MUE Values Increased for LER Add-on CPT Codes

As a result of advocacy by ACR^® and multiple other specialty societies  — Society for Vascular Surgery, American College of Cardiology, Outpatient Endovascular and Interventional Society, Society for Cardiovascular Angiography and Interventions and Society of Interventional Radiology — CMS through its National Correct Coding Initiative (NCCI) increased the Medically Unlikely Edit (MUE) value for lower extremity revascularization (LER) add-on CPT^® codes 37255–37299 from 1 to 3, retroactive to April 1, for both Practitioner (PRA) and Outpatient Hospital (OPH) settings.

MUEs represent the maximum number of units of service that a provider or supplier would typically report for a HCPCS/CPT code for the same beneficiary on the same date of service.

CMS released Transmittal 13829 Q4 2026 NCCI Procedure-to-Procedure (PTP) Edits, Version 32.3, effective Oct. 1. This includes all prior edits and revisions dating back to Jan. 1, 1996. CMS expect to implement the LER changes in this file. Test files will be available on or about July 31, and final files will be available on or about Aug. 14. CMS developed the NCCI to promote correct coding and prevent improper Medicare Part B payments.

Practices should review the edits and assess any impact on coding, billing, reimbursement and compliance processes.

Refer to CMS Transmittal 13829, ACR Bulletin, CMS NCCI webpage and MUE Program for additional information.

If you have questions, contact Maria Tran, ACR Director of Economic Policy.