0221T Plmt post facet implt lumb
What 0221T is
CMS fee schedule short descriptor: Plmt post facet implt lumb.
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 0221T (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 0221T at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 0221T? These codes are bundled into it
0221T is a Column 1 code in 198 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 | |
|---|---|---|---|
0333T | Visual ep scr acuity auto | 0 - no modifier bypass | Check pair |
0464T | Visual ep test for glaucoma | 0 - no modifier 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 |
0656T | Ant lmbr vrt bdy teth <7 seg | 1 - modifier may bypass | Check pair |
0657T | Ant lmbr vrt bdy teth 8+ seg | 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 |
12001 | Rpr s/n/ax/gen/trnk 2.5cm/< | 1 - modifier may bypass | Check pair |
12002 | Rpr s/n/ax/gen/trnk2.6-7.5cm | 1 - modifier may bypass | Check pair |
12004 | Rpr s/n/ax/gen/trk7.6-12.5cm | 1 - modifier may bypass | Check pair |
12005 | Rpr s/n/a/gen/trk12.6-20.0cm | 1 - modifier may bypass | Check pair |
12006 | Rpr s/n/a/gen/trk20.1-30.0cm | 1 - modifier may bypass | Check pair |
12007 | Rpr s/n/ax/gen/trnk >30.0 cm | 1 - modifier may bypass | Check pair |
12020 | Tx supfc wnd dehsn smpl clsr | 1 - modifier may bypass | Check pair |
12021 | Tx supfc wnd dehsn w/packing | 1 - modifier may bypass | Check pair |
12031 | Intmd rpr s/a/t/ext 2.5 cm/< | 1 - modifier may bypass | Check pair |
12032 | Intmd rpr s/a/t/ext 2.6-7.5 | 1 - modifier may bypass | Check pair |
12034 | Intmd rpr s/tr/ext 7.6-12.5 | 1 - modifier may bypass | Check pair |
12035 | Intmd rpr s/a/t/ext 12.6-20 | 1 - modifier may bypass | Check pair |
12036 | Intmd rpr s/a/t/ext 20.1-30 | 1 - modifier may bypass | Check pair |
12037 | Intmd rpr s/tr/ext >30.0 cm | 1 - modifier may bypass | Check pair |
13100 | Cmplx rpr trunk 1.1-2.5 cm | 1 - modifier may bypass | Check pair |
13101 | Cmplx rpr trunk 2.6-7.5 cm | 1 - modifier may bypass | Check pair |
20930 | Sp bone algrft morsel add-on | 1 - modifier may bypass | Check pair |
20931 | Sp bone algrft struct add-on | 1 - modifier may bypass | Check pair |
Showing 30 of 198 column 2 codes. Use the pair checker for any specific combination.
0221T is bundled into these codes
0221T appears as a Column 2 code in 9 active edits. Reported with one of these Column 1 codes on the same date of service, 0221T is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
0220T | Plmt post facet implt thor | 1 | Check pair |
22610 | Arthrd pst tq 1ntrspc thrc | 1 | Check pair |
22612 | Arthrd pst tq 1ntrspc lumbar | 1 | Check pair |
22633 | Arthrd cmbn 1ntrspc lumbar | 1 | Check pair |
22634 | Arthrd cmbn 1ntrspc ea addl | 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 |
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.