Home / Medicare fees / 22586

22586 Arthrd pre-sac ntrbdy l5-s1

What 22586 is

CMS fee schedule short descriptor: Arthrd pre-sac ntrbdy l5-s1.

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 22586 (CY2026)

Work RVUPractice expense RVUMalpractice RVUTotalMedicare rate
Non-facility (office)27.4221.1111.5960.12$2,008.06
Facility (hospital, ASC)27.4221.1111.5960.12$2,008.06

National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.


Status: Active - payable under the Physician Fee Schedule. Global period: 90-day global period.

Advertisement

Medically Unlikely Edit (MUE)

Medicare caps 22586 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Anatomic Consideration. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 22586? These codes are bundled into it

22586 is a Column 1 code in 323 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
0566TAutol cell implt adps njx1 - 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
11010Debride skin at fx site1 - modifier may bypassCheck pair
11011Debride skin musc at fx site1 - modifier may bypassCheck pair
11012Deb skin bone at fx site1 - 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
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

Showing 30 of 323 column 2 codes. Use the pair checker for any specific combination.

22586 is bundled into these codes

22586 appears as a Column 2 code in 5 active edits. Reported with one of these Column 1 codes on the same date of service, 22586 is the code that denies.

Column 1 codeShort descriptionModifier indicator
22556Arthrd ant ntrbd min dsc thc1Check pair
22633Arthrd cmbn 1ntrspc lumbar1Check pair
22857Tot disc arthrp 1ntrspc lmbr1Check pair
22862Rev rplcm rthrp 1ntrspc lmbr1Check pair
22865Rmvl tot arthrp 1ntrspc 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.