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94772 Circadian respir pattern rec

What 94772 is

CMS fee schedule short descriptor: Circadian respir pattern rec.

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 94772 (CY2026)

This code has no Physician Fee Schedule rate: Carrier-priced - the Medicare contractor sets the price. 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 94772 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 94772? These codes are bundled into it

94772 is a Column 1 code in 38 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
00520Anes closed chest px nos0 - no modifier bypassCheck pair
36591Draw blood off venous device0 - no modifier bypassCheck pair
36592Collect blood from picc0 - no modifier bypassCheck pair
96523Irrig drug delivery device0 - no modifier bypassCheck pair
99202Office o/p new sf 15 min1 - modifier may bypassCheck pair
99203Office o/p new low 30 min1 - modifier may bypassCheck pair
99204Office o/p new mod 45 min1 - modifier may bypassCheck pair
99205Office o/p new hi 60 min1 - modifier may bypassCheck pair
99211Off/op est may x req phy/qhp1 - modifier may bypassCheck pair
99212Office o/p est sf 10 min1 - modifier may bypassCheck pair
99213Office o/p est low 20 min1 - modifier may bypassCheck pair
99214Office o/p est mod 30 min1 - modifier may bypassCheck pair
99215Office o/p est hi 40 min1 - modifier may bypassCheck pair
99281Emr dpt vst mayx req phy/qhp1 - modifier may bypassCheck pair
99282Emergency dept visit sf mdm1 - modifier may bypassCheck pair
99283Emergency dept visit low mdm1 - modifier may bypassCheck pair
99284Emergency dept visit mod mdm1 - modifier may bypassCheck pair
99285Emergency dept visit hi mdm1 - modifier may bypassCheck pair
993041st nf care sf/low mdm 251 - modifier may bypassCheck pair
993051st nf care moderate mdm 351 - modifier may bypassCheck pair
993061st nf care high mdm 501 - modifier may bypassCheck pair
99307Sbsq nf care sf mdm 101 - modifier may bypassCheck pair
99308Sbsq nf care low mdm 201 - modifier may bypassCheck pair
99309Sbsq nf care moderate mdm 301 - modifier may bypassCheck pair
99310Sbsq nf care high mdm 451 - modifier may bypassCheck pair
99315Nf dschrg mgmt 30 min/less1 - modifier may bypassCheck pair
99316Nf dschrg mgmt 30 min+1 - modifier may bypassCheck pair
99341Home/res vst new sf mdm 151 - modifier may bypassCheck pair
99342Home/res vst new low mdm 301 - modifier may bypassCheck pair
99344Home/res vst new mod mdm 601 - modifier may bypassCheck pair

Showing 30 of 38 column 2 codes. Use the pair checker for any specific combination.

94772 is bundled into these codes

94772 appears as a Column 2 code in 4 active edits. Reported with one of these Column 1 codes on the same date of service, 94772 is the code that denies.

Column 1 codeShort descriptionModifier indicator
94774Ped home apnea mntr evnt rec1Check pair
94775Ped home apnea mntr att only1Check pair
94776Ped home apnea mntr dl&alys1Check pair
94777Ped home apnea mntr rvw i&r1Check 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.