`22838` Rev rplc/rmv thrc vrt tethrg

What 22838 is

CMS fee schedule short descriptor: Rev rplc/rmv thrc vrt tethrg.

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 22838 (CY2026)

	Work RVU	Practice expense RVU	Malpractice RVU	Total	Medicare rate
Non-facility (office)	35.10	11.57	3.75	50.42	$1,684.07
Facility (hospital, ASC)	35.10	11.57	3.75	50.42	$1,684.07

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.

Adjust for a Medicare locality:

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

Medically Unlikely Edit (MUE)

Medicare caps 22838 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 22838? These codes are bundled into it

22838 is a Column 1 code in 19 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
`11000`	Dbrdmt ecz/infected skin<10%	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
`22845`	Insert spine fixation device	0 - no modifier bypass	Check pair
`22846`	Insert spine fixation device	0 - no modifier bypass	Check pair
`22847`	Insert spine fixation device	0 - no modifier bypass	Check pair
`22849`	Reinsert spinal fixation	0 - no modifier bypass	Check pair
`22855`	Removal anterior instrmj	0 - no modifier bypass	Check pair
`32601`	Thoracoscopy diagnostic	0 - no modifier bypass	Check pair
`36591`	Draw blood off venous device	0 - no modifier bypass	Check pair
`36592`	Collect blood from picc	0 - no modifier bypass	Check pair
`69990`	Microsurgery add-on	0 - no modifier bypass	Check pair
`96523`	Irrig drug delivery device	0 - no modifier bypass	Check pair
`97597`	Dbrdmt opn wnd 1st 20 cm/<	1 - modifier may bypass	Check pair
`97602`	Wound(s) care non-selective	1 - modifier may bypass	Check pair

22838 is bundled into these codes

22838 appears as a Column 2 code in 8 active edits. Reported with one of these Column 1 codes on the same date of service, 22838 is the code that denies.

Column 1 code	Short description
`22800`	Arthrd pst dfrm<6 vrt sgm	Check pair
`22802`	Arthrd pst dfrm 7-12 vrt sgm	Check pair
`22804`	Arthrd pst dfrm 13+ vrt sgm	Check pair
`22808`	Arthrd ant dfrm 2-3 vrt sgm	Check pair
`22810`	Arthrd ant dfrm 4-7 vrt sgm	Check pair
`22812`	Arthrd ant dfrm 8+ vrt sgm	Check pair
`22818`	Kyphectomy 1-2 segments	Check pair
`22819`	Kyphectomy 3 or more	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.