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87253 Virus inoculate tissue addl

What 87253 is

CMS fee schedule short descriptor: Virus inoculate tissue addl.

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 87253 (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 87253 at 2 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 87253? These codes are bundled into it

87253 is a Column 1 code in 57 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
0429U1 - modifier may bypassCheck pair
0463U1 - modifier may bypassCheck pair
87260Adenovirus ag if1 - modifier may bypassCheck pair
87267Enterovirus antibody dfa1 - modifier may bypassCheck pair
87271Cytomegalovirus dfa1 - modifier may bypassCheck pair
87274Herpes simplex 1 ag if1 - modifier may bypassCheck pair
87276Influenza a ag if1 - modifier may bypassCheck pair
87280Respiratory syncytial ag if1 - modifier may bypassCheck pair
87290Varicella zoster ag if1 - modifier may bypassCheck pair
87301Adenovirus ag ia1 - modifier may bypassCheck pair
87305Aspergillus ag ia1 - modifier may bypassCheck pair
87332Cytomegalovirus ag ia1 - modifier may bypassCheck pair
87340Hepatitis b surface ag ia1 - modifier may bypassCheck pair
87350Hepatitis be ag ia1 - modifier may bypassCheck pair
87380Hepatitis delta agent ag ia1 - modifier may bypassCheck pair
87389Hiv-1 ag w/hiv-1&-2 ab ag ia1 - modifier may bypassCheck pair
87390Hiv-1 ag ia1 - modifier may bypassCheck pair
87391Hiv-2 ag ia1 - modifier may bypassCheck pair
87420Resp syncytial virus ag ia1 - modifier may bypassCheck pair
87425Rotavirus ag ia1 - modifier may bypassCheck pair
87467Hepatitis b surface ag quan1 - modifier may bypassCheck pair
87483Cns dna amp probe type 12-251 - modifier may bypassCheck pair
87495Cytomeg dna dir probe1 - modifier may bypassCheck pair
87496Cytomeg dna amp probe1 - modifier may bypassCheck pair
87497Cytomeg dna quant1 - modifier may bypassCheck pair
87498Enterovirus probe&revrs trns1 - modifier may bypassCheck pair
87516Hepatitis b dna amp probe1 - modifier may bypassCheck pair
87517Hepatitis b dna quant1 - modifier may bypassCheck pair
87520Hepatitis c rna dir probe1 - modifier may bypassCheck pair
87521Hepatitis c probe&rvrs trnsc1 - modifier may bypassCheck pair

Showing 30 of 57 column 2 codes. Use the pair checker for any specific combination.

87253 is bundled into these codes

87253 appears as a Column 2 code in 11 active edits. Reported with one of these Column 1 codes on the same date of service, 87253 is the code that denies.

Column 1 codeShort descriptionModifier indicator
0202U1Check pair
0502U1Check pair
0527U1Check pair
87254Virus inoculation shell via1Check pair
87255Genet virus isolate hsv1Check pair
87500Vanomycin dna amp probe1Check pair
87501Influenza dna amp prob 1+1Check pair
87502Influenza dna amp probe1Check pair
87626Hpv sep hi-rsk typ&pool rslt1Check pair
87636Sarscov2 & inf a&b amp prb1Check pair
87637Sarscov2&inf a&b&rsv amp prb1Check 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.