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NCCI edits for CPT 97028

CMS lists 7 active pairs with modifier indicator 0 (no NCCI-associated modifier bypasses those edits) and 63 pairs with modifier indicator 1, where an NCCI-associated modifier may be allowed when the documentation supports it.

NCCI release: Q4 2026. Source: CMS National Correct Coding Initiative (NCCI) Edits. Complete plain-text list.

Check a paired code Copy link

Medically Unlikely Edit (MUE) Copy link

The published MUE is 1 unit per patient per date of service.

Not separately payable together Copy link

Modifier indicator 0: the edit cannot be bypassed with an NCCI-associated modifier. Each row names the code that denies. CMS writes every edit as an ordered pair: the Column Two code is denied and the Column One code is paid.

Modifier may be allowed Copy link

Modifier indicator 1: an NCCI-associated modifier may be used when the circumstances and documentation support it. Each row names the Column Two code, which is the one denied absent an allowed modifier.

Showing 50 of 63. The plain-text version contains every pair.

NCCI edits are not a coverage determination or a substitute for the current CMS NCCI Policy Manual. Deleted pairs are excluded from this page.