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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.

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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 codeShort descriptionModifier indicator
0333TVisual ep scr acuity auto0 - no modifier bypassCheck pair
0464TVisual ep test for glaucoma0 - no modifier bypassCheck pair
0596TTemp fml iu vlv-pmp 1st insj1 - modifier may bypassCheck pair
0597TTemp fml iu valve-pmp rplcmt1 - modifier may bypassCheck pair
0656TAnt lmbr vrt bdy teth <7 seg1 - modifier may bypassCheck pair
0657TAnt lmbr vrt bdy teth 8+ seg1 - 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
12001Rpr s/n/ax/gen/trnk 2.5cm/<1 - modifier may bypassCheck pair
12002Rpr s/n/ax/gen/trnk2.6-7.5cm1 - modifier may bypassCheck pair
12004Rpr s/n/ax/gen/trk7.6-12.5cm1 - modifier may bypassCheck pair
12005Rpr s/n/a/gen/trk12.6-20.0cm1 - modifier may bypassCheck pair
12006Rpr s/n/a/gen/trk20.1-30.0cm1 - modifier may bypassCheck pair
12007Rpr s/n/ax/gen/trnk >30.0 cm1 - modifier may bypassCheck pair
12020Tx supfc wnd dehsn smpl clsr1 - modifier may bypassCheck pair
12021Tx supfc wnd dehsn w/packing1 - modifier may bypassCheck pair
12031Intmd rpr s/a/t/ext 2.5 cm/<1 - modifier may bypassCheck pair
12032Intmd rpr s/a/t/ext 2.6-7.51 - modifier may bypassCheck pair
12034Intmd rpr s/tr/ext 7.6-12.51 - modifier may bypassCheck pair
12035Intmd rpr s/a/t/ext 12.6-201 - modifier may bypassCheck pair
12036Intmd rpr s/a/t/ext 20.1-301 - modifier may bypassCheck pair
12037Intmd rpr s/tr/ext >30.0 cm1 - modifier may bypassCheck pair
13100Cmplx rpr trunk 1.1-2.5 cm1 - modifier may bypassCheck pair
13101Cmplx rpr trunk 2.6-7.5 cm1 - modifier may bypassCheck pair
20930Sp bone algrft morsel add-on1 - modifier may bypassCheck pair
20931Sp bone algrft struct add-on1 - modifier may bypassCheck 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 codeShort descriptionModifier indicator
0220TPlmt post facet implt thor1Check pair
22610Arthrd pst tq 1ntrspc thrc1Check pair
22612Arthrd pst tq 1ntrspc lumbar1Check pair
22633Arthrd cmbn 1ntrspc lumbar1Check pair
22634Arthrd cmbn 1ntrspc ea addl1Check 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

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.