Home / Medicare fees / 0943T

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.

Advertisement

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 codeShort descriptionModifier indicator
00910Anes transurethral px nos0 - no modifier bypassCheck pair
00916Anes trurl px rescj bleeding0 - no modifier bypassCheck pair
00918Anes trurl px urtrl cal rmvl0 - no modifier bypassCheck pair
0213TNjx paravert w/us cer/thor0 - no modifier bypassCheck pair
0216TNjx paravert w/us lumb/sac0 - no modifier bypassCheck pair
0596TTemp fml iu vlv-pmp 1st insj0 - no modifier bypassCheck pair
0597TTemp fml iu valve-pmp rplcmt0 - no modifier bypassCheck pair
0708TId ca immntx prep & 1st njx1 - 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
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
12007Rpr s/n/ax/gen/trnk >30.0 cm1 - modifier may bypassCheck pair
12011Rpr f/e/e/n/l/m 2.5 cm/<1 - modifier may bypassCheck pair
12013Rpr f/e/e/n/l/m 2.6-5.0 cm1 - modifier may bypassCheck pair
12014Rpr f/e/e/n/l/m 5.1-7.5 cm1 - modifier may bypassCheck pair
12015Rpr f/e/e/n/l/m 7.6-12.5 cm1 - modifier may bypassCheck pair
12016Rpr fe/e/en/l/m 12.6-20.0 cm1 - modifier may bypassCheck pair
12017Rpr fe/e/en/l/m 20.1-30.0 cm1 - modifier may bypassCheck pair
12018Rpr f/e/e/n/l/m >30.0 cm1 - modifier may bypassCheck pair
12020Tx supfc wnd dehsn smpl clsr1 - modifier may bypassCheck pair
12021Tx supfc wnd dehsn w/packing1 - modifier may bypassCheck 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 codeShort descriptionModifier indicator
36640Insertion catheter artery1Check pair
50385Change stent via transureth1Check pair
50386Remove stent via transureth1Check pair
50947Laparo new ureter/bladder0Check pair
52001Cysto w/irrg&evac mlt clots0Check pair
52005Cysto w/urtrl cathj0Check pair
52007Cysto urtrl cathj brush bx0Check pair
52204Cystoscopy w/biopsy(s)0Check pair
52214Cystoscopy and treatment0Check pair
52224Cystoscopy and treatment0Check pair
52234Cystoscopy and treatment0Check pair
52235Cystoscopy and treatment0Check pair
52240Cystoscopy and treatment0Check pair
52250Cystoscopy and radiotracer0Check pair
52260Cystoscopy and treatment0Check 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.