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0690T Quan us tis charac w/dx us

What 0690T is

CMS fee schedule short descriptor: Quan us tis charac w/dx us.

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 0690T (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 0690T at 2 units per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Nature of Service/Procedure. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 0690T? These codes are bundled into it

0690T is a Column 1 code in 3 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
96523Irrig drug delivery device0 - no modifier bypassCheck pair

0690T is bundled into these codes

0690T appears as a Column 2 code in 66 active edits. Reported with one of these Column 1 codes on the same date of service, 0690T is the code that denies.

Column 1 codeShort descriptionModifier indicator
0689TQuan us tis charac w/o dx us0Check pair
76506Echo exam of head1Check pair
76510Oph us dx b-scan&quan a-scan1Check pair
76511Oph us dx quan a-scan only1Check pair
76512Oph us dx b-scan1Check pair
76513Oph us dx ant sgm us uni/bi1Check pair
76514Echo exam of eye thickness1Check pair
76516Echo exam of eye1Check pair
76519Echo exam of eye1Check pair
76706Us abdl aorta screen aaa1Check pair
76776Us exam k transpl w/doppler1Check pair
76800Us exam spinal canal1Check pair
76801Ob us < 14 wks single fetus1Check pair
76802Ob us < 14 wks addl fetus1Check pair
76805Ob us >/= 14 wks sngl fetus1Check 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.