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81418 Rx metab gen seq alys pnl 6

What 81418 is

CMS fee schedule short descriptor: Rx metab gen seq alys pnl 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 81418 (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 81418 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 81418? These codes are bundled into it

81418 is a Column 1 code in 386 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
0016U1 - modifier may bypassCheck pair
0017U1 - modifier may bypassCheck pair
0027U1 - modifier may bypassCheck pair
0030U1 - modifier may bypassCheck pair
0034U1 - modifier may bypassCheck pair
0040U1 - modifier may bypassCheck pair
0046U1 - modifier may bypassCheck pair
0049U1 - modifier may bypassCheck pair
0069U1 - modifier may bypassCheck pair
0070U1 - modifier may bypassCheck pair
0071U0 - no modifier bypassCheck pair
0072U0 - no modifier bypassCheck pair
0073U0 - no modifier bypassCheck pair
0074U0 - no modifier bypassCheck pair
0075U0 - no modifier bypassCheck pair
0076U0 - no modifier bypassCheck pair
0086U1 - modifier may bypassCheck pair
0111U1 - modifier may bypassCheck pair
0112U1 - modifier may bypassCheck pair
0115U1 - modifier may bypassCheck pair
0136U1 - modifier may bypassCheck pair
0137U1 - modifier may bypassCheck pair
0138U1 - modifier may bypassCheck pair
0140U1 - modifier may bypassCheck pair
0141U1 - modifier may bypassCheck pair
0142U1 - modifier may bypassCheck pair
0155U1 - modifier may bypassCheck pair
0156U1 - modifier may bypassCheck pair
0157U1 - modifier may bypassCheck pair

Showing 30 of 386 column 2 codes. Use the pair checker for any specific combination.

81418 is bundled into these codes

81418 appears as a Column 2 code in 124 active edits. Reported with one of these Column 1 codes on the same date of service, 81418 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.