CPT 22585
Global ZZZ ActiveArthrd ant ntrbd min dsc ea
CPT 22585 Billing & Documentation Guide
CPT code 22585 (Arthrd ant ntrbd min dsc ea) is classified under Surgery (Musculoskeletal) with a global period indicator of ZZZ. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 5.38, a non-facility practice expense RVU of 1.62, and a malpractice RVU of 1.61, a total non-facility RVU of 8.61 and facility RVU of 8.61. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $285.87, though rates vary from $248.1 to $372.02 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 22585, 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 22585 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 5 units of 22585 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 22585
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 5.38 | 5.38 |
| Practice Expense RVU | 1.62 | 1.62 |
| Malpractice RVU | 1.61 | 1.61 |
| Total RVU | 8.61 | 8.61 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 22585
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 | $279.33 | $279.33 | $270.88 - $306.31 | 29 |
| Florida | $338.67 | $338.67 | $312.25 - $372.02 | 3 |
| Georgia | $295.93 | $295.93 | $292.06 - $299.8 | 2 |
| Illinois | $335.38 | $335.38 | $313.15 - $358.75 | 4 |
| Michigan | $306.2 | $306.2 | $289.81 - $322.58 | 2 |
| North Carolina | $264.54 | $264.54 | $264.54 - $264.54 | 1 |
| New York | $321.69 | $321.69 | $268.9 - $355.39 | 5 |
| Ohio | $283.3 | $283.3 | $283.3 - $283.3 | 1 |
| Pennsylvania | $291.8 | $291.8 | $280.19 - $303.41 | 2 |
| Texas | $283.91 | $283.91 | $276.7 - $308.86 | 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 22585
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 22585 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 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 |
| 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 |
| 11006 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 11012 | Column 1 (primary), can be billed with modifier | 9 | Mutually exclusive procedures |
| 11042 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 11043 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 22585
What does CPT code 22585 mean? +
CPT code 22585 represents: Arthrd ant ntrbd min dsc ea. It's in the Surgery (Musculoskeletal) category with a global period of ZZZ.
What is the Medicare reimbursement for CPT 22585? +
The 2026 Medicare national average non-facility payment for CPT 22585 is $285.87. Rates range from $248.1 to $372.02 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 22585? +
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 22585? +
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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