CPT 22554
Global 090 ActiveArthrd ant ntrbd min dsc crv
CPT 22554 Billing & Documentation Guide
CPT code 22554 (Arthrd ant ntrbd min dsc crv) is classified under Surgery (Musculoskeletal) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 17.25, a non-facility practice expense RVU of 13.35, and a malpractice RVU of 5.8, a total non-facility RVU of 36.4 and facility RVU of 36.4. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $1219.11, though rates vary from $1058.96 to $1530.28 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 22554, 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 22554 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
90-day global period (major surgery: 1 day pre-op + procedure + 90 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 22554 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 22554
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 17.25 | 17.25 |
| Practice Expense RVU | 13.35 | 13.35 |
| Malpractice RVU | 5.8 | 5.8 |
| Total RVU | 36.4 | 36.4 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 22554
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 | $1229.5 | $1229.5 | $1178.51 - $1386.37 | 29 |
| Florida | $1400.67 | $1400.67 | $1293.62 - $1530.28 | 3 |
| Georgia | $1234.21 | $1234.21 | $1204.83 - $1263.59 | 2 |
| Illinois | $1379.25 | $1379.25 | $1286.07 - $1472.93 | 4 |
| Michigan | $1267.53 | $1267.53 | $1201.99 - $1333.08 | 2 |
| North Carolina | $1115.98 | $1115.98 | $1115.98 - $1115.98 | 1 |
| New York | $1364.31 | $1364.31 | $1135.96 - $1502.97 | 5 |
| Ohio | $1178.55 | $1178.55 | $1178.55 - $1178.55 | 1 |
| Pennsylvania | $1225.2 | $1225.2 | $1168.57 - $1281.83 | 2 |
| Texas | $1198.27 | $1198.27 | $1161.91 - $1290.12 | 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 22554
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 22554 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0090T | Column 1 (primary), can be billed with modifier | Yes | Mutually exclusive procedures |
| 0093T | Column 1 (primary), can be billed with modifier | Yes | Mutually exclusive procedures |
| 0096T | Column 1 (primary), can be billed with modifier | Yes | Mutually exclusive procedures |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0333T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0464T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0566T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 22554
What does CPT code 22554 mean? +
CPT code 22554 represents: Arthrd ant ntrbd min dsc crv. It's in the Surgery (Musculoskeletal) category with a global period of 090.
What is the Medicare reimbursement for CPT 22554? +
The 2026 Medicare national average non-facility payment for CPT 22554 is $1219.11. Rates range from $1058.96 to $1530.28 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 22554? +
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 22554? +
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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