level 9	1	Check pair
`81425`	Genome sequence analysis	1	Check pair
`81427`	Genome re-evaluation	1	Check pair
`81455`	So/hl 51/>gsap dna/dna&rna	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.