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94781 Cars/bd tst inft-12mo +30min

What 94781 is

CMS fee schedule short descriptor: Cars/bd tst inft-12mo +30min.

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 94781 (CY2026)

Work RVUPractice expense RVUMalpractice RVUTotalMedicare rate
Non-facility (office)0.170.480.010.66$22.04
Facility (hospital, ASC)0.170.030.010.21$7.01

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: Add-on code: global period of the primary procedure applies.

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Medically Unlikely Edit (MUE)

Medicare caps 94781 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: CMS Workgroup. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 94781? These codes are bundled into it

94781 is a Column 1 code in 47 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
36591Draw blood off venous device0 - no modifier bypassCheck pair
36592Collect blood from picc0 - no modifier bypassCheck pair
93000Electrocardiogram complete1 - modifier may bypassCheck pair
93005Electrocardiogram tracing1 - modifier may bypassCheck pair
93010Electrocardiogram report1 - modifier may bypassCheck pair
93015Cv stress test supvj i&r1 - modifier may bypassCheck pair
93040Rhythm ecg with report1 - modifier may bypassCheck pair
93041Rhythm ecg tracing1 - modifier may bypassCheck pair
93042Rhythm ecg report1 - modifier may bypassCheck pair
94760N-invas ear/pls oximetry 11 - modifier may bypassCheck pair
94761N-invas ear/pls oximetry mlt1 - modifier may bypassCheck pair
94762N-invas ear/pls oximtry cont1 - modifier may 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

Showing 30 of 47 column 2 codes. Use the pair checker for any specific combination.

94781 is bundled into these codes

94781 appears as a Column 2 code in 16 active edits. Reported with one of these Column 1 codes on the same date of service, 94781 is the code that denies.

Column 1 codeShort descriptionModifier indicator
99291Critical care first hour0Check pair
99292Critical care addl 30 min0Check pair
99466Ped crit care transport0Check pair
99467Ped crit care transport addl0Check pair
99468Neonate crit care initial0Check pair
99469Neonate crit care subsq0Check pair
99471Ped critical care initial0Check pair
99472Ped critical care subsq0Check pair
99475Ped crit care age 2-5 init0Check pair
99476Ped crit care age 2-5 subsq0Check pair
99477Init day hosp neonate care0Check pair
99478Sbsq ic vlbw inf<1,500 gm0Check pair
99479Sbsq ic lbw inf 1,500-2,5000Check pair
99480Sbsq ic inf pbw 2,501-5,0000Check pair
99485Suprv interfacilty transport0Check 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.