C8937

What C8937 is

Computer-aided detection, including computer algorithm analysis of breast mri image data for lesion detection/characterization, pharmacokinetic analysis, with further physician review for interpretation (list separately in addition to code for primary procedure)

HCPCS Level II long description, CMS October 2026 file. See the C codes page for the full section.

Medically Unlikely Edit (MUE)

Medicare caps C8937 at 2 units per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Anatomic Consideration. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with C8937? These codes are bundled into it

C8937 is a Column 1 code in 2 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.

C8937 is bundled into these codes

C8937 appears as a Column 2 code in 3 active edits. Reported with one of these Column 1 codes on the same date of service, C8937 is the code that denies.

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.