86153
What 86153 is
This code appears in the Medicare NCCI edit tables. It has no RVUs in the CY2026 Physician Fee Schedule file.
Medically Unlikely Edit (MUE)
Medicare caps 86153 at 1 unit per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Clinical: Data. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 86153? These codes are bundled into it
86153 is a Column 1 code in 18 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 | |
|---|---|---|---|
86355 | B cells total count | 1 - modifier may bypass | Check pair |
86356 | Mononuclear cell antigen | 1 - modifier may 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 |
88184 | Flowcytometry/ tc 1 marker | 1 - modifier may bypass | Check pair |
88185 | Flowcytometry/tc add-on | 1 - modifier may bypass | Check pair |
88187 | Flowcytometry/read 2-8 | 1 - modifier may bypass | Check pair |
88188 | Flowcytometry/read 9-15 | 1 - modifier may bypass | Check pair |
88189 | Flowcytometry/read 16 & > | 1 - modifier may bypass | Check pair |
88313 | Special stains group 2 | 1 - modifier may bypass | Check pair |
88346 | Imfluor 1st 1antb stain px | 1 - modifier may bypass | Check pair |
88358 | Analysis tumor | 1 - modifier may bypass | Check pair |
88360 | Tumor immunohistochem/manual | 1 - modifier may bypass | Check pair |
88361 | Tumor immunohistochem/comput | 1 - modifier may bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | 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.