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81455 So/hl 51/>gsap dna/dna&rna

What 81455 is

CMS fee schedule short descriptor: So/hl 51/>gsap dna/dna&rna.

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 81455 (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 81455 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 81455? These codes are bundled into it

81455 is a Column 1 code in 355 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
0020M1 - modifier may bypassCheck pair
0027U1 - modifier may bypassCheck pair
0030U1 - modifier may bypassCheck pair
0034U1 - modifier may bypassCheck pair
0040U1 - modifier may bypassCheck pair
0045U1 - modifier may bypassCheck pair
0046U1 - modifier may bypassCheck pair
0047U1 - modifier may bypassCheck pair
0049U1 - modifier may bypassCheck pair
0055U1 - modifier may bypassCheck pair
0069U1 - modifier may bypassCheck pair
0070U1 - modifier may bypassCheck pair
0071U1 - modifier may bypassCheck pair
0086U1 - modifier may bypassCheck pair
0087U1 - modifier may bypassCheck pair
0088U1 - modifier may bypassCheck pair
0089U1 - modifier may bypassCheck pair
0090U1 - modifier may bypassCheck pair
0108U1 - modifier may bypassCheck pair
0111U1 - modifier may bypassCheck pair
0118U1 - modifier may bypassCheck pair
0133U0 - no modifier 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

Showing 30 of 355 column 2 codes. Use the pair checker for any specific combination.

81455 is bundled into these codes

81455 appears as a Column 2 code in 56 active edits. Reported with one of these Column 1 codes on the same date of service, 81455 is the code that denies.

Column 1 codeShort descriptionModifier indicator
0005U1Check pair
0011M1Check pair
0012M1Check pair
0013M1Check pair
0016M1Check pair
0018U1Check pair
0019U1Check pair
0022U1Check pair
0023U1Check pair
0036U1Check pair
0037U1Check pair
0048U1Check pair
0050U1Check pair
0113U1Check pair
0120U1Check 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.