87086 Urine culture/colony count
What 87086 is
CMS fee schedule short descriptor: Urine culture/colony count.
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 87086 (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 87086 at 3 units 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 87086? These codes are bundled into it
87086 is a Column 1 code in 8 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 | |
|---|---|---|---|
87070 | Culture othr specimn aerobic | 1 - modifier may bypass | Check pair |
87071 | Culture aerobic quant other | 1 - modifier may bypass | Check pair |
87073 | Culture bacteria anaerobic | 1 - modifier may bypass | Check pair |
87075 | Cultr bacteria except blood | 1 - modifier may bypass | Check pair |
87081 | Culture screen only | 1 - modifier may bypass | Check pair |
87084 | Culture of specimen by kit | 1 - modifier may bypass | Check pair |
88387 | Macroscopic xm dsj&prep tiss | 1 - modifier may bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
87086 is bundled into these codes
87086 appears as a Column 2 code in 1 active edits. Reported with one of these Column 1 codes on the same date of service, 87086 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
81007 | Urine screen for bacteria | 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.