Home / Medicare fees / 0202T

0202T Post vert arthrplst 1 lumbar

What 0202T is

CMS fee schedule short descriptor: Post vert arthrplst 1 lumbar.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 0202T (CY2026)

This code has no Physician Fee Schedule rate: Carrier-priced - the Medicare contractor sets the price. It may be paid under a different fee schedule (clinical laboratory, DMEPOS, anesthesia) or not paid at all - check the relevant CMS schedule.

Advertisement

Medically Unlikely Edit (MUE)

Medicare caps 0202T at 1 unit per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 0202T? These codes are bundled into it

0202T is a Column 1 code in 184 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 codeShort descriptionModifier indicator
0213TNjx paravert w/us cer/thor0 - no modifier bypassCheck pair
0216TNjx paravert w/us lumb/sac0 - no modifier bypassCheck pair
0333TVisual ep scr acuity auto0 - no modifier bypassCheck pair
0464TVisual ep test for glaucoma0 - no modifier bypassCheck pair
0565TAutol cell implt adps hrvg1 - modifier may bypassCheck pair
0596TTemp fml iu vlv-pmp 1st insj1 - modifier may bypassCheck pair
0597TTemp fml iu valve-pmp rplcmt1 - modifier may bypassCheck pair
0708TId ca immntx prep & 1st njx1 - modifier may bypassCheck pair
0709TId ca immntx each addl njx1 - modifier may bypassCheck pair
0901TPlmt bone marrow smplg port0 - no modifier bypassCheck pair
0903TEcg alg 12 lead reduced i&r1 - modifier may bypassCheck pair
0904TEcg alg 12 ld rdcd trcg only1 - modifier may bypassCheck pair
0905TEcg alg 12 ld rdcd i&r only1 - modifier may bypassCheck pair
11000Dbrdmt ecz/infected skin<10%1 - modifier may bypassCheck pair
11001Dbrdmt ecz/infct skn ea addl1 - modifier may bypassCheck pair
11004Dbrdmt skin xtrnl gent&per1 - modifier may bypassCheck pair
11005Dbrdmt skin abdominal wall1 - modifier may bypassCheck pair
11006Dbrdmt skin xtrnl gent per1 - modifier may bypassCheck pair
11042Dbrdmt subq tis 1st 20sqcm/<1 - modifier may bypassCheck pair
11043Dbrdmt musc&/fsca 1st 20/<1 - modifier may bypassCheck pair
11044Dbrdmt bone 1st 20 sq cm/<1 - modifier may bypassCheck pair
11045Dbrdmt subq tiss each addl1 - modifier may bypassCheck pair
11046Dbrdmt musc&/fsca ea addl1 - modifier may bypassCheck pair
11047Dbrdmt bone each addl1 - modifier may bypassCheck pair
15769Grfg autol soft tiss dir exc1 - modifier may bypassCheck pair
20240Bone biopsy open superficial1 - modifier may bypassCheck pair
20251Biopsy vrt bdy open lmbr/crv1 - modifier may bypassCheck pair
22505Manipulation of spine0 - no modifier bypassCheck pair
22511Perq lumbosacral injection1 - modifier may bypassCheck pair
22514Perq vertebral augmentation1 - modifier may bypassCheck pair

Showing 30 of 184 column 2 codes. Use the pair checker for any specific combination.

0202T is bundled into these codes

0202T appears as a Column 2 code in 31 active edits. Reported with one of these Column 1 codes on the same date of service, 0202T is the code that denies.

Column 1 codeShort descriptionModifier indicator
22102Remove part lumbar vertebra1Check pair
22207Incis spine 3 column lumbar1Check pair
22526Idet single level1Check pair
22630Arthrd pst tq 1ntrspc lum1Check pair
22633Arthrd cmbn 1ntrspc lumbar1Check pair
22634Arthrd cmbn 1ntrspc ea addl1Check pair
22840Insert spine fixation device1Check pair
22857Tot disc arthrp 1ntrspc lmbr1Check pair
22867Insj stablj dev w/dcmprn1Check pair
22868Insj stablj dev w/dcmprn1Check pair
22869Insj stablj dev w/o dcmprn1Check pair
22870Insj stablj dev w/o dcmprn1Check pair
62287Dcmprn pq nuc pul 1/mlt lmbr1Check pair
62380Ndsc dcmprn 1 ntrspc lumbar1Check pair
63005Remove spine lamina 1/2 lmbr1Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.