`0474U`

What 0474U 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 0474U 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 0474U? These codes are bundled into it

0474U is a Column 1 code in 146 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
`0009U`	1 - modifier may bypass	Check pair
`0016U`	1 - modifier may bypass	Check pair
`0017U`	1 - modifier may bypass	Check pair
`0048U`	0 - no modifier bypass	Check pair
`0069U`	1 - modifier may bypass	Check pair
`0089U`	0 - no modifier bypass	Check pair
`0091U`	0 - no modifier bypass	Check pair
`0111U`	1 - modifier may bypass	Check pair
`0129U`	0 - no modifier bypass	Check pair
`0155U`	1 - modifier may bypass	Check pair
`0177U`	1 - modifier may bypass	Check pair
`0228U`	1 - modifier may bypass	Check pair
`0229U`	1 - modifier may bypass	Check pair
`0235U`	0 - no modifier bypass	Check pair
`0314U`	0 - no modifier bypass	Check pair
`0343U`	1 - modifier may bypass	Check pair
`0359U`	1 - modifier may bypass	Check pair
`0368U`	0 - no modifier bypass	Check pair
`0403U`	1 - modifier may bypass	Check pair
`0405U`	1 - modifier may bypass	Check pair
`0406U`	1 - modifier may bypass	Check pair
`0410U`	1 - modifier may bypass	Check pair
`0421U`	0 - no modifier bypass	Check pair
`0422U`	1 - modifier may bypass	Check pair
`0424U`	1 - modifier may bypass	Check pair
`0433U`	1 - modifier may bypass	Check pair
`0453U`	0 - no modifier bypass	Check pair
`0471U`	1 - modifier may bypass	Check pair
`0475U`	0 - no modifier bypass	Check pair
`0501U`	0 - no modifier bypass	Check pair

Showing 30 of 146 column 2 codes. Use the pair checker for any specific combination.

0474U is bundled into these codes

0474U appears as a Column 2 code in 21 active edits. Reported with one of these Column 1 codes on the same date of service, 0474U is the code that denies.

Column 1 code	Short description	Modifier indicator
`0045U`		1	Check pair
`0047U`		1	Check pair
`0090U`		0	Check pair
`0101U`		0	Check pair
`0153U`		0	Check pair
`0250U`		0	Check pair
`0288U`		1	Check pair
`0317U`		1	Check pair
`0334U`		1	Check pair
`81162`	Brca1&2 gen full seq dup/del	0	Check pair
`81437`	Hered neuroend tum-rlt do 5+	0	Check pair
`81518`	Onc brst mrna 11 genes	1	Check pair
`81519`	Oncology breast mrna	1	Check pair
`81520`	Onc breast mrna 58 genes	1	Check pair
`81521`	Onc breast mrna 70 genes	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.