One claim.
Every code pair.
Find procedure-to-procedure edits in your precompiled NCCI spreadsheet, without wrestling with Excel filters.
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Check claim interactions
Portland fee schedule estimator
Leave the switch OFF to use 100% of the reference fee schedule. Switch ON to estimate 85% for NP / PA professional PFS services. Rates imported from your workbook: Portland 2026 nonfacility / home, locality 02302-01. These imported amounts have not been independently verified against the official fee file. Edit amounts as needed. Unknown codes require an amount and payment-rule selection.
| Line / code | Units | Reference / manual rate | Payment rule | Claim modifiers (reviewed) | MP factor | Provider factor | Estimated allowed |
|---|
Estimates assume coverage and any PTP edits are appropriately resolved. Unresolved edits can prevent payment; a modifier does not guarantee payment. Indicator 2: highest fee is 100%, procedures 2–5 are 50%; beyond five require individual review. Other MPPR rules are outside this estimator. Multiple units on indicator-2 lines require review. Amounts are before deductible, sequestration, charge caps, and other adjustments. The optional 85% factor is a scenario setting, not a determination of a payer's contract.
CMS multiple-procedure rules · CMS NP payment guidanceRead the result with confidence
0 · Modifier not allowed
The edit cannot be bypassed with an NCCI-associated modifier.
1 · Modifier may be allowed
Only when the clinical circumstances and documentation support it.
9 · Not applicable
The modifier indicator is not relevant for this deleted edit.
This checks PTP pairs in your uploaded data. A missing pair does not guarantee payment, especially with a filtered or incomplete spreadsheet. Confirm the quarter and practitioner / hospital or Medicare / Medicaid dataset. MUEs and payer-specific edits are outside this lookup.
Official CMS NCCI tables ↗