CPT 22511
Global 010 ActivePerq lumbosacral injection
CPT 22511 Billing & Documentation Guide
CPT code 22511 (Perq lumbosacral injection) is classified under Surgery (Musculoskeletal) with a global period indicator of 010. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 7.15, a non-facility practice expense RVU of 44.89, and a malpractice RVU of 1.07, a total non-facility RVU of 53.11 and facility RVU of 10.82. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $1839.08, though rates vary from $1545.18 to $2446.33 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 22511, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 22511 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
10-day global period (minor procedure: pre-op day + procedure + 10 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 22511 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 22511
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 7.15 | 7.15 |
| Practice Expense RVU | 44.89 | 2.6 |
| Malpractice RVU | 1.07 | 1.07 |
| Total RVU | 53.11 | 10.82 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 22511
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $2040.92 | $369.51 | $1905.34 - $2446.33 | 29 |
| Florida | $1812.75 | $395.52 | $1725.93 - $1890.04 | 3 |
| Georgia | $1712.33 | $364.78 | $1618.85 - $1805.81 | 2 |
| Illinois | $1756.71 | $391.86 | $1663.6 - $1843.67 | 4 |
| Michigan | $1697.03 | $370.66 | $1648.09 - $1745.96 | 2 |
| North Carolina | $1660.56 | $342.68 | $1660.56 - $1660.56 | 1 |
| New York | $1971.42 | $395.61 | $1688.34 - $2103.21 | 5 |
| Ohio | $1643.76 | $354.13 | $1643.76 - $1643.76 | 1 |
| Pennsylvania | $1747.8 | $364.23 | $1649.01 - $1846.59 | 2 |
| Texas | $1749.45 | $358.82 | $1636.44 - $1857.29 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 22511
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 22511 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0171T | Column 1 (primary), can be billed with modifier | Yes | Mutually exclusive procedures |
| 01935 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01936 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01937 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01938 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01939 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01940 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01941 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01942 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 22511
What does CPT code 22511 mean? +
CPT code 22511 represents: Perq lumbosacral injection. It's in the Surgery (Musculoskeletal) category with a global period of 010.
What is the Medicare reimbursement for CPT 22511? +
The 2026 Medicare national average non-facility payment for CPT 22511 is $1839.08. Rates range from $1545.18 to $2446.33 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 22511? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 22511? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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