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CPT 77522 Medicare carrier-priced amounts

Contractor-priced

77522 · PFS Q1 2024 · Historical

Contractor-published range

$765.00–$1,031.28

Participating · Office (non-facility) · Whole service

MAC-published fee schedules available in Localis: 18 of 144 payment localities. Missing data does not establish a $0 allowance.

No national PFS rate in Q1 2024

Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation.

Check for a published amount in your locality.

View contractor sources and effective dates

Amount evidence: MAC-published fee schedules and effective dates. The PFS row shows this code is priced by the contractor.

Inspect PFS status evidence
Code
77522
Release
Q1 2024, revision 2
Result
Contractor-priced

Citations

  • Shows this code’s PFS status (C). Result: Contractor-priced.

    Physician relative value file (PPRRVU)CMS RVU24AMarch 9 – March 31, 2024revision 2

    This PFS record alone does not establish a $0 allowance or a coverage determination. Any amount from another schedule needs its own evidence.

    PPRRVU24_JAN.csv row 14,515 in rvu24ar-posted-04-01-2024.zip

    In the CMS file

    Loading rows 14,513–14,517 of PPRRVU24_JAN.csv…

    Download rvu24ar-posted-04-01-2024.zip from CMS File fingerprint b6c71c98c3e26e2b217817da7000cc3516dc360a1c74d5ffd8f46bfa835f9741

Report a problem

CPT 77522 carries status C (carrier-priced) in the Q1 2024 release, so there is no single national rate—Medicare contractors publish their own amounts. Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation. Contractor-published amounts on file range $765.00–$1,031.28 across 18 localities; enter a ZIP for the exact local amount.

Why is there no national PFS amount for 77522?

Its status indicator is C (carrier-priced). Your Medicare Administrative Contractor prices this code case by case, usually after reviewing documentation.

Find the local Medicare amount for 77522 Copy link

Medicare sets this price locally

77522 has no single national Physician Fee Schedule amount. Use the ZIP, modifier, setting, and participation fields above to match it to a Medicare locality and the contractor amount we have on file.

Your practical estimate will appear here

We hold files from First_coast and Novitas across JH and JN, most recently effective Jan 1, 2024. A missing locality means our contractor coverage is incomplete—not that Medicare pays $0.

This is the published amount for this code—not necessarily the entire visit or procedure. A hospital may bill a separate facility charge, and other services, drugs, or supplies can add to the total.

Contractor-published source figures, not a national rate. Par = participating-provider amount Non-par = nonparticipating-provider amount C = technical component capped at the OPPS amount # = facility-setting amount
View all 18 published fee rows
Jurisdiction / locality Modifier Note Par Non-par Limiting charge Effective Source
JH · Arkansas, Area 13 CMS 07102-13 — — $772.52 $733.89 $843.97 Jan 1, 2024 Contractor file
JH · Colorado, Area 01 CMS 04112-01 — — $897.28 $852.42 $980.28 Jan 1, 2024 Contractor file
JH · Louisiana, Area 01 CMS 07202-01 — — $872.41 $828.79 $953.11 Jan 1, 2024 Contractor file
JH · Louisiana, Area 99 CMS 07202-99 — — $783.77 $744.58 $856.27 Jan 1, 2024 Contractor file
JH · Mississippi, Area 00 CMS 07302-00 — — $773.98 $735.28 $845.57 Jan 1, 2024 Contractor file
JH · New Mexico, Area 05 CMS 04212-05 — — $818.99 $778.04 $894.75 Jan 1, 2024 Contractor file
JH · Oklahoma, Area 00 CMS 04312-00 — — $765.00 $726.75 $835.76 Jan 1, 2024 Contractor file
JH · Texas, Area 09 CMS 04412-09 — — $882.21 $838.10 $963.82 Jan 1, 2024 Contractor file
JH · Texas, Area 11 CMS 04412-11 — — $908.83 $863.39 $992.90 Jan 1, 2024 Contractor file
JH · Texas, Area 15 CMS 04412-15 — — $890.35 $845.83 $972.70 Jan 1, 2024 Contractor file
JH · Texas, Area 18 CMS 04412-18 — — $895.59 $850.81 $978.43 Jan 1, 2024 Contractor file
JH · Texas, Area 20 CMS 04412-20 — — $801.05 $761.00 $875.15 Jan 1, 2024 Contractor file
JH · Texas, Area 28 CMS 04412-28 — — $874.92 $831.17 $955.85 Jan 1, 2024 Contractor file
JH · Texas, Area 31 CMS 04412-31 — — $901.54 $856.46 $984.93 Jan 1, 2024 Contractor file
JH · Texas, Area 99 CMS 04412-99 — — $815.08 $774.33 $890.48 Jan 1, 2024 Contractor file
JN · Florida, Area 03 CMS 09102-03 — — $1,031.28 $979.72 $1,126.68 Jan 1, 2024 Contractor file
JN · Florida, Area 04 CMS 09102-04 — — $1,031.28 $979.72 $1,126.68 Jan 1, 2024 Contractor file
JN · Florida, Area 99 CMS 09102-99 — — $1,031.28 $979.72 $1,126.68 Jan 1, 2024 Contractor file

The authenticated MAC fees API returns the same source rows. ZIP5s that span localities are flagged and use only the crosswalk's dominant locality until ZIP+4 overrides are available.

Contract rate as % of Medicare Copy link

Arbitration outcomes for 77522 are coming Join the waitlist →

Which billing rules and modifiers apply? Copy link

CMS indicators that apply to 77522: PCTC 3 (technical component only).

Professional/technical split

Technical component only

PCTC

3

Only a technical component exists for this code—there is no corresponding professional-component amount to bill.

Global surgery period XXX (does not apply).

Why would a Medicare claim for 77522 be denied or paid less?

These come from CMS indicators on this page, not general billing advice.

Payer-specific coverage and documentation rules live outside these files, so a claim that clears every check here can still be denied on other grounds.

CMS RVU24AMarch 9 – March 31, 2024revision 2

Can you bill it with another code? Copy link

This code

77522

See every current NCCI pair for 77522 →

Reconciling a contractor-priced payment for 77522 Copy link

Checking a paid 77522 line?

Check an actual payment Model this code in a contract
What to check (4)

There is no national allowed amount for 77522, so every reconciliation of this line runs against the MAC fee schedule that was in force for the date of service rather than against a national baseline.

  • Compare the paid amount against the MAC fee schedule in force for the date of service; there is no national allowed amount here to reconcile against.
  • Only a technical-component amount is published for this code, so a professional charge billed on it has no fee-schedule amount behind it.
  • Check for documentation on file before appealing an assistant-at-surgery denial: payment on the -80 or -AS line is restricted for this procedure unless medical necessity is established.
  • Reprice the line against the release, locality, setting, modifier and participation status that applied to the date of service before treating any difference as an underpayment.

Sources: CMS Medicare Physician Fee Schedule Relative Value Files; CMS Medicare Physician Fee Schedule Relative Value Files (status indicator field); CMS Medicare Claims Processing Manual (Pub. 100-04); 42 USC 1395w-4(i)(2) (SSA §1848(i)(2))—Assistants-at-surgery.

Source & method Copy link

The PFS file shows this code is priced by the contractor. Its amounts come from the MAC-published schedules and effective dates shown above.

  1. 01 PPRRVU24_JAN.csv · Q1 2024 (RVU24A) · row 14,515—priced by the contractor
    Source
    Physician relative value file (PPRRVU), Q1 2024 release
    Effective
    March 9 – March 31, 2024
    Locator
    PPRRVU24_JAN.csv in rvu24ar-posted-04-01-2024.zip · row 14,515 of 18,499 · via CMS
    Fields read
    Status C (col 4)
    SHA-256 b6c71c98c3e26e2b…
  2. 02 MAC-published fee schedules · 18 on file—the contractor amounts
    Source
    MAC-published fee schedules
    Effective
    Effective dates shown above
  3. 03 Physician & Other Practitioners · CY2024—volume and who bills it limits
    Source
    CMS Physician & Other Practitioners dataset
    Effective
    Calendar-year snapshot, on a different cycle from the Q1 2024 fee schedule
    Doesn’t establish
    Medicare Advantage, Medicaid or commercial volume.
    Note
    The dataset suppresses rows under 11 beneficiaries.

Cite this rate

CPT 77522 National PFS baseline: No national PFS rate (Q1 2024; participating physician; whole service; GPCI 1.000; sequestration excluded). CMS RVU24A, PPRRVU24_JAN.csv row 14,515. Localis. https://localishealth.com/cpt/77522/2024/A

Past releases are never edited, so the citation stays checkable after CMS publishes a newer one. Methodology · Plain-text summary · JSON

How has it changed? Copy link

When does this rate change?

CMS publishes a fee schedule release every quarter (January, April, July, October), and each is versioned here. See what changed each release, or get an email when a new release moves rates.

Sources: CMS Medicare Physician Fee Schedule Relative Value Files.

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Usage and related codes Copy link

In CY2024, 77522 ranked #2,320 of the 7,879 CPT codes billed to Medicare that year, by patients served or total allowed dollars.

Services
2,369
Allowed
$2.1M
Beneficiaries
115

CY2024 Medicare fee-for-service, from the CMS Physician & Other Practitioners dataset (limits).