CPT 62225
Global 090 ActiveReplace/irrigate catheter
CPT 62225 Billing & Documentation Guide
CPT code 62225 (Replace/irrigate catheter) is classified under Surgery (Endocrine/Nervous/Eye/Ear) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 6.04, a non-facility practice expense RVU of 8.58, and a malpractice RVU of 2.51, a total non-facility RVU of 17.13 and facility RVU of 17.13. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $576.7, though rates vary from $491.09 to $712.09 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 62225, 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 62225 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 2 units of 62225 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 62225
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 6.04 | 6.04 |
| Practice Expense RVU | 8.58 | 8.58 |
| Malpractice RVU | 2.51 | 2.51 |
| Total RVU | 17.13 | 17.13 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 62225
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 | $593.54 | $593.54 | $564.2 - $682.12 | 29 |
| Florida | $652.48 | $652.48 | $601.72 - $712.09 | 3 |
| Georgia | $575.75 | $575.75 | $557.3 - $594.2 | 2 |
| Illinois | $639.56 | $639.56 | $594.42 - $683.57 | 4 |
| Michigan | $588.84 | $588.84 | $558.04 - $619.64 | 2 |
| North Carolina | $522.69 | $522.69 | $522.69 - $522.69 | 1 |
| New York | $645 | $645 | $532.93 - $711.08 | 5 |
| Ohio | $547.9 | $547.9 | $547.9 - $547.9 | 1 |
| Pennsylvania | $573.89 | $573.89 | $544.05 - $603.72 | 2 |
| Texas | $562.86 | $562.86 | $540.41 - $603.29 | 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 62225
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 62225 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0169T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 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 | Standards of medical/surgical practice |
| 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 |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 62225
What does CPT code 62225 mean? +
CPT code 62225 represents: Replace/irrigate catheter. It's in the Surgery (Endocrine/Nervous/Eye/Ear) category with a global period of 090.
What is the Medicare reimbursement for CPT 62225? +
The 2026 Medicare national average non-facility payment for CPT 62225 is $576.7. Rates range from $491.09 to $712.09 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 62225? +
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 62225? +
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 April 17, 2026.
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