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0863T Rlcj pg wcs lv trnsmtr only

What 0863T is

CMS fee schedule short descriptor: Rlcj pg wcs lv trnsmtr only.

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 0863T (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 0863T 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 0863T? These codes are bundled into it

0863T is a Column 1 code in 60 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
0522TPrgrmg dev eval wcs ip0 - no modifier bypassCheck pair
0861TRmvl pg wcs lv both compnt0 - no modifier bypassCheck pair
0932TN-invs det hrt fail aug echo1 - modifier may bypassCheck pair
11000Dbrdmt ecz/infected skin<10%1 - modifier may bypassCheck pair
11004Dbrdmt skin xtrnl gent&per1 - modifier may bypassCheck pair
11005Dbrdmt skin abdominal wall1 - modifier may bypassCheck pair
11006Dbrdmt skin xtrnl gent per1 - modifier may bypassCheck pair
11042Dbrdmt subq tis 1st 20sqcm/<1 - modifier may bypassCheck pair
11043Dbrdmt musc&/fsca 1st 20/<1 - modifier may bypassCheck pair
11044Dbrdmt bone 1st 20 sq cm/<1 - modifier may bypassCheck pair
35231Repair blvsl vn grf neck1 - modifier may bypassCheck pair
35236Repair blvsl vn grf uxtr1 - modifier may bypassCheck pair
35241Rpr blvsl vn grf ntrthrc w/b1 - modifier may bypassCheck pair
35246Rpr blvsl vn grf ntrthrc w/o1 - modifier may bypassCheck pair
35251Rpr blvsl vn grf intra-abdl1 - modifier may bypassCheck pair
35256Repair blvsl vn grf lxtr1 - modifier may bypassCheck pair
35261Rpr blvsl grf oth/thn vn nck1 - modifier may bypassCheck pair
35266Rpr blvsl grf oth/th vn uxtr1 - modifier may bypassCheck pair
35271Rpr blvs gr ot/th vn ntrth w1 - modifier may bypassCheck pair
35276Rpr blvs gr ot/t vn ntrth wo1 - modifier may bypassCheck pair
35281Rpr blvsl gr ot/th vn ntr-ab1 - modifier may bypassCheck pair
35286Rpr blvsl grf oth/th vn lxtr1 - modifier may bypassCheck pair
36591Draw blood off venous device0 - no modifier bypassCheck pair
36592Collect blood from picc0 - no modifier bypassCheck pair
76000Fluoroscopy <1 hr phys/qhp1 - modifier may bypassCheck pair
76998Us guide intraop0 - no modifier bypassCheck pair
93303Echo transthoracic0 - no modifier bypassCheck pair
93304Echo transthoracic0 - no modifier bypassCheck pair
93306Tte w/doppler complete0 - no modifier bypassCheck pair
93307Tte w/o doppler complete0 - no modifier bypassCheck pair

Showing 30 of 60 column 2 codes. Use the pair checker for any specific combination.

0863T is bundled into these codes

0863T appears as a Column 2 code in 6 active edits. Reported with one of these Column 1 codes on the same date of service, 0863T is the code that denies.

Column 1 codeShort descriptionModifier indicator
0515TInsj wcs lv compl sys0Check pair
0517TInsj wcs lv both compnt pg0Check pair
0518TRmvl pg wcs lv battery only0Check pair
0519TRmv&rplcmt pg wcs lv both0Check pair
0520TRmv&rplcmt pg wcs lv battery0Check pair
0521TInterrog dev eval wcs ip0Check 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.