NCCI edits for 57455 Code page: https://localishealth.com/cpt/57455 NCCI release: 2026 C Source: https://www.cms.gov/medicare/coding-billing/national-correct-coding-initiative-ncci-edits NOT SEPARATELY PAYABLE TOGETHER — NO NCCI-ASSOCIATED MODIFIER BYPASSES THE EDIT (modifier indicator 0) 00940 57455 is Column One, 00940 is Column Two — 00940 denies 0213T 57455 is Column One, 0213T is Column Two — 0213T denies 0216T 57455 is Column One, 0216T is Column Two — 0216T denies 0664T 0664T is Column One, 57455 is Column Two — 57455 denies 0665T 0665T is Column One, 57455 is Column Two — 57455 denies 0666T 0666T is Column One, 57455 is Column Two — 57455 denies 0667T 0667T is Column One, 57455 is Column Two — 57455 denies 36591 57455 is Column One, 36591 is Column Two — 36591 denies 36592 57455 is Column One, 36592 is Column Two — 36592 denies 51701 57455 is Column One, 51701 is Column Two — 51701 denies 51702 57455 is Column One, 51702 is Column Two — 51702 denies 57410 57455 is Column One, 57410 is Column Two — 57410 denies 57420 57455 is Column One, 57420 is Column Two — 57420 denies 57421 57421 is Column One, 57455 is Column Two — 57455 denies 57452 57455 is Column One, 57452 is Column Two — 57452 denies 57454 57454 is Column One, 57455 is Column Two — 57455 denies 57460 57460 is Column One, 57455 is Column Two — 57455 denies 57461 57461 is Column One, 57455 is Column Two — 57455 denies 57500 57455 is Column One, 57500 is Column Two — 57500 denies 57505 57455 is Column One, 57505 is Column Two — 57505 denies 57530 57530 is Column One, 57455 is Column Two — 57455 denies 57540 57540 is Column One, 57455 is Column Two — 57455 denies 57545 57545 is Column One, 57455 is Column Two — 57455 denies 57550 57550 is Column One, 57455 is Column Two — 57455 denies 57555 57555 is Column One, 57455 is Column Two — 57455 denies 57556 57556 is Column One, 57455 is Column Two — 57455 denies 57800 57455 is Column One, 57800 is Column Two — 57800 denies 58100 57455 is Column One, 58100 is Column Two — 58100 denies 58150 58150 is Column One, 57455 is Column Two — 57455 denies 58152 58152 is Column One, 57455 is Column Two — 57455 denies 58200 58200 is Column One, 57455 is Column Two — 57455 denies 58210 58210 is Column One, 57455 is Column Two — 57455 denies 58240 58240 is Column One, 57455 is Column Two — 57455 denies 58260 58260 is Column One, 57455 is Column Two — 57455 denies 58262 58262 is Column One, 57455 is Column Two — 57455 denies 58263 58263 is Column One, 57455 is Column Two — 57455 denies 58267 58267 is Column One, 57455 is Column Two — 57455 denies 58270 58270 is Column One, 57455 is Column Two — 57455 denies 58275 58275 is Column One, 57455 is Column Two — 57455 denies 58280 58280 is Column One, 57455 is Column Two — 57455 denies 58285 58285 is Column One, 57455 is Column Two — 57455 denies 58290 58290 is Column One, 57455 is Column Two — 57455 denies 58291 58291 is Column One, 57455 is Column Two — 57455 denies 58292 58292 is Column One, 57455 is Column Two — 57455 denies 58294 58294 is Column One, 57455 is Column Two — 57455 denies 58548 58548 is Column One, 57455 is Column Two — 57455 denies 58550 58550 is Column One, 57455 is Column Two — 57455 denies 58552 58552 is Column One, 57455 is Column Two — 57455 denies 58553 58553 is Column One, 57455 is Column Two — 57455 denies 58554 58554 is Column One, 57455 is Column Two — 57455 denies 58570 58570 is Column One, 57455 is Column Two — 57455 denies 58571 58571 is Column One, 57455 is Column Two — 57455 denies 58572 58572 is Column One, 57455 is Column Two — 57455 denies 58573 58573 is Column One, 57455 is Column Two — 57455 denies 58575 58575 is Column One, 57455 is Column Two — 57455 denies 58951 58951 is Column One, 57455 is Column Two — 57455 denies 58953 58953 is Column One, 57455 is Column Two — 57455 denies 58954 58954 is Column One, 57455 is Column Two — 57455 denies 58956 58956 is Column One, 57455 is Column Two — 57455 denies 62320 57455 is Column One, 62320 is Column Two — 62320 denies 62321 57455 is Column One, 62321 is Column Two — 62321 denies 62322 57455 is Column One, 62322 is Column Two — 62322 denies 62323 57455 is Column One, 62323 is Column Two — 62323 denies 62324 57455 is Column One, 62324 is Column Two — 62324 denies 62325 57455 is Column One, 62325 is Column Two — 62325 denies 62326 57455 is Column One, 62326 is Column Two — 62326 denies 62327 57455 is Column One, 62327 is Column Two — 62327 denies 64400 57455 is Column One, 64400 is Column Two — 64400 denies 64405 57455 is Column One, 64405 is Column Two — 64405 denies 64408 57455 is Column One, 64408 is Column Two — 64408 denies 64415 57455 is Column One, 64415 is Column Two — 64415 denies 64416 57455 is Column One, 64416 is Column Two — 64416 denies 64417 57455 is Column One, 64417 is Column Two — 64417 denies 64418 57455 is Column One, 64418 is Column Two — 64418 denies 64420 57455 is Column One, 64420 is Column Two — 64420 denies 64421 57455 is Column One, 64421 is Column Two — 64421 denies 64425 57455 is Column One, 64425 is Column Two — 64425 denies 64430 57455 is Column One, 64430 is Column Two — 64430 denies 64435 57455 is Column One, 64435 is Column Two — 64435 denies 64445 57455 is Column One, 64445 is Column Two — 64445 denies 64446 57455 is Column One, 64446 is Column Two — 64446 denies 64447 57455 is Column One, 64447 is Column Two — 64447 denies 64448 57455 is Column One, 64448 is Column Two — 64448 denies 64449 57455 is Column One, 64449 is Column Two — 64449 denies 64450 57455 is Column One, 64450 is Column Two — 64450 denies 64451 57455 is Column One, 64451 is Column Two — 64451 denies 64454 57455 is Column One, 64454 is Column Two — 64454 denies 64461 57455 is Column One, 64461 is Column Two — 64461 denies 64462 57455 is Column One, 64462 is Column Two — 64462 denies 64463 57455 is Column One, 64463 is Column Two — 64463 denies 64479 57455 is Column One, 64479 is Column Two — 64479 denies 64480 57455 is Column One, 64480 is Column Two — 64480 denies 64483 57455 is Column One, 64483 is Column Two — 64483 denies 64484 57455 is Column One, 64484 is Column Two — 64484 denies 64486 57455 is Column One, 64486 is Column Two — 64486 denies 64487 57455 is Column One, 64487 is Column Two — 64487 denies 64488 57455 is Column One, 64488 is Column Two — 64488 denies 64489 57455 is Column One, 64489 is Column Two — 64489 denies 64490 57455 is Column One, 64490 is Column Two — 64490 denies 64491 57455 is Column One, 64491 is Column Two — 64491 denies 64492 57455 is Column One, 64492 is Column Two — 64492 denies 64493 57455 is Column One, 64493 is Column Two — 64493 denies 64494 57455 is Column One, 64494 is Column Two — 64494 denies 64495 57455 is Column One, 64495 is Column Two — 64495 denies 64505 57455 is Column One, 64505 is Column Two — 64505 denies 64510 57455 is Column One, 64510 is Column Two — 64510 denies 64517 57455 is Column One, 64517 is Column Two — 64517 denies 64520 57455 is Column One, 64520 is Column Two — 64520 denies 64530 57455 is Column One, 64530 is Column Two — 64530 denies 69990 57455 is Column One, 69990 is Column Two — 69990 denies 96523 57455 is Column One, 96523 is Column Two — 96523 denies 99155 57455 is Column One, 99155 is Column Two — 99155 denies 99156 57455 is Column One, 99156 is Column Two — 99156 denies 99157 57455 is Column One, 99157 is Column Two — 99157 denies 99446 57455 is Column One, 99446 is Column Two — 99446 denies 99447 57455 is Column One, 99447 is Column Two — 99447 denies 99448 57455 is Column One, 99448 is Column Two — 99448 denies 99449 57455 is Column One, 99449 is Column Two — 99449 denies 99451 57455 is Column One, 99451 is Column Two — 99451 denies 99452 57455 is Column One, 99452 is Column Two — 99452 denies G0471 57455 is Column One, G0471 is Column Two — G0471 denies BILLABLE TOGETHER ONLY WHEN AN NCCI-ASSOCIATED MODIFIER IS APPROPRIATE (modifier indicator 1) 0596T 57455 is Column One, 0596T is Column Two — 0596T denies 0597T 57455 is Column One, 0597T is Column Two — 0597T denies 0708T 57455 is Column One, 0708T is Column Two — 0708T denies 0709T 57455 is Column One, 0709T is Column Two — 0709T denies 0903T 57455 is Column One, 0903T is Column Two — 0903T denies 0904T 57455 is Column One, 0904T is Column Two — 0904T denies 0905T 57455 is Column One, 0905T is Column Two — 0905T denies 10005 57455 is Column One, 10005 is Column Two — 10005 denies 10007 57455 is Column One, 10007 is Column Two — 10007 denies 10009 57455 is Column One, 10009 is Column Two — 10009 denies 10011 57455 is Column One, 10011 is Column Two — 10011 denies 10021 57455 is Column One, 10021 is Column Two — 10021 denies 12001 57455 is Column One, 12001 is Column Two — 12001 denies 12002 57455 is Column One, 12002 is Column Two — 12002 denies 12004 57455 is Column One, 12004 is Column Two — 12004 denies 12005 57455 is Column One, 12005 is Column Two — 12005 denies 12006 57455 is Column One, 12006 is Column Two — 12006 denies 12007 57455 is Column One, 12007 is Column Two — 12007 denies 12011 57455 is Column One, 12011 is Column Two — 12011 denies 12013 57455 is Column One, 12013 is Column Two — 12013 denies 12014 57455 is Column One, 12014 is Column Two — 12014 denies 12015 57455 is Column One, 12015 is Column Two — 12015 denies 12016 57455 is Column One, 12016 is Column Two — 12016 denies 12017 57455 is Column One, 12017 is Column Two — 12017 denies 12018 57455 is Column One, 12018 is Column Two — 12018 denies 12020 57455 is Column One, 12020 is Column Two — 12020 denies 12021 57455 is Column One, 12021 is Column Two — 12021 denies 12031 57455 is Column One, 12031 is Column Two — 12031 denies 12032 57455 is Column One, 12032 is Column Two — 12032 denies 12034 57455 is Column One, 12034 is Column Two — 12034 denies 12035 57455 is Column One, 12035 is Column Two — 12035 denies 12036 57455 is Column One, 12036 is Column Two — 12036 denies 12037 57455 is Column One, 12037 is Column Two — 12037 denies 12041 57455 is Column One, 12041 is Column Two — 12041 denies 12042 57455 is Column One, 12042 is Column Two — 12042 denies 12044 57455 is Column One, 12044 is Column Two — 12044 denies 12045 57455 is Column One, 12045 is Column Two — 12045 denies 12046 57455 is Column One, 12046 is Column Two — 12046 denies 12047 57455 is Column One, 12047 is Column Two — 12047 denies 12051 57455 is Column One, 12051 is Column Two — 12051 denies 12052 57455 is Column One, 12052 is Column Two — 12052 denies 12053 57455 is Column One, 12053 is Column Two — 12053 denies 12054 57455 is Column One, 12054 is Column Two — 12054 denies 12055 57455 is Column One, 12055 is Column Two — 12055 denies 12056 57455 is Column One, 12056 is Column Two — 12056 denies 12057 57455 is Column One, 12057 is Column Two — 12057 denies 13100 57455 is Column One, 13100 is Column Two — 13100 denies 13101 57455 is Column One, 13101 is Column Two — 13101 denies 13102 57455 is Column One, 13102 is Column Two — 13102 denies 13120 57455 is Column One, 13120 is Column Two — 13120 denies 13121 57455 is Column One, 13121 is Column Two — 13121 denies 13122 57455 is Column One, 13122 is Column Two — 13122 denies 13131 57455 is Column One, 13131 is Column Two — 13131 denies 13132 57455 is Column One, 13132 is Column Two — 13132 denies 13133 57455 is Column One, 13133 is Column Two — 13133 denies 13151 57455 is Column One, 13151 is Column Two — 13151 denies 13152 57455 is Column One, 13152 is Column Two — 13152 denies 13153 57455 is Column One, 13153 is Column Two — 13153 denies 36000 57455 is Column One, 36000 is Column Two — 36000 denies 36400 57455 is Column One, 36400 is Column Two — 36400 denies 36405 57455 is Column One, 36405 is Column Two — 36405 denies 36406 57455 is Column One, 36406 is Column Two — 36406 denies 36410 57455 is Column One, 36410 is Column Two — 36410 denies 36420 57455 is Column One, 36420 is Column Two — 36420 denies 36425 57455 is Column One, 36425 is Column Two — 36425 denies 36430 57455 is Column One, 36430 is Column Two — 36430 denies 36440 57455 is Column One, 36440 is Column Two — 36440 denies 36600 57455 is Column One, 36600 is Column Two — 36600 denies 36640 57455 is Column One, 36640 is Column Two — 36640 denies 43752 57455 is Column One, 43752 is Column Two — 43752 denies 51703 57455 is Column One, 51703 is Column Two — 51703 denies 57100 57455 is Column One, 57100 is Column Two — 57100 denies 57180 57455 is Column One, 57180 is Column Two — 57180 denies 57400 57400 is Column One, 57455 is Column Two — 57455 denies 57520 57520 is Column One, 57455 is Column Two — 57455 denies 57522 57522 is Column One, 57455 is Column Two — 57455 denies 64466 57455 is Column One, 64466 is Column Two — 64466 denies 64467 57455 is Column One, 64467 is Column Two — 64467 denies 64468 57455 is Column One, 64468 is Column Two — 64468 denies 64469 57455 is Column One, 64469 is Column Two — 64469 denies 64473 57455 is Column One, 64473 is Column Two — 64473 denies 64474 57455 is Column One, 64474 is Column Two — 64474 denies 76000 57455 is Column One, 76000 is Column Two — 76000 denies 77001 57455 is Column One, 77001 is Column Two — 77001 denies 77002 57455 is Column One, 77002 is Column Two — 77002 denies 92012 57455 is Column One, 92012 is Column Two — 92012 denies 92014 57455 is Column One, 92014 is Column Two — 92014 denies 93000 57455 is Column One, 93000 is Column Two — 93000 denies 93005 57455 is Column One, 93005 is Column Two — 93005 denies 93010 57455 is Column One, 93010 is Column Two — 93010 denies 93040 57455 is Column One, 93040 is Column Two — 93040 denies 93041 57455 is Column One, 93041 is Column Two — 93041 denies 93042 57455 is Column One, 93042 is Column Two — 93042 denies 93318 57455 is Column One, 93318 is Column Two — 93318 denies 93355 57455 is Column One, 93355 is Column Two — 93355 denies 94002 57455 is Column One, 94002 is Column Two — 94002 denies 94200 57455 is Column One, 94200 is Column Two — 94200 denies 94680 57455 is Column One, 94680 is Column Two — 94680 denies 94681 57455 is Column One, 94681 is Column Two — 94681 denies 94690 57455 is Column One, 94690 is Column Two — 94690 denies 95812 57455 is Column One, 95812 is Column Two — 95812 denies 95813 57455 is Column One, 95813 is Column Two — 95813 denies 95816 57455 is Column One, 95816 is Column Two — 95816 denies 95819 57455 is Column One, 95819 is Column Two — 95819 denies 95822 57455 is Column One, 95822 is Column Two — 95822 denies 95829 57455 is Column One, 95829 is Column Two — 95829 denies 95955 57455 is Column One, 95955 is Column Two — 95955 denies 96360 57455 is Column One, 96360 is Column Two — 96360 denies 96361 57455 is Column One, 96361 is Column Two — 96361 denies 96365 57455 is Column One, 96365 is Column Two — 96365 denies 96366 57455 is Column One, 96366 is Column Two — 96366 denies 96367 57455 is Column One, 96367 is Column Two — 96367 denies 96368 57455 is Column One, 96368 is Column Two — 96368 denies 96372 57455 is Column One, 96372 is Column Two — 96372 denies 96374 57455 is Column One, 96374 is Column Two — 96374 denies 96375 57455 is Column One, 96375 is Column Two — 96375 denies 96376 57455 is Column One, 96376 is Column Two — 96376 denies 96377 57455 is Column One, 96377 is Column Two — 96377 denies 99211 57455 is Column One, 99211 is Column Two — 99211 denies 99212 57455 is Column One, 99212 is Column Two — 99212 denies 99213 57455 is Column One, 99213 is Column Two — 99213 denies 99214 57455 is Column One, 99214 is Column Two — 99214 denies 99215 57455 is Column One, 99215 is Column Two — 99215 denies 99221 57455 is Column One, 99221 is Column Two — 99221 denies 99222 57455 is Column One, 99222 is Column Two — 99222 denies 99223 57455 is Column One, 99223 is Column Two — 99223 denies 99231 57455 is Column One, 99231 is Column Two — 99231 denies 99232 57455 is Column One, 99232 is Column Two — 99232 denies 99233 57455 is Column One, 99233 is Column Two — 99233 denies 99234 57455 is Column One, 99234 is Column Two — 99234 denies 99235 57455 is Column One, 99235 is Column Two — 99235 denies 99236 57455 is Column One, 99236 is Column Two — 99236 denies 99238 57455 is Column One, 99238 is Column Two — 99238 denies 99239 57455 is Column One, 99239 is Column Two — 99239 denies 99242 57455 is Column One, 99242 is Column Two — 99242 denies 99243 57455 is Column One, 99243 is Column Two — 99243 denies 99244 57455 is Column One, 99244 is Column Two — 99244 denies 99245 57455 is Column One, 99245 is Column Two — 99245 denies 99252 57455 is Column One, 99252 is Column Two — 99252 denies 99253 57455 is Column One, 99253 is Column Two — 99253 denies 99254 57455 is Column One, 99254 is Column Two — 99254 denies 99255 57455 is Column One, 99255 is Column Two — 99255 denies 99291 57455 is Column One, 99291 is Column Two — 99291 denies 99292 57455 is Column One, 99292 is Column Two — 99292 denies 99304 57455 is Column One, 99304 is Column Two — 99304 denies 99305 57455 is Column One, 99305 is Column Two — 99305 denies 99306 57455 is Column One, 99306 is Column Two — 99306 denies 99307 57455 is Column One, 99307 is Column Two — 99307 denies 99308 57455 is Column One, 99308 is Column Two — 99308 denies 99309 57455 is Column One, 99309 is Column Two — 99309 denies 99310 57455 is Column One, 99310 is Column Two — 99310 denies 99315 57455 is Column One, 99315 is Column Two — 99315 denies 99316 57455 is Column One, 99316 is Column Two — 99316 denies 99347 57455 is Column One, 99347 is Column Two — 99347 denies 99348 57455 is Column One, 99348 is Column Two — 99348 denies 99349 57455 is Column One, 99349 is Column Two — 99349 denies 99350 57455 is Column One, 99350 is Column Two — 99350 denies 99374 57455 is Column One, 99374 is Column Two — 99374 denies 99375 57455 is Column One, 99375 is Column Two — 99375 denies 99377 57455 is Column One, 99377 is Column Two — 99377 denies 99378 57455 is Column One, 99378 is Column Two — 99378 denies 99495 57455 is Column One, 99495 is Column Two — 99495 denies 99496 57455 is Column One, 99496 is Column Two — 99496 denies G0463 57455 is Column One, G0463 is Column Two — G0463 denies MUE units per patient per date of service: not published