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81458 So gsap dna cpy nmbr&mcrstl

What 81458 is

CMS fee schedule short descriptor: So gsap dna cpy nmbr&mcrstl.

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 81458 (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 81458 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 81458? These codes are bundled into it

81458 is a Column 1 code in 1 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
81457So neo gsap dna mcrstl ins0 - no modifier bypassCheck pair

81458 is bundled into these codes

81458 appears as a Column 2 code in 9 active edits. Reported with one of these Column 1 codes on the same date of service, 81458 is the code that denies.

Column 1 codeShort descriptionModifier indicator
0422U1Check pair
0485U1Check pair
0486U0Check pair
0487U0Check pair
0491U1Check pair
0492U1Check pair
0523U1Check pair
0530U1Check pair
81459So neo gsap dna/dna&rna0Check 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.