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78267 Urea breath tst c-14 acquisj

What 78267 is

CMS fee schedule short descriptor: Urea breath tst c-14 acquisj.

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 78267 (CY2026)

This code has no Physician Fee Schedule rate: Statutory exclusion - not payable under the Physician Fee Schedule. 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 78267 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 78267? These codes are bundled into it

78267 is a Column 1 code in 10 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
0694T3d vol img&rcnstj brst/ax1 - modifier may bypassCheck pair
36005Injection ext venography1 - modifier may bypassCheck pair
36591Draw blood off venous device0 - no modifier bypassCheck pair
36592Collect blood from picc0 - no modifier bypassCheck pair
763763d render w/intrp postproces1 - modifier may bypassCheck pair
763773d render w/intrp postproces1 - modifier may bypassCheck pair
77790Radiation handling0 - no modifier bypassCheck pair
78445Vascular flow imaging0 - no modifier bypassCheck pair
83013H pylori (c-13) breath1 - modifier may bypassCheck pair
96523Irrig drug delivery device0 - no modifier bypassCheck pair

78267 is bundled into these codes

78267 appears as a Column 2 code in 4 active edits. Reported with one of these Column 1 codes on the same date of service, 78267 is the code that denies.

Column 1 codeShort descriptionModifier indicator
79005Nuclear rx oral admin0Check pair
83014H pylori drug admin1Check pair
83519Ria nonantibody1Check pair
83520Immunoassay quant nos nonab1Check 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.