94452 Hast w/i&r phys/qhp
What 94452 is
CMS fee schedule short descriptor: Hast w/i&r phys/qhp.
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 94452 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 0.30 | 1.40 | 0.02 | 1.72 | $57.45 |
| Facility (hospital, ASC) | 0.30 | 1.40 | 0.02 | 1.72 | $57.45 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.
Medically Unlikely Edit (MUE)
Medicare caps 94452 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 94452? These codes are bundled into it
94452 is a Column 1 code in 46 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 | |
|---|---|---|---|
36591 | Draw blood off venous device | 0 - no modifier bypass | Check pair |
36592 | Collect blood from picc | 0 - no modifier bypass | Check pair |
94450 | Breathing response hypoxia | 1 - modifier may bypass | Check pair |
94760 | N-invas ear/pls oximetry 1 | 0 - no modifier bypass | Check pair |
94761 | N-invas ear/pls oximetry mlt | 0 - no modifier bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
99202 | Office o/p new sf 15 min | 1 - modifier may bypass | Check pair |
99203 | Office o/p new low 30 min | 1 - modifier may bypass | Check pair |
99204 | Office o/p new mod 45 min | 1 - modifier may bypass | Check pair |
99205 | Office o/p new hi 60 min | 1 - modifier may bypass | Check pair |
99211 | Off/op est may x req phy/qhp | 1 - modifier may bypass | Check pair |
99212 | Office o/p est sf 10 min | 1 - modifier may bypass | Check pair |
99213 | Office o/p est low 20 min | 1 - modifier may bypass | Check pair |
99214 | Office o/p est mod 30 min | 1 - modifier may bypass | Check pair |
99215 | Office o/p est hi 40 min | 1 - modifier may bypass | Check pair |
99281 | Emr dpt vst mayx req phy/qhp | 1 - modifier may bypass | Check pair |
99282 | Emergency dept visit sf mdm | 1 - modifier may bypass | Check pair |
99283 | Emergency dept visit low mdm | 1 - modifier may bypass | Check pair |
99284 | Emergency dept visit mod mdm | 1 - modifier may bypass | Check pair |
99285 | Emergency dept visit hi mdm | 1 - modifier may bypass | Check pair |
99304 | 1st nf care sf/low mdm 25 | 1 - modifier may bypass | Check pair |
99305 | 1st nf care moderate mdm 35 | 1 - modifier may bypass | Check pair |
99306 | 1st nf care high mdm 50 | 1 - modifier may bypass | Check pair |
99307 | Sbsq nf care sf mdm 10 | 1 - modifier may bypass | Check pair |
99308 | Sbsq nf care low mdm 20 | 1 - modifier may bypass | Check pair |
99309 | Sbsq nf care moderate mdm 30 | 1 - modifier may bypass | Check pair |
99310 | Sbsq nf care high mdm 45 | 1 - modifier may bypass | Check pair |
99315 | Nf dschrg mgmt 30 min/less | 1 - modifier may bypass | Check pair |
99316 | Nf dschrg mgmt 30 min+ | 1 - modifier may bypass | Check pair |
99341 | Home/res vst new sf mdm 15 | 1 - modifier may bypass | Check pair |
Showing 30 of 46 column 2 codes. Use the pair checker for any specific combination.
94452 is bundled into these codes
94452 appears as a Column 2 code in 1 active edits. Reported with one of these Column 1 codes on the same date of service, 94452 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
94453 | Hast w/suppl oxygen titrj | 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.