`0504U`

What 0504U 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 0504U 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 0504U? These codes are bundled into it

0504U is a Column 1 code in 42 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
`0330U`		0 - no modifier 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
`81400`	Mopath procedure level 1	1 - modifier may bypass	Check pair
`81401`	Mopath procedure level 2	1 - modifier may bypass	Check pair
`81402`	Mopath procedure level 3	1 - modifier may bypass	Check pair
`81403`	Mopath procedure level 4	1 - modifier may bypass	Check pair
`81404`	Mopath procedure level 5	1 - modifier may bypass	Check pair
`81405`	Mopath procedure level 6	1 - modifier may bypass	Check pair
`81406`	Mopath procedure level 7	1 - modifier may bypass	Check pair
`81513`	Nfct ds bv rna vag flu alg	1 - modifier may bypass	Check pair
`81514`	Nfct ds bv&vaginitis dna alg	1 - modifier may bypass	Check pair
`87040`	Blood culture for bacteria	1 - modifier may bypass	Check pair
`87076`	Culture anaerobe ident each	1 - modifier may bypass	Check pair
`87077`	Culture aerobic identify	1 - modifier may bypass	Check pair
`87081`	Culture screen only	1 - modifier may bypass	Check pair
`87103`	Blood fungus culture	1 - modifier may bypass	Check pair
`87106`	Fungi identification yeast	1 - modifier may bypass	Check pair
`87107`	Fungi identification mold	1 - modifier may bypass	Check pair
`87181`	Sc std agar dilution per agt	1 - modifier may bypass	Check pair
`87184`	Sc std disk method per plate	1 - modifier may bypass	Check pair
`87185`	Sc std enzyme detcj per nzm	1 - modifier may bypass	Check pair
`87186`	Sc std microdil/agar dil	1 - modifier may bypass	Check pair
`87188`	Sc std macrobroth dil meth	1 - modifier may bypass	Check pair
`87190`	Sc std myobacteria prop meth	1 - modifier may bypass	Check pair
`87482`	Candida dna quant	1 - modifier may bypass	Check pair
`88271`	Cytogenetics dna probe	1 - modifier may bypass	Check pair

Showing 30 of 42 column 2 codes. Use the pair checker for any specific combination.

0504U is bundled into these codes

0504U appears as a Column 2 code in 6 active edits. Reported with one of these Column 1 codes on the same date of service, 0504U is the code that denies.

Column 1 code	Short description	Modifier indicator
`0321U`		1	Check pair
`81407`	Mopath procedure level 8	1	Check pair
`81408`	Mopath procedure level 9	1	Check pair
`88321`	Consltj&reprt sld prep elswr	1	Check pair
`88323`	Consltj&reprt matrl prep sld	1	Check pair
`88325`	Consltj compre rvw rec reprt	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.