Home / Medicare fees / 0916T

0916T Insj perm ccm-d sys pg only

What 0916T is

CMS fee schedule short descriptor: Insj perm ccm-d sys pg 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 0916T (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.

Advertisement

Medically Unlikely Edit (MUE)

Medicare caps 0916T 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 0916T? These codes are bundled into it

0916T is a Column 1 code in 234 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
00530Anes perm transvns pm insj0 - no modifier bypassCheck pair
00534Anes insertion/rplcmt cvdfb0 - no modifier bypassCheck pair
0213TNjx paravert w/us cer/thor0 - no modifier bypassCheck pair
0216TNjx paravert w/us lumb/sac0 - no modifier bypassCheck pair
0412TRmvl cardiac modulj pls gen0 - no modifier bypassCheck pair
0416TReloc skin pocket pls gen0 - no modifier bypassCheck pair
0417TPrgrmg eval cardiac modulj0 - no modifier bypassCheck pair
0418TInterro eval cardiac modulj0 - no modifier bypassCheck pair
0575TPrgrmg dev eval icds ss ip1 - modifier may bypassCheck pair
0576TInterrog dev eval icds ss ip0 - no modifier bypassCheck pair
0596TTemp fml iu vlv-pmp 1st insj1 - modifier may bypassCheck pair
0597TTemp fml iu valve-pmp rplcmt1 - modifier may bypassCheck pair
0708TId ca immntx prep & 1st njx1 - modifier may bypassCheck pair
0919TRmvl perm ccm-d sys pg only0 - no modifier bypassCheck pair
0923TRmvl&rplcmt perm ccm-d pg0 - no modifier bypassCheck pair
0925TRlcj skin pocket ccm-d pg0 - no modifier bypassCheck pair
0926TPrgrmg dev eval ccm-d ip0 - no modifier bypassCheck pair
0927TInterrog dev eval ccm-d ip0 - no modifier 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
12001Rpr s/n/ax/gen/trnk 2.5cm/<1 - modifier may bypassCheck pair
12002Rpr s/n/ax/gen/trnk2.6-7.5cm1 - modifier may bypassCheck pair
12004Rpr s/n/ax/gen/trk7.6-12.5cm1 - modifier may bypassCheck pair
12005Rpr s/n/a/gen/trk12.6-20.0cm1 - modifier may bypassCheck pair
12006Rpr s/n/a/gen/trk20.1-30.0cm1 - modifier may bypassCheck pair

Showing 30 of 234 column 2 codes. Use the pair checker for any specific combination.

0916T is bundled into these codes

0916T appears as a Column 2 code in 64 active edits. Reported with one of these Column 1 codes on the same date of service, 0916T is the code that denies.

Column 1 codeShort descriptionModifier indicator
0408TInsj/rplc cardiac modulj sys0Check pair
0410TInsj/rplc car modulj atr elt0Check pair
0411TInsj/rplc car modulj vnt elt0Check pair
0414TRmvl & rpl car modulj pls gn0Check pair
0915TInsj perm ccm-d sys pg&eltrd0Check pair
0931TEphys eval ccm-d ld separate0Check pair
33206Insert heart pm atrial0Check pair
33207Insert heart pm ventricular0Check pair
33208Insrt heart pm atrial & vent0Check pair
33210Insert electrd/pm cath sngl0Check pair
33211Insert card electrodes dual0Check pair
33212Insert pulse gen sngl lead0Check pair
33213Insert pulse gen dual leads0Check pair
33214Upgrade of pacemaker system0Check pair
33215Reposition pacing-defib lead0Check 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.