Home / Medicare fees / 0515U

0515U

What 0515U is

This code appears in the Medicare NCCI edit tables. It has no RVUs in the CY2026 Physician Fee Schedule file.

Advertisement

Medically Unlikely Edit (MUE)

Medicare caps 0515U 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 0515U? These codes are bundled into it

0515U is a Column 1 code in 7 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
36591Draw blood off venous device0 - no modifier bypassCheck pair
36592Collect blood from picc0 - no modifier bypassCheck pair
80230Drug assay infliximab0 - 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
96523Irrig drug delivery device0 - no modifier bypassCheck pair

0515U is bundled into these codes

0515U appears as a Column 2 code in 1 active edits. Reported with one of these Column 1 codes on the same date of service, 0515U is the code that denies.

Column 1 codeShort descriptionModifier indicator
0203U1Check 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.