| Official Description | Common Description | Codes | Possible Additional Codes | Explanations | Work RVU | Total RVU | Examples |
|---|---|---|---|---|---|---|---|
| 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. | +22851 - No RVU | +22851 - No RVU | |||
| Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2 | Anterior Cervical Discectomy and Fusion (ACDF) | 22551 | +22552 Cervical below C2, each additional interspace (list separately in addition to code for separate procedure) | Coding Tips (22551, 22552) Codes 22551 and +22552 include +69990 (do not separately report 69990). This is combined decompression and arthrodesis code. Decompression (e.g. anterior foraminotomy osteophyte removal for spinal cord or spinal nerve decompression). May separately report codes(s) for instrumentation (+22845, +22845, +22853) and bone graft (+20930 to +20939) as appropriate. Append modifier 62 if another surgeon (ENT) does the approach. Use of intraoperative fluoroscopy is not separately billable. SSEP's EMG monitoring is included. Clinical documentation improvement tips: "Anterior cervical discectomy, decompression and arthrodesis at C3-4 with PEEK device filled with DBM and a separate place", "C6-C7 anterior cervical discectomy, osteophytectomy, and decompression", "C6-C7 anterior cervical arthrodesis with a low-profile, integrated PEEK device". | 22551 - 25.00 +22552 - 6.50 | 22551 - 49.87 +22552 - 11.68 | One level : 22551 (ACDF), +22845 (Plate) , +20931 (allograft) One level with PEEK: 22551 (ACDF), +22845-59, +22853(PEEK), +20930 (Allograft) One level with combined PEEK: 22551 (ACDF), +22853, +20930 Two level: 22551 +22552, +22845, +20931 Two Level with PEEK: 22551, +22552, +22845-59, +22853x2, +20930 Two level with combined PEEK: 22551, +22552, +22853x2, +20930 Three level: 22551, +22552x2, +22846, +20931 Three level with PEEK: 22551, +22552x2, +22846-59, +22853x3, +20930 Three level with combined PEEK: 22551, +22552x2, 22853x3, +20930 |
| Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2, each additional interspace (list separately in addition to code for separate procedure) | +22552 | +22552 - 6.50 | +22552 - 11.68 | ||||
| Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); cervical below C2 | 22554 | Use 22554 instead of +22551 if no decompression was done such as in trauma Coding Tips (22554, +22585): Codes do not include decompression (e.g. Anterior foraminotomies, osteophyte removal for spinal cord or spinal nerve decompression). Use only if discectomy is performed without documentation of decompression. These arthrodesis codes will also be used for arthrodesis with a cervical corpectomy. A Single level cervical corpectomy will assume a two level interbody arthrodesis, 22554 and 22585. Very important that the surgeon specifically document decompression to support using 22551, rather than 22554 for an ACDF. | 22554 - 17.69 | 22554 - 36.48 | |||
| Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); each additional interspace (List separately in addition to code for primary procedure) | +22585 | +22585 - 5.52 | +22585 - 9.61 | ||||
| Arthrodesis, posterior or posterolateral technique, single interspace; cervical below C2 segment | Posterior Fusion | 22600 | +22614 | 22600 - posterior cervical fusion code; +22614 - additional level (Do not use +22614 with 22590, 22595) | 22600 - 17.40 +22614 - 6.43 | 22600 - 37.51 +22614 - 11.47 | |
| Arthrodesis, posterior technique, atlas-axis (C1-C2) | C1-C2 fusion | 22595 | There is no add-on code for 22595. | 22595 - 20.64 | 22595 - 43.91 | ||
| Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); single interspace, cervical | C5-6 ADR | 22856 | #+22858(#=code out of sequential order per CPT) | +22858 - additional level (Use 22858 in conjunction with 22856) | 22856 - 24.05 +22858 - 8.40 | 22856 - 47.57 +22858 - 14.63 | Example1. C5-C6 and C6-C7 total disk arthroplasties including anterior cervical discectomies, decompression with foraminotomies and placement of devices 22856, 22858 Example 2. Single level total disk arthroplasty with adjacent level ACDF 22551 22856-59 with ACDF instrumentation and grafts codes |
| Biopsy, vertebral body, open; lumbar or cervical | 20251 | 20251 - 5.72 | 20251 - 12.26 | ||||
| Closed treatment of vertebral body fracture(s), without manipulation, requiring and including casting or bracing | Includes 22660 | 22310 | Global period = 90 days Do not use 22310 for spinous process or transverse process fracture management | ||||
| Closed treatment of vertebral fracture(s) and/or dislocation(s) requiring casting or bracing, with and including casting and/or bracing, by manipulation or traction | Includes 20660 and 20661 | 22315 | Global Period = 90 days This code includes intraoperative fluoroscopic guidance and intraoperative traction or manipulation to reduce facture/dislocation and intraoperative traction or manipulation to reduce fracture/dislocation as well as application of external orthosis. There is no code for a closed treatment of a vertebral process fracture (e.g., placing a collar) because 22305 was deleted in 2017. Use E/M codes to report services provided for closed treatment of a vertebral process fracture(s). | 22315 - 10.11 | 22315 - 22.25 | ||
| Incision and drainage, open, of deep abscess (subfascial), posterior spine; cervical, thoracic, or cervicothoracic | I&D of deep below fascia infection or abscess, cervical | 22010 | modifier 78 | I&D of Deep Infection Posterior Spine, Cervical Lumbar Use for incision and drainage of posterior deep spinal abscess. This code includes necessary debridement, irrigation, and packing. Global period = 90 days, in the OR | 22010 - 12.75 | 22010 - 27.56 | |
| 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) | Intervertebral Device (Anterior or Posterior) with Arthrodesis, No corpectomy | 22853 | 22853 is used for a device, with fusion, with or without integrated anterior fixation. Examples: Polyether ether ketone (PEEK), titanium, expandable cage, carbon fiber. If the anterior instrumentation is indeed separate, then Medicare allows appending modifier 59 to the anterior instrumentation code (=22845, +22846) to show that it was truly a separate device and not integrated with the intervertebral device. (+22853, +22854). 22853 is used for a standalone device as well as one with an integrated plate. CPT does not allow modifier 62 on spinal instrumentation code. | 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) | Corpectomy Device with Arthrodesis | 22854 | Used for a device to fill a corpectomy defect, with fusion, with or without integrated anterior fixation | 22854 - 5.5 | 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) | Intervertebral or Corpectomy Device without Arthrodesis | 22859 | Used for interbody device insertion without fusion. Use +22859 for an "open Kyphoplasty" or "open Vertebroplasty" where a vertebral body defect is filled with a substance, such as methylmethacrylate, in an open procedure. | 22859 - 5.5 | 22859 - 9.89 | ||
| Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, cervical | Laminectomy for neoplasm, Cervical Epidural | 63275 | 63280 - Intradural, extramedullary 63285 - Intradural, intramedullary | Cervical Laminectomies and resection of epidural tumor. There are no "additional segment or interspace" codes. Choose one code per tumor regardless of tumor size or levels of laminectomy performed. Repair of dura is included in the intradural codes - do not separately report code for spinal dura repair. +69990 may be separately reported if used of microscope for microdissection. | 63275 - 25.86 | 63275 - 52.60 | |
| Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; cervical | Cervical laminectomies and evacuation of epidural hematoma, abscess - Non-Neoplasm | 63265 | There is no additional segment or interspace codes. One code includes any number of levels of contiguous laminectomy(ies) required to remove/evacuate the pathology. +69990 may be separately reported for use of microscope for microdissection. Repair of dura is included in the intradural codes. | 63265 - 23.82 | 63265 - 48.79 | ||
| Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), 1 or 2 vertebral segments; cervical | C2 and C3 laminectomies | 63001 | Cervical laminectomies, 1 or 2 levels or cervical laminotomies. No additional level codes. If laminectomies cross a spinal junction such as cervical to thoracic, then use only one CPT code. Codes are unilateral or bilateral - no modifier 50. | 63001 - 17.61 | 63001 - 36.23 | C6-C7 Laminectomy | |
| Laminectomy with exploration and/or decompression of spinal cord and/or cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis), more than 2 vertebral segments; cervical | Cervical laminectomies without facetectomy, foraminotomy or discectomy, greater than 2 levels | 63015 | More than 2 vertebral segments | 63015 - 20.85 | 63015 - 43.3 | C2-C7 laminectomies: 63015 | |
| Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), single vertebral segment; cervical | Cervical laminectomy or laminotomy with facetectomy, foraminotomy or discectomy | 63045 | +63048 - each additional level | A "single vertebral segment" means per motion segment. No modifier 50. Also use these codes for minimally invasive procedure (e.g., using tubular retractor system) where direction visualization of the operative area is maintained. Report code the same as if performed via longer incision. | 63045 - 17.95 +63048 - 3.47 | 63045 - 37.58 +63048 - 6.19 | |
| Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or lateral recess stenosis]), each additional segment, cervical, thoracic, or lumbar (List separately in addition to code for primary procedure) | Each additional vertebral segment, cervical | '+63048 | +63048 - 3.47 | +63048 - 6.19 | |||
| Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; cervical | Open Reduction (ORLF) | 22326 | +22328 | USE ONLY FOR TRAUMATIC FRACTURES. Do not use this for anterior open reduction. Open treatment code includes a laminectomy/discectomy so laminectomy/decompression code is not separately reported. It does not include repair of traumatic dural laceration. May separately report spinal dura repair code. Be sure to document specifics of what was done such as removal of bone fragments, realignment of the spine, unlocking facet joints. etc. May separately report placement of halo vest (20661) if it stays on after patient leaves the operating room, converting it to a treatment. | 22326 - 20.84 | 22326 - 43.34 | |
| Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; each additional fractured vertebrae or dislocated segment (List separately in addition to code for primary procedure) | +22328 | +22328 - 4.60 | +22328 - 9.20 | ||||
| Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; cervical | 22210 | 22216 | 22210 - osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment, this code is a primary code but -51 modifier should be used as other higher value codes would typically precede this code; 22216 - additional levels of osteotomies | 22210 - 25.38 22216 - 6.03 | 22210 - 51.91 22216 - 10.62 | ||
| 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 | ||
| 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 (e.g., 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 (2025) | +22842 - 25.12 (2025) | |||
| Posterior segmental instrumentation (e.g., 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 | |||
| Posterior segmental instrumentation (e.g., pedicle fixation, dual rods with multiple hooks and sublaminar wires); 13 or more vertebral segments | +22844 | +22844 - 16.42 | +22844 - 32.84 | ||||
| Removal of Anterior Instrumentation | Removal of anterior spinal instrumentation | 22855 | 22855 - 15.86 | 22855 - 32.19 | |||
| Repair of dural/cerebrospinal fluid leak or pseudomeningocele, with laminectomy | Repair of CSF leak with laminectomy | 63709 | +69990 - Use of microscope | Do not code a separate laminectomy code; +69990 - Use of microscope | 63709 - 15.65 +69990 - 3.46 | 63709 - 32.02 +69990 - 6.43 | |
| 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 | ||
| Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, single interspace, cervical | 22861 | 22861 - 33.36 | 22861 - 57.01 | ||||
| Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter) | 62272 | Spinal Tap, Lumbar Drain Placement | 62272 - 1.35 | 62272 - 2.43 | |||
| Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, single segment | Corpectomy for trauma and degenerative conditions | 63081 | +63082 | 63081 - cervical corpectomy one vertebrae; +63082 - additional vertebrae for cervical corpectomy | 63081 - 26.10 +63082 - 4.36 | 63081 - 51.19 +63082 - 7.80 | |
| Second level, cervical (list separately in addition for code for primary procedure) | +22858 | 22858 - 8.4 | 22858 - 14.63 | ||||
| Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, each additional interspace, cervical (List separately in addition to code for primary procedure) | 0098T | 0098T - No RVU | 0098T - No RVU | ||||
| Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace, cervical | 22864 | 22864 - 29.40 | 22864 - 60.37 | ||||
| Removal of total disc arthroplasty (artificial disc), anterior approach, each additional interspace, cervical (List separately in addition to code for primary procedure) | 0095T | 0095T - No RVU | 0095T - No RVU | ||||
| 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 | ||
| 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 | ||
| Arthrodesis, posterior technique, craniocervical (occiput-C2) | Occipital-cervical (OC) fusion | 22590 | 22590 - 21.76 | 22590 - 46.03 | |||
| Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, cervical | Corpectomy for infection, osteomyelitis | 63300 | 63300 - 26.80 | 63300 - 53.35 | |||
| Exploration of spinal fusion mass | Exploration of spinal fusion mass | 22830 | 22830 - 11.22 (2025) | 22830 - 22.44 (2025) | |||
| Biopsy, bone, open; deep (eg, humeral shaft, ischium, femoral shaft) | 20245 | Excisional biopsy of bone, deep | 20245- 6.00 | 20245 - 12.00 | |||
| Anterior instrumentation; 2 to 3 vertebral segments (List separately in addition to code for primary procedure) | Cervical plate | +22845 | Do not code this code for stand-alone cage/graft. The plate must be separate from the cage. Use modifier -59 when coding with +22853. | +22845 - 11.94 | +22845 - 21.42 | ||
| 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) | Placement of cervical graft | +22853 | +22853 - 4.25 | +22853 - 7.64 | |||
| Laminoplasty, cervical, with decompression of the spinal cord, two or more vertebral segments; with reconstruction of the posterior bony elements (including the application of bridging bone graft and non-segmental fixation devices (e.g., wire, suture, mini-plates), when performed) | Cervical laminoplasty WITH plates; Use these codes if bone graft was used | 63051 | 63051 - 25.51 | 63051 - 51.02 | |||
| Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection), cervical, three or more levels | 0375T | 0375T - 0.00 | 0375T - 0.00 | ||||
| Laminotomy (hemilaminectomy), with decompression of nerve root(s). including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, cervical | 63020 | 63020 - 16.20 | 63020 - 33.81 | ||||
| Laminotomy (hemilaminectomy), with decompression of nerve root(s). including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; each additional interspace. cervical or lumbar (List separately in addition to code for primary procedure) | +63035 | 63035 - 3.15 | 63035 - 5.61 | ||||
| Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; cervical | 63040 | 63040 - 11.03 | 63040 - 18.37 | ||||
| Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; each additional cervical interspace (List separately in addition to code for primary procedure) | 63043 | 63043 - 5.34 | 63043 - 8.98 | ||||
| Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; cervical | 63270 | 63270 - 29.80 | 63270 - 59.60 | ||||
| Reinsertion of spinal fixation device | Revision of spinal instrumentation; screw revision | +22849 | +22849 - 19.17 | +22849 - 37.75 | |||
| Application of cranial tongs, caliper, or stereotactic frame, including removal (separate procedure) | 20660 | 20660 - 4.00 | 20660 - 8.00 | ||||
| Application of halo, including removal; cranial | HALO PLACEMENT | 20661 | 20661 - 5.26 | 20661 - 10.52 | |||
| Dural graft, spinal | 63710 | Use this code if graft was used to repair dura | 63710 - 15.40 | 63710 - 30.80 | |||
| Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single | I&D simple | 10060 | 10060 - 1.22 | 10060 - 2.44 | |||
| Incision and drainage of hematoma, seroma or fluid collection | I&D of hematoma, seroma or fluid collection | 10140 | 10140 - 1.58 | 10140 - 3.16 | |||
| Incision and drainage, complex, postoperative wound infection | I&D of superficial wound | 10180 | 10180 - 2.30 | 10180 - 4.60 | |||
| Treatment of superficial wound dehiscence; simple closure | Treatment of superficial would dehiscence simple | 12020 | 12020 - 2.67 | 12020 - 5.34 | |||
| Treatment of superficial wound dehiscence; with packing | 12021 | 12021 - 1.89 | 12021 - 3.78 | ||||
| Anterior plating for 4 - 7 vertebral segments | C4 to C7 plating; C4 TO T1 plating | +22846 | +22846 - 12.40 | +22846 - 22.24 | |||
| Removal of implant; deep (eg, buried wire, pin, screw, metal band, nail, rod or plate) | 20680 | 20680 - 5.96 | 20680 - 11.92 | ||||
| Unlisted code | 28999 | 28999 - 0.00 | 28999 - 0.00 | ||||
| Structural allograft | Structural cadaveric bone graft | 20931 | 20931 - 1.81 | 20931 - 3.62 | |||
| Removal of tongs applied by another physician | 20665 | 20665 - 1.36 | 20665 - 2.72 | ||||
| Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment | Corpectomy for tumor | 63304 | 63304 - 33.85 | 63304 - 67.70 | |||
| Open treatment and/or reduction of odontoid fracture(s) and or dislocation(s) (including os odontoideum), anterior approach, including placement of internal fixation; without grafting | Odontoid screw placement WITHOUT plate | 22318 | 22318 - 22.72 | 22318 - 45.44 | |||
| Open treatment and/or reduction of odontoid fracture(s) and or dislocation(s) (including os odontoideum), anterior approach, including placement of internal fixation; with grafting | Odontoid screw placement WITH plate | 22319 | 22319 - 25.33 | 22319 - 50.66 | |||
| Arthrodesis, anterior transoral or extraoral technique, clivus-C1-C2 (atlas-axis), with or without excision of odontoid process | 22548 | 22548 - 27.06 | 22548 - 54.12 | ||||
| Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment | 22110 | 22110 - 14.00 | 22110 - 28.00 | ||||
| Laminoplasty, cervical, with decompression of the spinal cord, two or more vertebral segments; | Cervical laminoplasty WITHOUT plates | 63050 | 63050 - 22.01 | 63050 - 43.79 | |||
| Incision and drainage, open, of deep abscess (subfascial), posterior spine; cervical | I&D of deep below fascia or subfascial infection or abscess, cervical | 22015 | 22015 - 12.64 | 22015 - 27.14 |