"The edits in this MUE change report are effective beginning on April 1, 2026. This file should NOT be used by state Medicaid programs as their edit file.

Current Procedural Terminology (CPT) codes, descriptions and other data only are copyright 2025 American Medical Association. All rights reserved.

CPT® is a registered trademark of the American Medical Association.

Applicable FARS\DFARS Restrictions Apply to Government Use.

Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for the data contained or not contained herein."	
HCPCS/CPT Code	Outpatient Hospital Services MUE Values
C5271	1
C5272	3
C5273	1
C5274	35
C5275	1
C5276	3
C5277	1
C5278	15
C9089	300
C9751	1
C9784	1
D9248	1
G0071	1
G0511	8
G0512	1
G6001	2
G6002	2
G6003	2
G6004	2
G6005	2
G6006	2
G6007	2
G6008	2
G6009	2
G6010	2
G6011	2
G6012	2
G6013	2
G6014	2
G6015	2
G6016	2
G6017	2
J0190	0
J0200	0
J0205	0
J0215	30
J0288	0
J0350	0
J0365	0
J0380	1
J0395	0
J0710	0
J0715	0
J0795	100
J1267	150
J1330	1
J1443	272
J1444	272
J1445	68
J1452	0
J1562	0
J1620	0
J1655	0
J1710	0
J1945	0
J2504	15
J2513	1
J2910	0
J2940	0
J2995	0
J3280	0
J3305	0
J3310	0
J3320	0
J3355	6
J3364	0
J3365	0
J3400	0
J7309	1
J7310	0
J7505	1
J7513	0
J8562	12
J8650	6
J9019	60
J9020	0
J9098	5
J9151	12
J9165	0
J9212	0
J9270	0
Q0174	0
Q2017	12
Q5109	150
Q9969	3
