Quick reference guide for CPT codes for thoracic spine procedures.
| Official Description | Common Description | Procedure Codes | Possible Additional Codes | Explanations | Work RVU | Total RVU |
|---|---|---|---|---|---|---|
| For cervicothoracic or thoracolumbar posterior fusion use 22610 followed by +22614 if majority of the levels are thoracic vertebrae, e.g. T10, T11, T12, L1, L2 or C6, C7, T1, T2, T3. If there are equal number of vertebrae, then simply choose one 22600 (cervical), 22610 (thoracic), or 22612 (lumbar) followed by +22614 for additional levels | 22610 - 17.28; +22614 - 6.43; +22842 - 12.56; 22600 - 17.40; 22612 - 23.53 | 22610 - 36.7; +22614 - 11.47; +22842 - 22.35; 22600 - 37.51; 22612 - 46.14 | ||||
| Repair of dural/cerebrospinal fluid leak or pseudomeningocele, with laminectomy | 63709 | +69990 | Repair of CSF Leak with Laminectomy. Cannot code with laminectomy codes. | 63709 - 15.65; +69990 - 3.46 | 63709 - 32.02; +69990 - 6.43 | |
| Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation) | +22840 | 2 vertebral posterior instrumented fixation; List separately in addition to code for primary procedure; Count vertebrae and not levels. | +22840 - 12.52 | +22840 - 22.26 | ||
| Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments | +22842 | 3 to 6 vertebral posterior instrumented fixation; List separately in addition to code for primary procedure; Count vertebrae and not levels. | +22842 - 12.56 | +22842 - 22.35 | ||
| Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments | +22843 | 7 to 12 vertebral posterior instrumented fixation; List separately in addition to code for primary procedure; Count vertebrae and not levels. | +22843 - 13.44 | +22843 - 23.91 | ||
| Application of intervertebral biomechanical device(s) (eg, synthetic cage(s), methylmethacrylate) to vertebral defect or interspace (list separately in addition to code for primary procedure) | +22851 | This code as of 1/1/17 will no longer be used by Medicare. Some other payers may continue to use this code. Use +22853 (interbody cage), +22854 (corpectomy cage), +22859 (any cage without fusion) instead. | ||||
| Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure) | +22853 | Used for a device, with fusion, with or without integrated anterior fixation | +22853 - 4.25 | +22853 - 7.64 | ||
| Insertion of intervertebral biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to vertebral corpectomy(ies) (vertebral body resection, partial or complete) defect, in conjunction with interbody arthrodesis, each contiguous defect (List separately in addition to code for primary procedure) | +22854 | Used for a device to fill a corpectomy defect, with fusion, with or without integrated anterior fixation | +22854 - 5.50 | +22854 - 9.89 | ||
| Insertion of intervertebral biomechanical device(s) (eg, synthetic cage, mesh, methylmethacrylate) to intervertebral disc space or vertebral body defect without interbody arthrodesis, each contiguous defect (List separately in addition to code for primary procedure) | +22859 | Used for interbody device insertion without fusion | +22859 - 5.50 | +22859 - 9.89 | ||
| I&D of Deep Subfascial Posterior Thoracic Wound | 22010 | 22010 - 12.75 | 22010 - 27.56 | |||
| Posterior Thoracic Spine Osteotomy | 22212; +22216 | 22212 can be used for Smith-Petersen or Ponte osteotomy; it is a primary code and -51 modifier should be used as other higher value codes would typically precede this code; +22216 is for additional levels of osteotomies | 22212 - 20.99; +22216 - 6.03 | 22212 - 43.06; +22216 - 10.62 | ||
| Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; thoracic | 22327 | +22328 | Open reduction of thoracic spine fracture and/or dislocation posterior approach, 1 level; +22328 - each additional level | 22327 - 20.77; +22328 - 4.60 | 22327 - 43.59; +22328 - 8.27 | |
| Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; cervicothoracic | 22510 | +22512 | +22512 - each additional vertebral body | 22510 - 7.90; +22512 - 4.00 | 22510 - 12.63; +22512 - 6.07 | |
| Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; thoracic | 22513 | +22515 | +22515 - each additional vertebral body; Kphoplasty | 22513 - 8.65; +22515 - 4.00 | 22513 - 15.11; +22515 - 6.54 | |
| Thoracic Kyphoplasty 2 Levels | 22523; 22525; 76012 | 22523; 22525; 76012 | 22523 - No RVU; 22525 - No RVU; 76012 - No RVU | 22523 - No RVU; 22525 - No RVU; 76012 - No RVU | ||
| Thoracic Kyphoplasty 1 Level | 22523; 76012 | 22523; 76012 | 22523 - No RVU; 76012 - No RVU | 22523 - No RVU; 76012 - No RVU | ||
| Arthodesis, Lateral Extracavitary; Thoracic | 22532 | 22532 - 25.99 | 22532 - 51.61 | |||
| Arthodesis, Lateral Extracavitary; Thoracic or Lumbar, Each Additional Vertebral Segment | 22534 | 22534 - 5.99 | 22534 - 10.54 | |||
| Arthrodesis, posterior or posterolateral technique, single level; thoracic (with lateral transverse technique, when performed) | 22610 | +22614 | 22610 - 17.28; +22614 - 6.43 | 22610 - 36.70; +22614 - 11.47 | ||
| Thoracic Instrumented Fusion with pedicle screw and rod fixation, 2 levels | 22610; +22614; +22842 | 22610 is the primary fusion code and refers to one level; +22614 is the add on fusion code for each additional level, e.g. T1/T2, T2/T3 = two levels; +22842 - 3 to 6 vertebral posterior instrumented fixation | 22610 - 17.28; +22614 - 6.43; +22842 - 12.56 | 22610 - 36.70; +22614 - 11.47; +22842 - 22.35 | ||
| Thoracic Instrumented Fusion with pedicle screw and rod fixation, 3 levels | 22610; +22614 x 2; +22842 | 22610 is the primary fusion code and refers to one level; +22614 is the add on fusion code for each additional level, e.g. T1/T2, T2/T3, T3/T4 = three levels; +22842 - 3 to 6 vertebral posterior instrumented fixation | 22610 - 17.28; +22614 x 2 - 12.86; +22842 - 12.56 | 22610 - 36.70; +22614 x 2 - 22.94; +22842 - 22.35 | ||
| Thoracic Instrumented Fusion with pedicle screw and rod fixation, 4 levels | 22610; +22614 x 3; +22842 | 22610 is the primary fusion code and refers to one level; +22614 is the add on fusion code for each additional level, e.g. T1/T2, T2/T3, T3/T4, T4/T5 = four levels; +22842 - 3 to 6 vertebral posterior instrumented fixation | 22610 - 17.28; +22614 x 3 - 19.29; +22842 - 12.56 | 22610 - 36.70; +22614 x 3 - 34.41; +22842 - 22.35 | ||
| Thoracic Instrumented Fusion with pedicle screw and rod fixation, 5 levels | 22610; +22614 x 4; +22842 | 22610 is the primary fusion code and refers to one level; +22614 is the add on fusion code for each additional level, e.g. T1/T2, T2/T3, T3/T4, T4/T5, T5/T6 = five levels; +22842 - 3 to 6 vertebral posterior instrumented fixation | 22610 - 17.28; +22614 x 4 - 25.72; +22842 - 12.56 | 22610 - 36.70; +22614 x 4 - 45.88; +22842 - 22.35 | ||
| Thoracic Instrumented Fusion with pedicle screw and rod fixation, 7 levels | 22610; +22614 x 6; +22843 | 22610 is the primary fusion code and refers to one level; +22614 is the add on fusion code for each additional level, e.g. T1/T2, T2/T3, T3/T4, T4/T5, T5/T6, T6/T7, T7/T8 = seven levels; +22843 - 7 to 12 vertebral posterior instrumented fixation | 22610 - 17.28; +22614 x 6 - 38.58; +22842 - 12.56 | 22610 - 36.7; +22614 x 6 - 68.82; +22843 - 23.91 | ||
| Thoracic Instrumented Fusion with pedicle screw and rod fixation, 1 level | 22610; +22840; +22614 | 22610 is the fusion code for one level thoracic posterolateral fusion, e.g. T1/T2 fusion = one level; +22840 - 2 vertebral posterior instrumentation | 22610 - 17.28; +22840 - 12.52 | 22610 - 36.70; +22840 - 22.26 | ||
| Reinsertion of spinal fixation device | 22849 | Only one code no matter how many levels; Removal and reinsertion of instrumentation, e.g. pedicle screws, plates, etc. e.g. pedicle screw revision. | 22849 - 19.17 | 22849 - 37.75 | ||
| Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter) | 62272 | Spinal Tap, Lumbar Drain Placement | 62272 - 1.35 | 62272 - 2.43 | ||
| Thoracic laminectomy(ies), without facetectomies, foraminotomies, or discectomies, 1 or 2 levels | 63003 | 63003 - 17.74 | 63003 - 36.18 | |||
| Thoracic laminectomies without facetectomies, foraminotomies, or discectomies, greater than 2 levels | 63016 | 63016 - 22.03 | 63016 - 44.52 | |||
| Thoracic Decompression and Instrumented Fusion | 63016; 22610; +22614 x ?; +22842 or +22843; +20936; +20930 | 63016 is thoracic laminectomies without facetectomies, foraminotomies, or discectomies, greater than 2 levels; 22610 is the primary fusion code and refers to one level, e.g. T1/T2 = one level; +22614 is the add on fusion code for each additional level, e.g. T1/T2, T2/T3 = two levels; +22842 - 3 to 6 vertebral posterior instrumented fixation; +22843 - 7 to 12 vertebral posterior instrumented fixation; +20936 is morselized autograft through same fascial incision; +20930 is morselized allograft | 63016 - 22.03; 22610 - 17.28; 22614 - 6.43; +22842 - 12.56; +22843 - 13.44; +20936 - 0; +20930 - 0 | 63016 - 44.52; 22610 - 36.70; 22614 - 11.47; +22842 - 22.35; +22843 - 23.91; +20936 - 0; +20930 - 0 | ||
| Thoracic laminectomy with facetectomies, foraminotomies, or discectomies, 1 level | 63045 | Unilateral or bilateral | 63045 - 17.95 | 63045 - 37.58 | ||
| Thoracic laminectomy with facetectomies, foraminotomies, or discectomies, 2 levels | 63045, +63048 | Add +63048 for each additional level | 63045 - 17.95 +63048 - 3.47 | 63045 - 37.58; +63048 - 6.19 | ||
| Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; thoracic | 63055 | Discectomy in the thoracic spine involving partial or total removal of pedicle. No instrumentation involved. | 63055 - 23.55 | 63055 - 47.59 | ||
| Posterior thoracic discectomy and instrumented fusion - COMPLETE TREATMENT PLAN | 63055; 22610; +22840 | 63055 - discectomy in the thoracic spine involving partial or total removal of pedicle; 22610 - fusion code for one level thoracic posterolateral fusion; +22840 - 2 vertebrae posterior instrumentation | 63055 - 23.55; 22610 - 17.28; +22840 - 12.52 | 63055 - 47.59; 22610 - 36.7; +22840 - 22.26 | ||
| Thoracic corpectomies, cage and plate fusion, 2 vertebraes | Thoracic Corpectomies, Cage and Plate Fusion, 2 vertebraes - COMPLETE TREATMENT PLAN | 63087; +63088; 22556-51; +22585; +22846; +22854; +22859 | 63087 for corpectomy for 1 vertebrae; +63088 for additional vertebrae removed; 22556-51 for fusion at one vertebra; +22585 for additional level of fusion at the other vertebra, use it twice; +22846 for plate 4 to 7 verterbrae; +22853 is used for a device, with fusion, with or without integrated anterior fixation; +22854 is used for a device to fill a corpectomy defect, with fusion, with or without integrated anterior fixation; +22859 is used for interbody device insertion without fusion | 63087 - 37.53; +63088 - 4.32; 22556 - 24.70; +22585 - 5.52; +22846 - 12.40; +22854 - 5.50; +22859 - 5.50 | 63087 - 70.26; +63088 - 7.61; 22556 - 48.52; +22585 - 9.61; +22846 - 22.24; +22854 - 9.89; +22859 - 9.89 | |
| Thoracic corpectomy, cage and plate fusion, 1 vertebrae | Thoracic Corpectomy, Cage and Plate Fusion, 1 vertebrae - COMPLETE TREATMENT PLAN | 63087; 22556-51; +22585; +22846; +22854; +22859 | 63087 for corpectomy for 1 vertebrae; 22556-51 for fusion at one vertebra; +22585 for additional level of fusion at the other vertebra; +22845 for plate 2 to 3 verterbrae; +22853 is used for a device, with fusion, with or without integrated anterior fixation; +22854 is used for a device to fill a corpectomy defect, with fusion, with or without integrated anterior fixation; +22859 is used for interbody device insertion without fusion | 63087 - 37.53; 22556 - 24.70; +22585 - 5.52; +22846 - 12.40; +22854 - 5.50; +22859 - 5.50 | 63087 - 70.26; 22556 - 48.52; +22585 - 9.61; +22846 - 22.24; +22854 - 9.89; +22859 - 9.89 | |
| Vertebral corpectomy at least 1/3 of vertebra via trans- or retroperitoneal approach for decompression | 63090 | 63090 - 30.93 | 63090 - 56.83 | |||
| Vertebral Corpectomy, partial or complete, Lateral Extracavitary approach with decompression; thoracic, single segment | 63101 | 63101 - 34.10 | 63101 - 67.55 | |||
| Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; thoracic | Thoracic laminectomies evacuation of epidural abscess, epidural hematoma, calcified ligamentum flavum, etc. | 63266 | 63266 - 24.68 | 63266 - 50.28 | ||
| Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; thoracic | 63271 | +69990 | 63271 - thoracic laminectomy (ies) and evacuation of intradural hematoma; +69990 - use of microscope | 63271 - 29.92; +69990 - 3.46 | 63271 - 60.42; +69990 - 6.43 | |
| Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, thoracic | Thoracic laminectomies and extradural tumor removal | 63276 | +69990 - use of microscope | 63276 - 25.69 | 63276 - 52.31 | |
| Thoracic laminectomies and resection of epidural metastatic tumor and instrumented fixation WITHOUT FUSION, 2 levels - COMPLETE TREATMENT PLAN | 63276 - thoracic laminectomies and extradural tumor removal | +22842 - 3 vertebra fixation; +61783 - use of Brainlab | 63276 - 25.69; +22842 - 12.56; +61783 - 3.75 | 63276 - 52.31; +22842 - 22.35; +61783 - 6.83 | ||
| Thoracic laminectomies and resection of epidural metastatic tumor and instrumented FUSION 5 levels | Thoracic laminectomies and resection of epidural metastatic tumor and instrumented FUSION 5 levels - COMPLETE TREATMENT PLAN | 63276 - thoracic laminectomies and extradural tumor removal | 22610; 22614; 22842; 61783; 20937; 20930 | 22610 is the fusion code for one level thoracic posterolateral fusion; 20930 is morselized allograft; 22842 - 3 to 6 vertebral posterior instrumented fixation | 63276 - 25.69; 22610 - 17.28; 22614 - 6.43; 22842 - 12.56; 61783 - 3.75 20937 - 2.79; 20930 - 0 | 63276 - 52.31; 22610 - 36.7; 22614 - 11.47; 22842 - 22.35; 61783 - 6.83; 20937 - 4.90; 20930 - 0 |
| Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, thoracic | 63281 | +69990 | 63281 - thoracic laminectomy (ies) and removal of intradural extramedullary tumor, e.g. meningioma; +69990 - use of microscope | 63281 - 29.99; +69990 - 3.46 | 63281 - 61.34; +69990 - 6.43 | |
| Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracic | 63286 | +69990 | 63286 - thoracic laminectomy (ies) and removal of intradural intramedullary tumor, e.g. glioma or astrocytoma, ependymoma; +69990 - use of microscope | 63286 - 37.62; +69990 - 3.46 | 63286 - 75.22; +69990 - 6.43 | |
| Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by transthoracic approach | Thoracic corpectomy through TRANSTHORACIC/THORACOTOMY approach for extradural lesion | 63301 | Use this code for any thoracic corpectomy for extradural pathology such as vertebral osteomyelitis, metastatic cancer via thransthoracic/thoracotomy approach. | 63301 - 31.57 | 63301 - 60.67 | |
| Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by transthoracic approach | Thoracic corpectomy through TRANSTHORACIC/THORACOTOMY approach for intratradural lesion | 63305 | Use this code for any thoracic corpectomy for intradural pathology such as spinal cord glioma via thransthoracic/thoracotomy approach. | 63305 - 36.24 | 63305 - 70.45 | |
| Repair of dural/cerebrospinal fluid leak, not requiring laminectomy | 63707 | +69990 | Repair of CSF Leak without Laminectomy | 63707 - 12.65; +69990 - 3.46 | 63707 - 26.77; +69990 - 6.43 | |
| Removal of anterior instrumentation | Removal of anterior spinal instrumentation | 22855 | 22855 - 15.86 | 22855 - 32.19 | ||
| Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by thoracolumbar approach | Thoracic corpectomy through THORACOLUMBAR approach for extradural lesion | 63302 | Use this code for any thoracic corpectomy for extradural pathology such as vertebral osteomyelitis, metastatic cancer via thoracolumbar approach. This is the code for pathology at T12 | 63302 - 31.15 | 63302 - 63.13 | |
| Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by thoracolumbar approach | Thoracic corpectomy through THORACOLUMBAR approach for intradural lesion | 63306 | Use this code for any thoracic corpectomy for intradural pathology such as spinal cord glioma via thoracolumbar approach. This is the code for pathology at T12 | 63306 - 35.55 | 63306 - 60.43 | |
| Removal of posterior segmental instrumentation | Removal of posterior instrumentation | 22852 | Use this code if fixation/instrumentation involves more than 2 vertebras (not levels) irrespective of how many vertebras are spanned. You cannot report this code if exploration of fusion or reimstrumentation was done. | 22852 - 9.37 | 22852 - 20.08 | |
| Removal of posterior nonsegmental instrumentation (eg, Harrington rod) | Removal of posterior instrumentation | 22850 | 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 reimstrumentation was done. | 22850 - 9.82 | 22850 - 20.98 |