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81560 Trnsplj pd lvr&bwl cd154+cll

What 81560 is

CMS fee schedule short descriptor: Trnsplj pd lvr&bwl cd154+cll.

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 81560 (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 81560 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 81560? These codes are bundled into it

81560 is a Column 1 code in 31 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
85008Bl smear w/o diff wbc count0 - no modifier bypassCheck pair
85032Manual cell count each0 - no modifier bypassCheck pair
86353Lymphocyte transformation0 - no modifier bypassCheck pair
86355B cells total count1 - modifier may bypassCheck pair
86356Mononuclear cell antigen0 - no modifier bypassCheck pair
86357Nk cells total count1 - modifier may bypassCheck pair
86359T cells total count1 - modifier may bypassCheck pair
86360T cell absolute count/ratio1 - modifier may bypassCheck pair
86361T cell absolute count1 - modifier may bypassCheck pair
86367Stem cells total count1 - modifier may bypassCheck pair
86821Lymphocyte culture mixed0 - no modifier bypassCheck pair
86930Frozen blood prep0 - no modifier bypassCheck pair
88108Cytopath concentrate tech1 - modifier may bypassCheck pair
88112Cytopath cell enhance tech1 - modifier may bypassCheck pair
88160Cytopath smear other source1 - modifier may bypassCheck pair
88161Cytopath smear other source1 - modifier may bypassCheck pair
88162Cytopath smear other source1 - modifier may bypassCheck pair
88184Flowcytometry/ tc 1 marker0 - no modifier bypassCheck pair
88185Flowcytometry/tc add-on0 - no modifier bypassCheck pair
88187Flowcytometry/read 2-80 - no modifier bypassCheck pair
88188Flowcytometry/read 9-150 - no modifier bypassCheck pair
88189Flowcytometry/read 16 & >0 - no modifier bypassCheck pair
88230Tissue culture lymphocyte0 - no modifier bypassCheck pair
88240Cell cryopreserve/storage0 - no modifier bypassCheck pair
88241Frozen cell preparation0 - no modifier bypassCheck pair
88342Imhchem/imcytchm 1st antb1 - modifier may bypassCheck pair
88344Imhchem/imcytchm ea mlt antb1 - modifier may bypassCheck pair
88387Macroscopic xm dsj&prep tiss1 - modifier may bypassCheck pair
89258Cryopreservation embryo(s)0 - no modifier bypassCheck pair
89259Cryopreservation sperm0 - no modifier bypassCheck pair

Showing 30 of 31 column 2 codes. Use the pair checker for any specific combination.

81560 is bundled into these codes

81560 appears as a Column 2 code in 2 active edits. Reported with one of these Column 1 codes on the same date of service, 81560 is the code that denies.

Column 1 codeShort descriptionModifier indicator
0018M1Check pair
0493U0Check 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.