`0485U`

What 0485U 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 0485U 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 0485U? These codes are bundled into it

0485U is a Column 1 code in 106 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
`0048U`		1 - modifier may bypass	Check pair
`0172U`		1 - modifier may bypass	Check pair
`0174U`		1 - modifier may bypass	Check pair
`0229U`		1 - modifier may bypass	Check pair
`0244U`		1 - modifier may bypass	Check pair
`0250U`		1 - modifier may bypass	Check pair
`0262U`		1 - modifier may bypass	Check pair
`0317U`		1 - modifier may bypass	Check pair
`0334U`		1 - modifier may bypass	Check pair
`0338U`		1 - modifier may bypass	Check pair
`0347U`		1 - modifier may bypass	Check pair
`0348U`		1 - modifier may bypass	Check pair
`0349U`		1 - modifier may bypass	Check pair
`0350U`		1 - modifier may bypass	Check pair
`0409U`		1 - modifier may bypass	Check pair
`0523U`		1 - modifier may bypass	Check pair
`0530U`		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
`81120`	Idh1 common variants	1 - modifier may bypass	Check pair
`81121`	Idh2 common variants	1 - modifier may bypass	Check pair
`81162`	Brca1&2 gen full seq dup/del	1 - modifier may bypass	Check pair
`81163`	Brca1&2 gene full seq alys	1 - modifier may bypass	Check pair
`81164`	Brca1&2 gen ful dup/del alys	1 - modifier may bypass	Check pair
`81165`	Brca1 gene full seq alys	1 - modifier may bypass	Check pair
`81166`	Brca1 gene full dup/del alys	1 - modifier may bypass	Check pair
`81167`	Brca2 gene full dup/del alys	1 - modifier may bypass	Check pair

Showing 30 of 106 column 2 codes. Use the pair checker for any specific combination.

0485U is bundled into these codes

0485U appears as a Column 2 code in 1 active edits. Reported with one of these Column 1 codes on the same date of service, 0485U is the code that denies.

Column 1 code	Short description	Modifier indicator
`81425`	Genome sequence analysis	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.