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83950 Oncoprotein her-2/neu

What 83950 is

CMS fee schedule short descriptor: Oncoprotein her-2/neu.

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 83950 (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 83950 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 83950? These codes are bundled into it

83950 is a Column 1 code in 6 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
86294Immunoassay tumor qual1 - modifier may bypassCheck pair
86316Immunoassay tumor other1 - modifier may bypassCheck pair
88271Cytogenetics dna probe0 - no modifier bypassCheck pair
88274Cytogenetics 25-990 - no modifier bypassCheck pair
88275Cytogenetics 100-3000 - no modifier bypassCheck pair
96523Irrig drug delivery device0 - no modifier bypassCheck 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.