NCCI edits for CPT 97804
CMS lists 216 active pairs with modifier indicator 0 (no NCCI-associated modifier bypasses those edits) and 27 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 6 units 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.
- 0395T 97804 denies
- 0591T 97804 denies
- 0592T 97804 denies
- 0593T 97804 denies
- 36591 36591 denies
- 36592 36592 denies
- 77261 97804 denies
- 77262 97804 denies
- 77263 97804 denies
- 77280 97804 denies
- 77285 97804 denies
- 77290 97804 denies
- 77293 97804 denies
- 77295 97804 denies
- 77300 97804 denies
- 77301 97804 denies
- 77306 97804 denies
- 77307 97804 denies
- 77316 97804 denies
- 77317 97804 denies
- 77318 97804 denies
- 77321 97804 denies
- 77331 97804 denies
- 77332 97804 denies
- 77333 97804 denies
- 77334 97804 denies
- 77336 97804 denies
- 77338 97804 denies
- 77370 97804 denies
- 77371 97804 denies
- 77372 97804 denies
- 77373 97804 denies
- 77402 97804 denies
- 77407 97804 denies
- 77412 97804 denies
- 77417 97804 denies
- 77423 97804 denies
- 77424 97804 denies
- 77425 97804 denies
- 77427 97804 denies
- 77431 97804 denies
- 77432 97804 denies
- 77435 97804 denies
- 77469 97804 denies
- 77470 97804 denies
- 77520 97804 denies
- 77522 97804 denies
- 77523 97804 denies
- 77525 97804 denies
- 77600 97804 denies
Showing 50 of 216. The plain-text version contains every pair.
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.
- 0944T 97804 denies
- 93668 97804 denies
- 93797 97804 denies
- 93798 97804 denies
- 94625 97804 denies
- 94626 97804 denies
- 97535 97804 denies
- 97537 97804 denies
- 99466 97804 denies
- 99471 97804 denies
- 99472 97804 denies
- 99475 97804 denies
- 99476 97804 denies
- 99479 97804 denies
- 99485 97804 denies
- 99486 97804 denies
- G0237 97804 denies
- G0238 97804 denies
- G0239 97804 denies
- G0257 97804 denies
- G0380 97804 denies
- G0381 97804 denies
- G0382 97804 denies
- G0383 97804 denies
- G0384 97804 denies
- G0422 97804 denies
- G0423 97804 denies
NCCI edits are not a coverage determination or a substitute for the current CMS NCCI Policy Manual. Deleted pairs are excluded from this page.