CPT 22515
Global ZZZ ActivePerq vertebral augmentation
CPT 22515 Billing & Documentation Guide
CPT code 22515 (Perq vertebral augmentation) is classified under Surgery (Musculoskeletal) with a global period indicator of ZZZ. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 3.9, a non-facility practice expense RVU of 84.46, and a malpractice RVU of 0.79, a total non-facility RVU of 89.15 and facility RVU of 5.66. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $3099.64, though rates vary from $2567.13 to $4226.68 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 22515, 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 22515 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Add-on code (global concept does not apply)
MUE Limit (Medically Unlikely Edits)
Submitting more than 4 units of 22515 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 22515
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 3.9 | 3.9 |
| Practice Expense RVU | 84.46 | 0.97 |
| Malpractice RVU | 0.79 | 0.79 |
| Total RVU | 89.15 | 5.66 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 22515
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 | $3487.31 | $187.58 | $3238.48 - $4226.68 | 29 |
| Florida | $3012.07 | $214.14 | $2866.84 - $3133.7 | 3 |
| Georgia | $2853.3 | $192.94 | $2678.08 - $3028.52 | 2 |
| Illinois | $2906.98 | $212.45 | $2747.12 - $3075.14 | 4 |
| Michigan | $2816.36 | $197.83 | $2735.66 - $2897.06 | 2 |
| North Carolina | $2779.15 | $177.35 | $2779.15 - $2779.15 | 1 |
| New York | $3319.47 | $208.46 | $2828.8 - $3541.82 | 5 |
| Ohio | $2732.47 | $186.44 | $2732.47 - $2732.47 | 1 |
| Pennsylvania | $2922.85 | $191.38 | $2744.91 - $3100.79 | 2 |
| Texas | $2932.8 | $187.39 | $2721.92 - $3138.56 | 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 22515
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 22515 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 10005 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 10007 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 10009 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 10011 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 10021 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 10022 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 11000 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 11001 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 11004 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 11005 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 22515
What does CPT code 22515 mean? +
CPT code 22515 represents: Perq vertebral augmentation. It's in the Surgery (Musculoskeletal) category with a global period of ZZZ.
What is the Medicare reimbursement for CPT 22515? +
The 2026 Medicare national average non-facility payment for CPT 22515 is $3099.64. Rates range from $2567.13 to $4226.68 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 22515? +
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 22515? +
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 June 1, 2026.
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