0943T Cysto flx rmvl urtl scaffold
What 0943T is
CMS fee schedule short descriptor: Cysto flx rmvl urtl scaffold.
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 0943T (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 0943T at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Anatomic Consideration. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 0943T? These codes are bundled into it
0943T is a Column 1 code in 213 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 | |
|---|---|---|---|
00910 | Anes transurethral px nos | 0 - no modifier bypass | Check pair |
00916 | Anes trurl px rescj bleeding | 0 - no modifier bypass | Check pair |
00918 | Anes trurl px urtrl cal rmvl | 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 |
0596T | Temp fml iu vlv-pmp 1st insj | 0 - no modifier bypass | Check pair |
0597T | Temp fml iu valve-pmp rplcmt | 0 - no modifier bypass | Check pair |
0708T | Id ca immntx prep & 1st njx | 1 - modifier may bypass | Check pair |
11000 | Dbrdmt ecz/infected skin<10% | 1 - modifier may bypass | Check pair |
11004 | Dbrdmt skin xtrnl gent&per | 1 - modifier may bypass | Check pair |
11005 | Dbrdmt skin abdominal wall | 1 - modifier may bypass | Check pair |
11006 | Dbrdmt skin xtrnl gent per | 1 - modifier may bypass | Check pair |
11042 | Dbrdmt subq tis 1st 20sqcm/< | 1 - modifier may bypass | Check pair |
11043 | Dbrdmt musc&/fsca 1st 20/< | 1 - modifier may bypass | Check pair |
11044 | Dbrdmt bone 1st 20 sq cm/< | 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 |
Showing 30 of 213 column 2 codes. Use the pair checker for any specific combination.
0943T is bundled into these codes
0943T appears as a Column 2 code in 67 active edits. Reported with one of these Column 1 codes on the same date of service, 0943T is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
36640 | Insertion catheter artery | 1 | Check pair |
50385 | Change stent via transureth | 1 | Check pair |
50386 | Remove stent via transureth | 1 | Check pair |
50947 | Laparo new ureter/bladder | 0 | Check pair |
52001 | Cysto w/irrg&evac mlt clots | 0 | Check pair |
52005 | Cysto w/urtrl cathj | 0 | Check pair |
52007 | Cysto urtrl cathj brush bx | 0 | Check pair |
52204 | Cystoscopy w/biopsy(s) | 0 | Check pair |
52214 | Cystoscopy and treatment | 0 | Check pair |
52224 | Cystoscopy and treatment | 0 | Check pair |
52234 | Cystoscopy and treatment | 0 | Check pair |
52235 | Cystoscopy and treatment | 0 | Check pair |
52240 | Cystoscopy and treatment | 0 | Check pair |
52250 | Cystoscopy and radiotracer | 0 | Check pair |
52260 | Cystoscopy and treatment | 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.