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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.

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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 codeShort descriptionModifier indicator
0633TCt breast w/3d uni c-0 - no modifier bypassCheck pair
0634TCt breast w/3d uni c+0 - no modifier bypassCheck pair
0635TCt breast w/3d uni c-/c+0 - no modifier bypassCheck pair
0694T3d vol img&rcnstj brst/ax1 - modifier may bypassCheck pair
0708TId ca immntx prep & 1st njx1 - modifier may bypassCheck pair
0709TId ca immntx each addl njx1 - modifier may bypassCheck pair
36000Place needle in vein1 - modifier may bypassCheck pair
36591Draw blood off venous device0 - no modifier bypassCheck pair
36592Collect blood from picc0 - no modifier bypassCheck pair
71250Ct thorax dx c-0 - no modifier bypassCheck pair
71260Ct thorax dx c+0 - no modifier bypassCheck pair
71270Ct thorax dx c-/c+0 - no modifier bypassCheck pair
71271Ct thorax lung cancer scr c-0 - no modifier bypassCheck pair
763763d render w/intrp postproces1 - modifier may bypassCheck pair
763773d render w/intrp postproces1 - modifier may bypassCheck pair
76380Cat scan follow-up study1 - modifier may bypassCheck pair
96360Hydration iv infusion init1 - modifier may bypassCheck pair
96365Ther/proph/diag iv inf init1 - modifier may bypassCheck pair
96372Ther/proph/diag inj sc/im1 - modifier may bypassCheck pair
96374Ther/proph/diag inj iv push1 - modifier may bypassCheck pair
96375Tx/pro/dx inj new drug addon1 - modifier may bypassCheck pair
96376Tx/pro/dx inj same drug adon1 - modifier may bypassCheck pair
96523Irrig drug delivery device0 - no modifier bypassCheck 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 codeShort descriptionModifier indicator
0637TCt breast w/3d bi c+0Check pair
0638TCt breast w/3d bi c-/c+0Check 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.