MUE Lookup
How many units will Medicare accept for that code in one day? Look up the official MUE cap and the adjudication indicator that decides whether extra units can ever be paid.
A Medically Unlikely Edit (MUE) is Medicare's plausibility cap: the maximum number of units of one service that a provider would ordinarily report for the same patient on the same date of service. Bill more units than the MUE value and the excess lines deny automatically — no human ever looks at them. Enter any CPT or HCPCS code below to see its official MUE value and the adjudication indicator that decides whether the cap can ever be exceeded.
Look up an MUE value
The three adjudication indicators (MAI)
| MAI | Type | What happens above the cap |
|---|---|---|
| 1 | Claim line edit | The cap applies per claim line. Units above the cap on one line deny, but additional units may be reported on separate lines with an appropriate modifier when the documentation supports them. |
| 2 | Date-of-service edit — policy | An absolute per-day cap set by policy (for example, a code that by definition can only be performed once a day). No modifier or appeal can override it. |
| 3 | Date-of-service edit — clinical | A clinical per-day cap. Units above it deny, but a contractor can pay them on appeal when the documentation proves the extra units were medically necessary. |
Using MUEs in your workflow
- Check units before submission. A two-second MUE check is cheaper than a denial, a corrected claim and a rebill cycle. Our Claim Scrubber Lite runs this check automatically for every line of a claim.
- Not every code has an MUE. CMS publishes MUEs for most practitioner services, but some codes have none — for those, no MUE cap applies (payer policies may still limit units).
- MUEs are per patient, per day, per provider. The same units split across two dates of service are two separate MUE checks.
Data: CMS Practitioner Services MUE table, effective October 1, 2026 (2026 Q4), published by CMS in the public domain. MUE values are the Medicare values; Medicaid and commercial payers may set different caps.
Disclaimer: This tool is for educational and estimation purposes only and does not constitute billing, coding or medical advice. Coverage, coding and payment rules vary by payer and change over time — always verify with the current CMS files and the payer's own policy before submitting claims or making financial decisions.
Frequently asked questions
What is an MUE in medical billing?
A Medically Unlikely Edit is the maximum number of units of a service that Medicare considers plausible for one patient on one date of service from one provider. Units above the MUE value are denied automatically. CMS publishes the practitioner MUE table quarterly; this lookup uses the table effective October 1, 2026.
Can an MUE denial ever be overturned?
It depends on the MUE Adjudication Indicator (MAI). MAI 1 edits apply per claim line, so correctly split lines with appropriate modifiers can be paid. MAI 2 edits are absolute policy caps and cannot be overridden. MAI 3 edits are clinical caps — a contractor can pay the extra units on appeal when the documentation supports medical necessity.
What if my code shows no MUE?
CMS does not publish an MUE for every code. No published MUE means Medicare applies no MUE unit cap to that code — but medical necessity, NCCI bundling and individual payer policies can still limit or deny units.