| Common Description | Possible Combinations | Procedure Codes | Explanations | Work RVU | Total RVU |
|---|---|---|---|---|---|
| ALIF or XLIF with laminectomies with posterolateral fusion with pedicle screw fixation, Front and Back, ONE LEVEL | L3-4 ALIF or XLIF with posterior pedicle screw and rod fixation | 22558 +22845 +22853 22612 63047 +22840 +61783 +20936 +20930 | 22558 - anterior lumbar interbody fusion; +22845 - anterior plating if used, do not use for standalone; +22853 - placement of intervertebral device such as PEEK, titanium, use for stand-alone cage with screw or wing fixation, do not use for structural bone allograft, instead use +20931; 22612 - is for single level posterolateral lumbar fusion; +22614 - additional level posterior lumbar fusion; +22840 - 2 vertebral posterior instrumentation; +61783 - use of neuronavigation, e.g. Brainlab, Stealth; ALIF = Anterior Lumbar Interbody Fusion, XLIF = Extreme Lateral Lumbar Interbody Fusion +20936 - morselized autograft through same fascial incision, e.g. spinous process, lamina; +20930 - morselized allograft, e.g. DBM, Infuse, BMP | 22558 - 23.53 +22845 - 11.94 +22853 - 4.25 22612 - 23.53 63047 - 15.37 +22840 - 12.52 +61783 - 3.75 +20936 - 0 +20930 - 0 | 22558 - 44.64 +22845 - 21.42 +22853 - 7.64 22612 - 46.14 63047 - 32.06 +22840 - 22.26 +61783 - 6.83 +20936 - 0 +20930 - 0 |
| ALIF 1 Level + ADR 1 Level | 22558 22857 +22845 +22853 +20930 | 22558 - anterior lumbar interbody fusion; 22857 - lumbar artificial disc replacement; +22845 - anterior plating if used, do not use for standalone; +22853 - placement of intervertebral device such as PEEK, titanium, use for stand-alone cage with screw or wing fixation, do not use for structural bone allograft, instead use +20931; +20930 - morselized allograft | 22558 - 23.53 22857 - 27.13 +22845 - 11.94 +22853 - 4.25 +20930 - 0 | 22558 - 44.64 22857 - 51.43 +22845 - 21.42 +22853 - 7.64 +20930 - 0 | |
| Lumbar posterior instrumented fusion, 3 levels | 22612 +22614 x 2 +22842 | 22612 - single level posterior lumbar fusion, e.g. L1/2; +22614 - additional level posterior lumbar fusion; +22842 - 3 to 6 vertebral posterior instrumented fixation; +61783 - use of neuronavigation, e.g. Brainlab, Stealth; +20937 - morselized autograft through separate fascial incision, e.g. iliac creast bone graft; +20936 is morselized autograft through same fascial incision, e.g. spinous process, lamina; +20930 is morselized allograft, e.g. DBM, Infuse, BMP | 22612 - 23.53 +22614 x 2 - 12.86 +22842 - 12.56 +61783 - 3.75 +20937 - 2.79 +20936 - 0 +20930 - 0 | 22612 - 46.14 +22614 x 2 - 22.94 +22842 - 22.35 +61783 - 6.83 +20937 - 4.90 +20936 - 0 +20930 - 0 | |
| Lumbar posterior instrumented fusion, 4 levels | 22612 +22614 x 3 +22842 | 22612 - single level posterior lumbar fusion, e.g. L1/2; +22614 - additional level posterior lumbar fusion; +22842 - 3 to 6 vertebral posterior instrumented fixation; +61783 - use of neuronavigation, e.g. Brainlab, Stealth; +20937 - morselized autograft through separate fascial incision, e.g. iliac creast bone graft; +20936 is morselized autograft through same fascial incision, e.g. spinous process, lamina; +20930 is morselized allograft, e.g. DBM, Infuse, BMP | 22612 - 23.53 +22614 x 3 - 19.29 +22842 - 12.56 +61783 - 3.75 +20937 - 2.79 +20936 - 0 +20930 - 0 | 22612 - 46.14 +22614 x 3 - 34.41 +22842 - 22.35 +61783 - 6.83 +20937 - 4.90 +20936 - 0 +20930 - 0 | |
| Lumbar posterior instrumented fusion, 5 levels | T12 - L5 redo fusion and fixation | 22612 +22614 x 4 +22842 | 22612 - single level posterior lumbar fusion, e.g. L1/2; +22614 - additional level posterior lumbar fusion; +22842 - 3 to 6 vertebral posterior instrumented fixation; +61783 - use of neuronavigation, e.g. Brainlab, Stealth; +20937 - morselized autograft through separate fascial incision, e.g. iliac creast bone graft; +20936 is morselized autograft through same fascial incision, e.g. spinous process, lamina; +20930 is morselized allograft, e.g. DBM, Infuse, BMP | 22612 - 23.53 +22614 x 4 - 25.72 +22842 - 12.56 +61783 - 3.75 +20937 - 2.79 +20936 - 0 +20930 - 0 | 22612 - 46.14 +22614 x 4 - 45.88 +22842 - 22.35 +61783 - 6.83 +20937 - 4.9 +20936 - 0 +20930 - 0 |
| Lumbar posterior instrumented fusion, 6 levels | 22612 +22614 x 5 +22842 | 22612 - single level posterior lumbar fusion, e.g. L1/2; +22614 - additional level posterior lumbar fusion; +22842 - 3 to 6 vertebral posterior instrumented fixation; +61783 - use of neuronavigation, e.g. Brainlab, Stealth; +20937 - morselized autograft through separate fascial incision, e.g. iliac creast bone graft; +20936 is morselized autograft through same fascial incision, e.g. spinous process, lamina; +20930 is morselized allograft, e.g. DBM, Infuse, BMP | 22612 - 23.53 +22614 x 5 - 32.15 +22842 - 12.56 +61783 - 3.75 +20937 - 2.79 +20936 - 0 +20930 - 0 | 22612 - 46.14 +22614 x 5 - 57.35 +22842 - 22.35 +61783 - 6.83 +20937 - 4.90 +20936 - 0 +20930 - 0 | |
| Lumbar posterior instrumented fusion, 7 levels | 22612 +22614 x 6 +22843 | 22612 - single level posterior lumbar fusion, e.g. L1/2; +22614 - additional level posterior lumbar fusion; +22843 - 7 to 12 vertebral posterior instrumented fixation; +61783 - use of neuronavigation, e.g. Brainlab, Stealth; +20937 - morselized autograft through separate fascial incision, e.g. iliac creast bone graft; +20936 is morselized autograft through same fascial incision, e.g. spinous process, lamina; +20930 is morselized allograft, e.g. DBM, Infuse, BMP | 22612 - 23.53 +22614 x 6 - 38.58 +22843 - 13.44 +61783 - 3.75 +20937 - 2.79 +20936 - 0 +20930 - 0 | 22612 - 46.14 +22614 x 6 - 68.82 +22843 - 23.91 +61783 - 6.83 +20937 - 4.9 +20936 - 0 +20930 - 0 | |
| Lumbar posterior instrumented fusion, 8 levels | T11 to pelvis fusion | 22612 +22614 x 7 +22843 +22848 +61783 +20937 +20936 +20930 | 22612 - single level posterior lumbar fusion, e.g. L1/2; +22614 - additional level posterior lumbar fusion; +22843 - 7 to 12 vertebral posterior instrumented fixation; +61783 - use of neuronavigation, e.g. Brainlab, Stealth; +20937 - morselized autograft through separate fascial incision, e.g. iliac creast bone graft; +20936 is morselized autograft through same fascial incision, e.g. spinous process, lamina; +20930 is morselized allograft, e.g. DBM, Infuse, BMP | 22612 - 23.53 +22614 x 7 - 45.01 +22843 - 13.44 +22848 - 5.99 +61783 - 3.75 +20937 - 2.79 +20936 - 0 +20930 - 0 | 22612 - 46.14 +22614 x 7 - 80.29 +22843 - 23.91 +22848 - 11.98 +61783 - 6.83 +20937 - 4.90 +20936 - 0 +20930 - 0 |
| Lumbar posterior instrumented fusion, 9 levels | T10 to pelvis fusion | 22612 +22614 x 8 +22843 +22848 +61783 +20937 +20936 +20930 | 22612 - single level posterior lumbar fusion, e.g. L1/2; +22614 - additional level posterior lumbar fusion; +22843 - 7 to 12 vertebral posterior instrumented fixation; +61783 - use of neuronavigation, e.g. Brainlab, Stealth +20937 - morselized autograft through separate fascial incision, e.g. iliac creast bone graft; +20936 is morselized autograft through same fascial incision, e.g. spinous process, lamina; +20930 is morselized allograft, e.g. DBM, Infuse, BMP | 22612 - 23.53 +22614 x 8 - 51.44 +22843 - 13.44 +22848 - 5.99 +61783 - 3.75 +20937 - 2.79 +20936 - 0 +20930 - 0 | 22612 - 46.14 +22614 x 8 - 91.76 +22843 - 23.91 +22848 - 11.98 +61783 - 6.83 +20937 - 4.9 +20936 - 0 +20930 - 0 |
| Lumbar posterior instrumented fusion, TWO levels | L1-L3 pedicle screw and rod fusion; L3-4 and L4-5 posterior instrumented fusion | 22612 +22614 +22842 | 22612 - single level posterior lumbar fusion, e.g. L1/2; +22614 - additional level posterior lumbar fusion; +22842 - 3 to 6 vertebral posterior instrumented fixation; +61783 - use of neuronavigation, e.g. Brainlab, Stealth; +20937 - morselized autograft through separate fascial incision, e.g. iliac creast bone graft; +20936 is morselized autograft through same fascial incision, e.g. spinous process, lamina; +20930 is morselized allograft, e.g. DBM, Infuse, BMP | 22612 - 23.53+22614 - 6.43 +22842 - 12.56 +61783 - 3.75 +20937 - 2.79 +20936 - 0 +20930 - 0 | 22612 - 46.14 +22614 - 11.47 +22842 - 22.35 +61783 - 6.83 +20937 - 4.90 +20936 - 0 +20930 - 0 |
| Lumbar posterior instrumented fusion, 1 level | 22612 +22840 | 22612 - single level posterior lumbar fusion, e.g. L1/2; +22840 - 2 vertebral posterior instrumentation; +61783 - use of neuronavigation, e.g. Brainlab, Stealth; +20937 - morselized autograft through separate fascial incision, e.g. iliac creast bone graft; +20936 is morselized autograft through same fascial incision, e.g. spinous process, lamina; +20930 is morselized allograft, e.g. DBM, Infuse, BMP | 22612 - 23.53 +22840 - 12.52 +61783 - 3.75 +20937 - 2.79 +20936 - 0 +20930 - 0 | 22612 - 46.14 +22840 - 22.26 +61783 - 6.83 +20937 - 4.9 +20936 - 0 +20930 - 0 | |
| PLIF or TLIF - 2 levels WITHOUT posterolateral fusion | 22630 +22632 63047-59 +63048-59 (commercial payor) 63047-51 +63048-51 (Medicare) +22842 +22853 x 2 +61783 +20936 | 22630 - PLIF or TLIF withOUT posterolateral fusion; +22632 - additional level of PLIF or TLIF; +22842 - 3 vertebra instrumented fixation; +22853 - PLIF or TLIF cage; +61783 - use of neuronavigation, e.g. Brainlab, Stealth; +20936 - morselized autograft through same fascial incision; STARTING IN 2018 CANNOT CODE 63047 AND +63048 FOR DECOMPRESSION; Other possible codes: +69990 - use of microscope; +20937: moreselized autograft through separate fascial incision; +20930 - morselized allograft; Medicare will not pay for 63047 but should bill to keep track of physician productivity | 22630 - 22.09 +22632 - 5.22 +22842 - 12.56 +22853 x 2 - 8.50 +69990 - 3.46 +61783 - 3.75 +20937 - 2.79 +20936 - 0 +20930 - 0 | 22630 - 45.76 +22632 - 9.43 +22842 - 22.35 +22853 x 2 - 15.28 +69990 - 6.43 +61783 - 6.83 +20937 - 4.90 +20936 - 0 +20930 - 0 | |
| PLIF or TLIF - 1 level WITHOUT posterolateral fusion | L5-S1 posterior lumbar interbody fusion | 22630 63047-59 (commercial payor) 63047-51 (Medicare)+22840 +22853 +61783 +20936 | 22630 - PLIF or TLIF withOUT posterolateral fusion; +22840 - 2 vertebra instrumented fixation; +22853 - PLIF or TLIF cage; +61783 - use of neuronavigation, e.g. Brainlab, Stealth; +20936 - morselized autograft through same fascial incision; STARTING IN 2018 CANNOT CODE 63047 FOR DECOMPRESSION; Other possible codes: +69990 - use of microscope; +20937: moreselized autograft through separate fascial incision; +20930 - morselized allograft; Medicare will not pay for 63047 but should bill to keep track of physician productivity | 22630 - 22.09 63047-59 - 15.37 +22840 - 12.52 +22853 - 4.25 +69990 - 3.46 +61783 - 3.75 +20937 - 2.79 +20936 - 0 +20930 - 0 | 22630 - 45.76 63047-59 - 32.06 +22840 - 22.26 +22853 - 7.64 +69990 - 6.43 +61783 - 6.83 +20937 - 4.90 +20936 - 0 +20930 - 0 |
| PLIF or TLIF - 2 levels WITH posterolateral fusion | L2-3 and L3-4 posterior lumbar interbody fusion with posterolateral fusion with local autograft; L3-4 and L4-5 posterior lumbar interbody fusion with posterolateral fusion with local autograft; L4-5 and L5-S1 posterior lumbar interbody fusion with posterolateral fusion with local autograft | 22633 +22634 63052 63053 +22842 +22853 x 2 +61783 +20936 | 22633 - PLIF or TLIF with posterolateral fusion; +22634 - additional level of PLIF or TLIF; 63052 - Posterior Extradural Laminotomy or Laminectomy for Exploration/ Decompression of Neural Elements or Excision of Herniated Intervertebral Disks Procedures; single vertebral segment 63053 - Posterior Extradural Laminotomy or Laminectomy for Exploration/ Decompression of Neural Elements or Excision of Herniated Intervertebral Disks Procedures; each additional vertebral segment +22842 - 3 vertebra instrumented fixation; +22853 - PLIF or TLIF cage; +61783 - use of neuronavigation, e.g. Brainlab, Stealth; +20936 - morselized autograft through same fascial incision; STARTING IN 2018 CANNOT CODE 63047 AND +63048 FOR DECOMPRESSION; Other possible codes: +69990 - use of microscope; +20937: moreselized autograft through separate fascial incision; +20930 - morselized allograft; Medicare will not pay for 63047 but should bill to keep track of physician productivity | 22633 - 27.75 +22634 - 8.16 63052 - 4.25 63053 - 8.5 +22842 - 12.56 +22853 x 2 - 8.50 +69990 - 3.46 +61783 - 3.75 +20937 - 2.79 +20936 - 0 +20930 - 0 | 22633 - 53.96 +22634 - 14.55 63052 - 3.78 63053 - 7.56 +22842 - 22.35 +22853 x 2 - 15.28 +69990 - 6.43 +61783 - 6.83 +20937 - 4.9 +20936 - 0 +20930 - 0 |
| PLIF or TLIF - 1 level WITH posterolateral fusion | L3-4 or L5-S1 posterior lumbar interbody fusion | 22633 +22840 +22853 +61783 +20936 | 22633 - PLIF or TLIF with posterolateral fusion; +22840 - 2 vertebra instrumented fixation; +22853 - PLIF or TLIF cage; +61783 - use of neuronavigation, e.g. Brainlab, Stealth; +20936 - morselized autograft through same fascial incision; STARTING IN 2018 CANNOT CODE 63047 FOR DECOMPRESSION; Other possible codes: +69990 - use of microscope; +20937: moreselized autograft through separate fascial incision; +20930 - morselized allograft; Medicare will not pay for 63047 but should bill to keep track of physician productivity | 22633 - 27.75 +22840 - 12.52 +22853 - 4.25 +61783 - 3.75 +69990 - 3.46 +20937 - 2.79 +20936 - 0 +20930 - 0 | 22633 - 53.96 +22840 - 22.26 +22853 - 7.64 +61783 - 6.83 +69990 - 6.43 +20937 - 4.90 +20936 - 0 +20930 - 0 |
| PLIF or TLIF - 3 levels WITH posterolateral fusion | 22633 +22634 63052 63053 +22842 +22853 x 3 +61783 +20936 | 22633 - PLIF or TLIF with posterolateral fusion; +22634 - additional level of PLIF or TLIF; 63052 - Posterior Extradural Laminotomy or Laminectomy for Exploration/ Decompression of Neural Elements or Excision of Herniated Intervertebral Disks Procedures; single vertebral segment 63053 - Posterior Extradural Laminotomy or Laminectomy for Exploration/ Decompression of Neural Elements or Excision of Herniated Intervertebral Disks Procedures; each additional vertebral segment +22842 - 3 vertebra instrumented fixation; +22853 - PLIF or TLIF cage; +61783 - use of neuronavigation, e.g. Brainlab, Stealth; +20936 - morselized autograft through same fascial incision; STARTING IN 2018 CANNOT CODE 63047 AND +63048 FOR DECOMPRESSION; Other possible codes: +69990 - use of microscope; +20937: moreselized autograft through separate fascial incision; +20930 - morselized allograft; Medicare will not pay for 63047 but should bill to keep track of physician productivity | 22633 - 27.75 +22634 - 8.16 63052 - 4.25 63053 - 8.5 +22842 - 12.56 +22853 x 3 - 12.75 +69990 - 3.46 +61783 - 3.75 +20937 - 2.79 +20936 - 0 +20930 - 0 | 22633 - 53.96 +22634 - 14.55 63052 - 3.78 63053 - 7.56 +22842 - 22.35 +22853 x 3 - 22.92 +69990 - 6.43 +61783 - 6.83 +20937 - 4.9 +20936 - 0 +20930 - 0 | |
| Lumbar Corpectomies, Cage and Plate Fusion, 2 Vertebraes | 63090 +63091 22558 +22585 +22845 +22854 +20936 +20930 | 63090 - lumbar corpectomy; +63091 - additional vertebrae corpectomy; 22558 - one level anterolateral fusion; +22585 - additional level of anterolateral fusion; +22845 - three vertebrae plating; +22854 - corpectomy cage placement; +20936 - morselized autograft through same fascial incision; +20930 - morselized allograft | 63090 - 30.93 +63091 - 3.03 22558 - 23.53 +22585 - 5.52 +22845 - 11.94 +22854 - 5.50 +20936 - 0 +20930 - 0 | 63090 - 56.83 +63091 - 5.18 22558 - 44.64 +22585 - 9.61 +22845 - 21.42 +22854 - 9.89 +20936 - 0 +20930 - 0 | |
| Lumbar Corpectomy, Cage and Plate Fusion, 1 Vertebrae | 63090 22558 +22585 +22845 +22854 +20936 +20930 | 63090 - lumbar corpectomy; 22558 - one level anterolateral fusion; +22585 - additional level of anterolateral fusion; +22845 - three vertebrae plating; +22854 - corpectomy cage placement; +20936 - morselized autograft through same fascial incision; +20930 - morselized allograft | 63090 - 30.93 22558 - 23.53 +22585 - 5.52 +22845 - 11.94 +22854 - 5.50 +20936 - 0 +20930 - 0 | 63090 - 56.83 22558 - 44.64 +22585 - 9.61 +22845 - 21.42 +22854 - 9.89 +20936 - 0 +20930 - 0 | |
| Laminectomy or laminotomy, unilateral or bilateral - ONE level | 63047 | 63047 - 15.37 | 63047 - 32.06 | ||
| Lumbar decompression and posterolateral instrumented fusion, 2 levels | 22612 22614 63047 63048 22842 61783 20937 20936 20930 | 22612 is for single level posterolateral lumbar fusion; 22614 - additional level posterior lumbar fusion; 63048 for additional level of decompression; 22842 - 3 to 6 vertebral posterior instrumented fixation; 61783 - use of neuronavigation, e.g. Brainlab, Stealth; 20937 - moreselized autograft through separate fascial incision; 20936 is morselized autograft through same fascial incision; 20930 is morselized allograft | 22612 - 23.53 22614 - 6.43 63047 - 15.37 63048 - 3.47 22842 - 12.56 61783 - 3.75 20937 - 2.79 20936 - 0 20930 - 0 | 22612 - 46.14 22614 - 11.47 63047 - 32.06 63048 - 6.19 22842 - 22.35 61783 - 6.83 20937 - 4.90 20936 - 0 20930 - 0 | |
| ALIF, Anterior Lumbar Interbody Fusion, XLIF, Extreme Lateral Lumbar Interbody Fusion, LLIF, Lateral Lumbar Interbody Fusion, DLIF, Olique lateral lumbar interbody fusion, OLIF - ONE LEVEL | L3-4 ALIF, L4-5 ALIF, L5-S1 ALIF | 22558 +22853 +20937 +20930 | 22558 - one level anterolateral fusion; +22853 - placement of intervertebral device such as PEEK, titanium, use for stand-alone cage with screw or wing fixation, do not use for structural bone allograft, instead use +20931; +20937 - morselized autograft through separate fascial incision, e.g. iliac creast bone graft; +20930 - morselized allograft | 22558 - 23.53 +22853 - 4.25 +20937 - 2.79 +20930 - 0 | 22558 - 44.64 +22853 - 7.64 +20937 - 4.90 +20930 - 0 |
| ALIF, Anterior Lumbar Interbody Fusion, XLIF, Extreme Lateral Lumbar Interbody Fusion, LLIF, Lateral Lumbar Interbody Fusion, DLIF - TWO LEVELS | L2-3 and L3-4 OLIF | 22558 +22585 +22853 x 2 +20930 | 22558 - one level anterolateral fusion; +22585 - additional level of anterolateral fusion; +22853 x 2 - placement of intervertebral device such as PEEK, titanium, use for stand-alone cage with screw or wing fixation, do not use for structural bone allograft, instead use +20931; +20930 - morselized allograft | 22558 - 23.53 +22585 - 5.52 +22853 x 2 - 8.50 +20930 - 0 | 22558 - 44.64 +22585 - 9.61 +22853 x 2 - 15.28 +20930 - 0 |
| Coflex placement with laminotomy and without fusion, 1 level | 22867 | 22867 - 13.50 | 22867 - 28.55 | ||
| Vertiflex placement with laminotomies and without fusion, 2 levels | 22869 | 22869 - 7.03 | 22869 - 15.70 | ||
| Coflex placement with laminotomies and without fusion, 2 levels | 22867 +22868 | 22867 -13.50 +22868 - 4.00 | 22867 - 28.55 +22868 - 7.14 | ||
| Vertiflex placement withOUT laminotomies and without fusion, 2 levels | 22869 +22870 | 22869 - 7.03 +22870 - 2.34 | 22869 - 15.70 +22870 - 4.16 | ||
| ONE LEVEL anterior lumbar interbody fusion | 22558 22853 +20930 | 22558 - anterior lumbar interbody fusion; 22853 - placement of intervertebral device such as PEEK, titanium, use for stand-alone cage with screw or wing fixation, do not use for structural bone allograft, instead use +20931; +20930 - morselized allograft | 22558 - 23.53 22853 - 4.25 +20930 - 0 | 22558 - 44.64 22853 - 7.64 +20930 - 0 | |
| Lumbar microdiscectomy | 63030 +69990 | +69990 Use of microscope | 63030 - 13.18 +69990 - 3.46 | 63030 - 28.20 +69990 - 6.43 | |
| Redo-lumbar microdiscectomy | 63042 +69990 | 63042 - 18.76 +69990 - 3.46 | 63042 - 37.67 +69990 - 6.43 | ||
| Repair of CSF leak without laminectomy | 63707 +69990 | Use this code if fixation/instrumentation involves only 2 vertebras (not levels) irrespective of how many vertebras are spanned. You cannot report this code if exploration of fusion or reinstrumentation was done. | 63707 - 12.65 +69990 - 3.46 | 63707 - 26.77 +69990 - 6.43 | |
| Repair of CSF leak with laminectomy | 63709 +69990 | 63709 - 15.65 +69990 - 3.46 | 63709 - 32.02 +69990 - 6.43 | ||
| Exploration of gunshot wound to back and removal of bullet | 20102 | 20102 - 3.98 | 20102 - 7.34 | ||
| Laminectomies or laminotomies, unilateral or bilateral - TWO levels | L3-4 and L4-5 decompression | 63047 +63048 | 63047 - 15.37 +63048 - 3.47 | 63047 - 32.06 +63048 - 6.19 | |
| ALIF, 2 levels + posterior instrumented fusion, 2 levels | L3-4 and L4-5 anterior lumbar interbody fusion and posterior instrumented fusion | 22558-62 +22585-62 22612 +22614 +22842 +22853 x 2 +61783 +20930 | 22558-62 - anterior lumbar interbody fusion; +22585-62 - anterior plating if used, do not use for standalone; 22612 - single level posterior lumbar fusion, e.g. L1/2; +22614 - additional level posterior lumbar fusion; +22842 - 3 to 6 vertebral posterior instrumented fixation; +22853 - placement of intervertebral device such as PEEK, titanium, use for stand-alone cage with screw or wing fixation, do not use for structural bone allograft, instead use +20931; +61783 - use of neuronavigation, e.g. Brainlab, Stealth; +20930 - morselized allograft | 22558-62 - 23.53 +22585-62 - 5.52 22612 - 23.53 +22614 - 6.43 +22842 - 12.56 +22853 x 2 - 8.50 +61783 - 3.75 +20930 - 0 | 22558-62 - 44.64 +22585-62 - 9.61 22612 - 46.14 +22614 - 11.47 +22842 - 22.35 +22853 x 2 - 15.28 +61783 - 6.83 +20930 - 0 |
| Lumbar decompression and posterolateral instrumented fusion, ONE LEVEL | 22612 63047-51 +22840 | 22612 is for single level posterolateral lumbar fusion; 63047 -51 for single level decompression; +22840 - 2 vertebral posterior instrumentation | 22612 - 23.53 63047-51 - no RVU +22840 - 12.52 | 22612 - 46.14 63047-51 - no RVU +22840 - 22.26 | |
| Lumbar decompression and posterolateral instrumented fusion with pelvic fixation, 3 LEVELS | L3-4, L4-5, and L5-S1 posterior decompression and instrumented fusion with sacral-alar-iliac (SAI) screws | 22612 22614 x 2 63047 63048 +22842 +22848 61783 20937 20936 20930 | 22612 is for single level posterolateral lumbar fusion; 20936 is morselized autograft through same fascial incision; 20930 is morselized allograft; +22842 - 3 to 6 vertebral posterior instrumented fixation | 22612 - 23.53 22614 x 2 - 12.86 63047 - 15.37 63048 - 3.47 +22842 - 12.56 +22848 - 5.99 61783 - 3.75 20937 - 2.79 20936 - 0 20930 - 0 | 22612 - 46.14 22614 x 2 - 22.94 63047 - 32.06 63048 - 6.19 +22842 - 22.35 +22848 - 11.98 61783 - 6.83 20937 - 4.90 20936 - 0 20930 - 0 |
| Lumbar decompression, posterior interbody and posterior/posterolateral instrumented fusion, 1 LEVEL | 22633 +22840 61783 20937 20936 20930 | +22840 - 2 vertebral posterior instrumentation; 20936 is morselized autograft through same fascial incision; 20930 is morselized allograft | 22633 - 27.75 +22840 - 12.52 61783 - 3.75 20937 - 2.79 20936 - 0 20930 - 0 | 22633 - 53.96 +22840 - 22.26 61783 - 6.83 20937 - 4.9 20936 - 0 20930 - 0 | |
| Lumbar decompression, posterior interbody and posterior/posterolateral instrumented fusion, 2 LEVELS | 22612 22614 22630 22632 63047 63048 +22842 61783 20937 20936 20930 | 22612 is for single level posterolateral lumbar fusion; 20936 is morselized autograft through same fascial incision; 20930 is morselized allograft; +22842 - 3 to 6 vertebral posterior instrumented fixation | 22612 - 23.53 22614 - 6.43 22630 - 22.09 22632 - 5.22 63047 - 15.37 63048 - 3.47 +22842 - 12.56 61783 - 3.75 20937 - 2.79 20936 - 0 20930 - 0 | 22612 - 46.14 22614 - 11.47 22630 - 45.76 22632 - 9.43 63047 - 32.06 63048 - 6.19 +22842 - 22.35 61783 - 6.83 20937 - 4.9 20936 - 0 20930 - 0 | |
| ONE LEVEL Lumbar artificial disc placement or athroplasty (ADR) | 22857 | 22857 - 27.13 | 22857 - 54.26 | ||
| Lumbar kyphoplasty 1 level | 22514 | 10 day global period | 22514 - 7.99 | 22514 - 15.98 | |
| Lumbar kyphoplasties 2 levels | 22514 +22515 | 10 day global period | 22514 - 7.99 +22515 - 4.00 | 22514 - 15.98 +22515 - 8.00 | |
| ALIF - Anterior Lumbar Interbody Fusion, XLIF - Extreme Lateral Lumbar Interbody Fusion, LLIF - Lateral Lumbar Interbody Fusion, DLIF - Direct Lateral Lumbar Interbody Fusion, OLIF- Olique Lateral Lumbar Interbody Fusion - THREE LEVELS | 22558 +22585 x 2 +22853 x 3 +20930 | 22558 - 23.53 +22585 x 2 - 11.04 +22853 x 3 - 12.75 +20930 - 0.00 | 22558 - 44.64 +22585 x 2 - 19.22 +22853 x 3 - 22.92 +20930 - 0.00 | ||
| Lumbar decompression and posterolateral instrumented fusion, 4 LEVELS | 22612 22614 x 3 63047 63048 x 3 +22842 61783 20937 20936 20930 | 22612 is for single level posterolateral lumbar fusion; 20936 is morselized autograft through same fascial incision; 20930 is morselized allograft; +22842 - 3 to 6 vertebral posterior instrumented fixation | 22612 - 23.53 22614 x 3 - 19.29 63047 - 15.37 63048 x 3 - 3.47 +22842 - 12.56 61783 - 3.75 20937 - 2.79 20936 - 0 20930 - 0 | 22612 - 46.14 22614 x 3 - 34.41 63047 - 32.06 63048 x 3 - 18.57 +22842 - 22.35 61783 - 6.83 20937 - 4.90 20936 - 0 20930 - 0 | |
| Lumbar posterior instrumented fusion, 10 levels | T9 to pelvis fusion | 22612 +22614 x 9 +22843 +22848 +61783 +20936 +20930 | 22612 - single level posterior lumbar fusion, e.g. L1/2; +22614 - additional level posterior lumbar fusion; +22843 - 7 to 12 vertebral posterior instrumented fixation; +61783 - use of neuronavigation, e.g. Brainlab, Stealth; +20937 - morselized autograft through separate fascial incision, e.g. iliac crest bone graft; +20936 - morselized autograft through same fascial incision, e.g. spinous process, lamina; +20930 - morselized allograft, e.g. DBM, Infuse, BMP | 22612 - 23.53 +22614 x 9 - 57.87 +22843 - 13.44 +22848 - 5.99 +61783 - 3.75 +20936 - 0.00 +20930 - 0.00 | 22612 - 46.14 +22614 x 9 - 103.23 +22843 - 23.91 +22848 - 11.98 +61783 - 6.83 +20936 - 0.00 +20930 - 0.00 |
| Repair of spinal CSF Leak withOUT laminectomy | 63707 69990 | 69990 - Use of microscope | 63707 - 12.65 69990 - 3.46 | 63707 - 26.77 69990 - 6.43 | |
| Repair of spinal CSF Leak with laminectomy | 63709 69990 | 69990 - Use of microscope | 63709 - 15.65 69990 - 3.46 | 63709 - 31.30 69990 - 6.92 | |
| ALIF or XLIF with laminectomies with posterolateral fusion with pedicle screw fixation, Front and Back, TWO LEVELS | L4-5 and L5-S1 ALIF or XLIF with posterior decompression and instrumented fusion | 22558 +22585 +22845 +22853 x 2 22612 +22614 63047 +63048 +22842 +61783 +20936 +20930 | ‘22558 for each additional level +22845 - anterior plating if used, do not use for standalone; +22853 - placement of intervertebral device such as PEEK, titanium, use for stand-alone cage with screw or wing fixation, do not use for structural bone allograft, instead use +20931; 22612 - is for single level posterolateral lumbar fusion; +22614 - additional level posterior lumbar fusion; +63048 - for additional level of decompression; +22842 - 3 to 6 vertebral posterior instrumented fixation; +61783 - use of neuronavigation, e.g. Brainlab, Stealth; +20936 - morselized autograft through same fascial incision, e.g. spinous process, lamina; +20930 - morselized allograft, e.g. DBM, Infuse, BMP | ‘22558 - 23.53 +22585 - 5.52 +22845 - 11.94 +22853 x 2 - 8.5 22612 - 23.53 +22614 - 6.43 63047 - 15.37 +63048 - 3.47 +22842 - 12.56 +61783 - 3.75 +20936 - 0 +20930 - 0 | 22558 - 44.64 +22585 - 11.04 +22845 - 21.42 +22853 x 2 - 15.28 22612 - 46.14 +22614 - 11.47 63047 - 32.06 +63048 - 6.19 +22842 - 22.35 +61783 - 6.83 +20936 - 0 +20930 - 0 |
| Lumbar Laminotomy with Cofix Placement, one level | 22612 63047 20930 20936 | 22612 - single level posterior lumbar fusion, e.g. L1/2; 20930 is morselized allograft; 20936 is morselized autograft through same fascial incision | 22612 - 23.53 63047 - 15.37 20930 - 0 20936 - 0 | 22612 - 46.14 63047 - 32.06 20930 - 0 20936 - 0 | |
| Lumbar Decompression and Instrumented Fusion, one level | 22612 63047 22840 61783 20930 20936 | 22612 - single level posterior lumbar fusion, e.g. L1/2; 22840 - 2 vertebral posterior instrumentation; 20930 is morselized allograft; 20936 is morselized autograft through same fascial incision | 22612 - 23.53 63047 - 15.37 22840 - 12.52 61783 - 3.75 20930 - 0 20936 - 0 | 22612 - 46.14 63047 - 32.06 22840 - 22.26 61783 - 6.83 20930 - 0 20936 - 0 | |
| Laminectomy, facetectomy or foraminotomy(Unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve roots(s) eg. spinal or lateral recess stenosis, during posterior interbody arthrodesis, lumbar;single vertebral segment | 63052 | 63053 - each additional vertebral segment | 63052 - 4.25 63053 - 3.19 | 63052 - 8.5 63053 - 6.38 | |
| Laminectomies or laminotomies, unilateral or bilateral - THREE levels | L3-4 and L4-5 decompression | 63047 +63048 x 2 | 63047 - 15.37 +63048 x 2 - 6.94 | 63047 - 32.06 +63048 x 2 - 12.38 | |
| Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression), two interspaces, lumbar, TWO LEVELS | 22857 +22860 | Lumbar ADR; 22867 for first level and 22860 for additional level | 22857 - 27.13 22860 - 6.88 | 22857 - 51.43 22860 - 13.76 |
