0636T Ct breast w/3d bi c-
What 0636T is
CMS fee schedule short descriptor: Ct breast w/3d bi c-.
Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.
Medicare payment for 0636T (CY2026)
This code has no Physician Fee Schedule rate: Carrier-priced - the Medicare contractor sets the price. It may be paid under a different fee schedule (clinical laboratory, DMEPOS, anesthesia) or not paid at all - check the relevant CMS schedule.
Medically Unlikely Edit (MUE)
Medicare caps 0636T 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 0636T? These codes are bundled into it
0636T is a Column 1 code in 23 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 | |
|---|---|---|---|
0633T | Ct breast w/3d uni c- | 0 - no modifier bypass | Check pair |
0634T | Ct breast w/3d uni c+ | 0 - no modifier bypass | Check pair |
0635T | Ct breast w/3d uni c-/c+ | 0 - no modifier bypass | Check pair |
0694T | 3d vol img&rcnstj brst/ax | 1 - modifier may bypass | Check pair |
0708T | Id ca immntx prep & 1st njx | 1 - modifier may bypass | Check pair |
0709T | Id ca immntx each addl njx | 1 - modifier may bypass | Check pair |
36000 | Place needle in vein | 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 |
71250 | Ct thorax dx c- | 0 - no modifier bypass | Check pair |
71260 | Ct thorax dx c+ | 0 - no modifier bypass | Check pair |
71270 | Ct thorax dx c-/c+ | 0 - no modifier bypass | Check pair |
71271 | Ct thorax lung cancer scr c- | 0 - no modifier bypass | Check pair |
76376 | 3d render w/intrp postproces | 1 - modifier may bypass | Check pair |
76377 | 3d render w/intrp postproces | 1 - modifier may bypass | Check pair |
76380 | Cat scan follow-up study | 1 - modifier may bypass | Check pair |
96360 | Hydration iv infusion init | 1 - modifier may bypass | Check pair |
96365 | Ther/proph/diag iv inf init | 1 - modifier may bypass | Check pair |
96372 | Ther/proph/diag inj sc/im | 1 - modifier may bypass | Check pair |
96374 | Ther/proph/diag inj iv push | 1 - modifier may bypass | Check pair |
96375 | Tx/pro/dx inj new drug addon | 1 - modifier may bypass | Check pair |
96376 | Tx/pro/dx inj same drug adon | 1 - modifier may bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
0636T is bundled into these codes
0636T appears as a Column 2 code in 2 active edits. Reported with one of these Column 1 codes on the same date of service, 0636T is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
0637T | Ct breast w/3d bi c+ | 0 | Check pair |
0638T | Ct breast w/3d bi c-/c+ | 0 | 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.