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 RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 0.17 | 0.48 | 0.01 | 0.66 | $22.04 |
| Facility (hospital, ASC) | 0.17 | 0.03 | 0.01 | 0.21 | $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.
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 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 |
93000 | Electrocardiogram complete | 1 - modifier may bypass | Check pair |
93005 | Electrocardiogram tracing | 1 - modifier may bypass | Check pair |
93010 | Electrocardiogram report | 1 - modifier may bypass | Check pair |
93015 | Cv stress test supvj i&r | 1 - modifier may bypass | Check pair |
93040 | Rhythm ecg with report | 1 - modifier may bypass | Check pair |
93041 | Rhythm ecg tracing | 1 - modifier may bypass | Check pair |
93042 | Rhythm ecg report | 1 - modifier may bypass | Check pair |
94760 | N-invas ear/pls oximetry 1 | 1 - modifier may bypass | Check pair |
94761 | N-invas ear/pls oximetry mlt | 1 - modifier may bypass | Check pair |
94762 | N-invas ear/pls oximtry cont | 1 - modifier may 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 |
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 code | Short description | Modifier indicator | |
|---|---|---|---|
99291 | Critical care first hour | 0 | Check pair |
99292 | Critical care addl 30 min | 0 | Check pair |
99466 | Ped crit care transport | 0 | Check pair |
99467 | Ped crit care transport addl | 0 | Check pair |
99468 | Neonate crit care initial | 0 | Check pair |
99469 | Neonate crit care subsq | 0 | Check pair |
99471 | Ped critical care initial | 0 | Check pair |
99472 | Ped critical care subsq | 0 | Check pair |
99475 | Ped crit care age 2-5 init | 0 | Check pair |
99476 | Ped crit care age 2-5 subsq | 0 | Check pair |
99477 | Init day hosp neonate care | 0 | Check pair |
99478 | Sbsq ic vlbw inf<1,500 gm | 0 | Check pair |
99479 | Sbsq ic lbw inf 1,500-2,500 | 0 | Check pair |
99480 | Sbsq ic inf pbw 2,501-5,000 | 0 | Check pair |
99485 | Suprv interfacilty transport | 0 | 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.