0743T B1 str & fx rsk vrt fx assmt
What 0743T is
CMS fee schedule short descriptor: B1 str & fx rsk vrt fx assmt.
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 0743T (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 0743T 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 0743T? These codes are bundled into it
0743T is a Column 1 code in 195 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 | |
|---|---|---|---|
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 |
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 |
12035 | Intmd rpr s/a/t/ext 12.6-20 | 1 - modifier may bypass | Check pair |
12036 | Intmd rpr s/a/t/ext 20.1-30 | 1 - modifier may bypass | Check pair |
12037 | Intmd rpr s/tr/ext >30.0 cm | 1 - modifier may bypass | Check pair |
12041 | Intmd rpr n-hf/genit 2.5cm/< | 1 - modifier may bypass | Check pair |
12042 | Intmd rpr n-hf/genit2.6-7.5 | 1 - modifier may bypass | Check pair |
12044 | Intmd rpr n-hf/genit7.6-12.5 | 1 - modifier may bypass | Check pair |
12045 | Intmd rpr n-hf/genit12.6-20 | 1 - modifier may bypass | Check pair |
Showing 30 of 195 column 2 codes. Use the pair checker for any specific combination.
0743T is bundled into these codes
0743T appears as a Column 2 code in 5 active edits. Reported with one of these Column 1 codes on the same date of service, 0743T is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
0554T | B1 str & fx rsk analysis | 0 | Check pair |
0555T | B1 str&fx rsk transmis data | 0 | Check pair |
0556T | B1 str & fx rsk assessment | 0 | Check pair |
0557T | B1 str & fx rsk i&r | 0 | Check pair |
0691T | Auto alys xst ct std vrt fx | 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.