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81405 Mopath procedure level 6

What 81405 is

CMS fee schedule short descriptor: Mopath procedure level 6.

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 81405 (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 81405 at 2 units per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Clinical: Data. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 81405? These codes are bundled into it

81405 is a Column 1 code in 38 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
0009U1 - modifier may bypassCheck pair
0086U1 - modifier may bypassCheck pair
0140U1 - modifier may bypassCheck pair
0141U1 - modifier may bypassCheck pair
0142U1 - modifier may bypassCheck pair
0321U1 - modifier may bypassCheck pair
0402U1 - modifier may bypassCheck pair
0429U1 - modifier may bypassCheck pair
0452U1 - modifier may bypassCheck pair
0455U1 - modifier may bypassCheck pair
0483U1 - modifier may bypassCheck pair
0484U1 - modifier may bypassCheck pair
0500U1 - modifier may bypassCheck pair
0501U1 - modifier may bypassCheck pair
80503Path clin consltj sf 5-201 - modifier may bypassCheck pair
80504Path clin consltj mod 21-401 - modifier may bypassCheck pair
80505Path clin consltj high 41-601 - modifier may bypassCheck pair
80506Path clin consltj prolng svc1 - modifier may bypassCheck pair
84311Spectrophotometry1 - modifier may bypassCheck pair
87513H pylri clrthmcn rst amp prb1 - modifier may bypassCheck pair
87564Mtb rifampin rst amp prb tq1 - modifier may bypassCheck pair
88271Cytogenetics dna probe1 - modifier may bypassCheck pair
88272Cytogenetics 3-51 - modifier may bypassCheck pair
88273Cytogenetics 10-301 - modifier may bypassCheck pair
88274Cytogenetics 25-991 - modifier may bypassCheck pair
88275Cytogenetics 100-3001 - modifier may bypassCheck pair
88291Cyto/molecular report1 - modifier may bypassCheck pair
88364Insitu hybridization (fish)1 - modifier may bypassCheck pair
88365Insitu hybridization (fish)1 - modifier may bypassCheck pair
88366Insitu hybridization (fish)1 - modifier may bypassCheck pair

Showing 30 of 38 column 2 codes. Use the pair checker for any specific combination.

81405 is bundled into these codes

81405 appears as a Column 2 code in 327 active edits. Reported with one of these Column 1 codes on the same date of service, 81405 is the code that denies.

Column 1 codeShort descriptionModifier indicator
0001U1Check pair
0004M1Check pair
0005U1Check pair
0006M1Check pair
0007M1Check pair
0008U1Check pair
0010U1Check pair
0011M1Check pair
0012M1Check pair
0013M1Check pair
0016M1Check pair
0018U1Check pair
0019U1Check pair
0022U1Check pair
0023U1Check 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.