81503 Onco (ovar) five proteins
What 81503 is
CMS fee schedule short descriptor: Onco (ovar) five proteins.
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 81503 (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.
Medically Unlikely Edit (MUE)
Medicare caps 81503 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 81503? These codes are bundled into it
81503 is a Column 1 code in 14 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 code | Short description | Modifier indicator | |
|---|---|---|---|
0251U | 0 - no modifier bypass | Check pair | |
80503 | Path clin consltj sf 5-20 | 1 - modifier may bypass | Check pair |
80504 | Path clin consltj mod 21-40 | 1 - modifier may bypass | Check pair |
80505 | Path clin consltj high 41-60 | 1 - modifier may bypass | Check pair |
80506 | Path clin consltj prolng svc | 1 - modifier may bypass | Check pair |
82172 | Assay of apolipoprotein | 0 - no modifier bypass | Check pair |
82232 | Assay of beta-2 protein | 0 - no modifier bypass | Check pair |
83695 | Assay of lipoprotein(a) | 1 - modifier may bypass | Check pair |
84134 | Assay of prealbumin | 0 - no modifier bypass | Check pair |
84466 | Assay of transferrin | 0 - no modifier bypass | Check pair |
86304 | Immunoassay tumor ca 125 | 0 - no modifier bypass | Check pair |
88291 | Cyto/molecular report | 1 - modifier may bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
G0452 | Molecular pathology interpr | 1 - modifier may bypass | Check pair |
81503 is bundled into these codes
81503 appears as a Column 2 code in 1 active edits. Reported with one of these Column 1 codes on the same date of service, 81503 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
0507U | 1 | Check 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.