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.
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 code | Short description | Modifier indicator | |
|---|---|---|---|
85008 | Bl smear w/o diff wbc count | 0 - no modifier bypass | Check pair |
85032 | Manual cell count each | 0 - no modifier bypass | Check pair |
86353 | Lymphocyte transformation | 0 - no modifier bypass | Check pair |
86355 | B cells total count | 1 - modifier may bypass | Check pair |
86356 | Mononuclear cell antigen | 0 - no modifier bypass | Check pair |
86357 | Nk cells total count | 1 - modifier may bypass | Check pair |
86359 | T cells total count | 1 - modifier may bypass | Check pair |
86360 | T cell absolute count/ratio | 1 - modifier may bypass | Check pair |
86361 | T cell absolute count | 1 - modifier may bypass | Check pair |
86367 | Stem cells total count | 1 - modifier may bypass | Check pair |
86821 | Lymphocyte culture mixed | 0 - no modifier bypass | Check pair |
86930 | Frozen blood prep | 0 - no modifier bypass | Check pair |
88108 | Cytopath concentrate tech | 1 - modifier may bypass | Check pair |
88112 | Cytopath cell enhance tech | 1 - modifier may bypass | Check pair |
88160 | Cytopath smear other source | 1 - modifier may bypass | Check pair |
88161 | Cytopath smear other source | 1 - modifier may bypass | Check pair |
88162 | Cytopath smear other source | 1 - modifier may bypass | Check pair |
88184 | Flowcytometry/ tc 1 marker | 0 - no modifier bypass | Check pair |
88185 | Flowcytometry/tc add-on | 0 - no modifier bypass | Check pair |
88187 | Flowcytometry/read 2-8 | 0 - no modifier bypass | Check pair |
88188 | Flowcytometry/read 9-15 | 0 - no modifier bypass | Check pair |
88189 | Flowcytometry/read 16 & > | 0 - no modifier bypass | Check pair |
88230 | Tissue culture lymphocyte | 0 - no modifier bypass | Check pair |
88240 | Cell cryopreserve/storage | 0 - no modifier bypass | Check pair |
88241 | Frozen cell preparation | 0 - no modifier bypass | Check pair |
88342 | Imhchem/imcytchm 1st antb | 1 - modifier may bypass | Check pair |
88344 | Imhchem/imcytchm ea mlt antb | 1 - modifier may bypass | Check pair |
88387 | Macroscopic xm dsj&prep tiss | 1 - modifier may bypass | Check pair |
89258 | Cryopreservation embryo(s) | 0 - no modifier bypass | Check pair |
89259 | Cryopreservation sperm | 0 - no modifier bypass | Check 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 code | Short description | Modifier indicator | |
|---|---|---|---|
0018M | 1 | Check pair | |
0493U | 0 | 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.