0728T Dx alys vstblr implt uni 1st
What 0728T is
CMS fee schedule short descriptor: Dx alys vstblr implt uni 1st.
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 0728T (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 0728T 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 0728T? These codes are bundled into it
0728T is a Column 1 code in 242 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 | |
|---|---|---|---|
0208T | Audiometry air only | 0 - no modifier bypass | Check pair |
0209T | Audiometry air & bone | 0 - no modifier bypass | Check pair |
0210T | Speech audiometry threshold | 0 - no modifier bypass | Check pair |
0211T | Speech audiom thresh & recog | 0 - no modifier bypass | Check pair |
0212T | Compre audiometry evaluation | 0 - no modifier bypass | Check pair |
0213T | Njx paravert w/us cer/thor | 0 - no modifier bypass | Check pair |
0216T | Njx paravert w/us lumb/sac | 0 - no modifier bypass | Check pair |
0485T | Oct mid ear i&r unilateral | 1 - modifier may bypass | Check pair |
0486T | Oct mid ear i&r bilateral | 1 - modifier may bypass | Check pair |
0903T | Ecg alg 12 lead reduced i&r | 1 - modifier may bypass | Check pair |
0904T | Ecg alg 12 ld rdcd trcg only | 1 - modifier may bypass | Check pair |
0905T | Ecg alg 12 ld rdcd i&r only | 1 - modifier may bypass | Check pair |
12001 | Rpr s/n/ax/gen/trnk 2.5cm/< | 1 - modifier may bypass | Check pair |
12002 | Rpr s/n/ax/gen/trnk2.6-7.5cm | 1 - modifier may bypass | Check pair |
12004 | Rpr s/n/ax/gen/trk7.6-12.5cm | 1 - modifier may bypass | Check pair |
12005 | Rpr s/n/a/gen/trk12.6-20.0cm | 1 - modifier may bypass | Check pair |
12006 | Rpr s/n/a/gen/trk20.1-30.0cm | 1 - modifier may bypass | Check pair |
12007 | Rpr s/n/ax/gen/trnk >30.0 cm | 1 - modifier may bypass | Check pair |
12011 | Rpr f/e/e/n/l/m 2.5 cm/< | 1 - modifier may bypass | Check pair |
12013 | Rpr f/e/e/n/l/m 2.6-5.0 cm | 1 - modifier may bypass | Check pair |
12014 | Rpr f/e/e/n/l/m 5.1-7.5 cm | 1 - modifier may bypass | Check pair |
12015 | Rpr f/e/e/n/l/m 7.6-12.5 cm | 1 - modifier may bypass | Check pair |
12016 | Rpr fe/e/en/l/m 12.6-20.0 cm | 1 - modifier may bypass | Check pair |
12017 | Rpr fe/e/en/l/m 20.1-30.0 cm | 1 - modifier may bypass | Check pair |
12018 | Rpr f/e/e/n/l/m >30.0 cm | 1 - modifier may bypass | Check pair |
12020 | Tx supfc wnd dehsn smpl clsr | 1 - modifier may bypass | Check pair |
12021 | Tx supfc wnd dehsn w/packing | 1 - modifier may bypass | Check pair |
12031 | Intmd rpr s/a/t/ext 2.5 cm/< | 1 - modifier may bypass | Check pair |
12032 | Intmd rpr s/a/t/ext 2.6-7.5 | 1 - modifier may bypass | Check pair |
12034 | Intmd rpr s/tr/ext 7.6-12.5 | 1 - modifier may bypass | Check pair |
Showing 30 of 242 column 2 codes. Use the pair checker for any specific combination.
0728T is bundled into these codes
0728T appears as a Column 2 code in 2 active edits. Reported with one of these Column 1 codes on the same date of service, 0728T is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
92601 | Cochlear implt f/up exam <7 | 0 | Check pair |
92603 | Cochlear implt f/up exam 7/> | 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.