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.
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 code | Short description | Modifier indicator | |
|---|---|---|---|
0213T | Njx paravert w/us cer/thor | 0 - no modifier bypass | Check pair |
0216T | Njx paravert w/us lumb/sac | 0 - no modifier bypass | Check pair |
0333T | Visual ep scr acuity auto | 0 - no modifier bypass | Check pair |
0464T | Visual ep test for glaucoma | 0 - no modifier bypass | Check pair |
0565T | Autol cell implt adps hrvg | 1 - modifier may bypass | Check pair |
0596T | Temp fml iu vlv-pmp 1st insj | 1 - modifier may bypass | Check pair |
0597T | Temp fml iu valve-pmp rplcmt | 1 - modifier may bypass | Check pair |
0708T | Id ca immntx prep & 1st njx | 1 - modifier may bypass | Check pair |
0709T | Id ca immntx each addl njx | 1 - modifier may bypass | Check pair |
0901T | Plmt bone marrow smplg port | 0 - no modifier bypass | Check pair |
0903T | Ecg alg 12 lead reduced i&r | 1 - modifier may bypass | Check pair |
0904T | Ecg alg 12 ld rdcd trcg only | 1 - modifier may bypass | Check pair |
0905T | Ecg alg 12 ld rdcd i&r only | 1 - modifier may bypass | Check pair |
11000 | Dbrdmt ecz/infected skin<10% | 1 - modifier may bypass | Check pair |
11001 | Dbrdmt ecz/infct skn ea addl | 1 - modifier may bypass | Check pair |
11004 | Dbrdmt skin xtrnl gent&per | 1 - modifier may bypass | Check pair |
11005 | Dbrdmt skin abdominal wall | 1 - modifier may bypass | Check pair |
11006 | Dbrdmt skin xtrnl gent per | 1 - modifier may bypass | Check pair |
11042 | Dbrdmt subq tis 1st 20sqcm/< | 1 - modifier may bypass | Check pair |
11043 | Dbrdmt musc&/fsca 1st 20/< | 1 - modifier may bypass | Check pair |
11044 | Dbrdmt bone 1st 20 sq cm/< | 1 - modifier may bypass | Check pair |
11045 | Dbrdmt subq tiss each addl | 1 - modifier may bypass | Check pair |
11046 | Dbrdmt musc&/fsca ea addl | 1 - modifier may bypass | Check pair |
11047 | Dbrdmt bone each addl | 1 - modifier may bypass | Check pair |
15769 | Grfg autol soft tiss dir exc | 1 - modifier may bypass | Check pair |
20240 | Bone biopsy open superficial | 1 - modifier may bypass | Check pair |
20251 | Biopsy vrt bdy open lmbr/crv | 1 - modifier may bypass | Check pair |
22505 | Manipulation of spine | 0 - no modifier bypass | Check pair |
22511 | Perq lumbosacral injection | 1 - modifier may bypass | Check pair |
22514 | Perq vertebral augmentation | 1 - modifier may bypass | Check 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 code | Short description | Modifier indicator | |
|---|---|---|---|
22102 | Remove part lumbar vertebra | 1 | Check pair |
22207 | Incis spine 3 column lumbar | 1 | Check pair |
22526 | Idet single level | 1 | Check pair |
22630 | Arthrd pst tq 1ntrspc lum | 1 | Check pair |
22633 | Arthrd cmbn 1ntrspc lumbar | 1 | Check pair |
22634 | Arthrd cmbn 1ntrspc ea addl | 1 | Check pair |
22840 | Insert spine fixation device | 1 | Check pair |
22857 | Tot disc arthrp 1ntrspc lmbr | 1 | Check pair |
22867 | Insj stablj dev w/dcmprn | 1 | Check pair |
22868 | Insj stablj dev w/dcmprn | 1 | Check pair |
22869 | Insj stablj dev w/o dcmprn | 1 | Check pair |
22870 | Insj stablj dev w/o dcmprn | 1 | Check pair |
62287 | Dcmprn pq nuc pul 1/mlt lmbr | 1 | Check pair |
62380 | Ndsc dcmprn 1 ntrspc lumbar | 1 | Check pair |
63005 | Remove spine lamina 1/2 lmbr | 1 | Check 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.