6 Common Spine Procedures and Their National Average CMS Reimbursement

Here are six common spine procedures by CPT code and their national average Medicare payments.

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1. CPT 22856 (Total disc arthroscopy (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression) cervical, single interspace) — $1,571

2. CPT 22857 (Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression), lumbar, single interspace) — $1,632

3. CPT 22861 (Revision of total disc arthroplasty, anterior approach cervical, single interspace) — $1,770

4. CPT 22862 (Revision including replacement of total disc arthroplasty (artificial disc) anterior approach, lumbar, single interspace) — $1,865

5. CPT 22864 (Removal of total disc arthroplasty, anterior approach cervical, single interspace) — $1,570

6. CPT 22865 (Removal of total disc arthroplasty (artificial disc), anterior approach, lumbar, single interspace) — $1,989

Note: Spinal arthroplasty procedures are currently not covered by Medicare as outpatient procedures.

Source: Federal Register Vol. 74, No. 226 (pdf), adapted from Ethicon-Endo Surgery table (pdf).

At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.

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Presenters: Joe Ganley, athenahealthJeffrey Flynn, CASC, Gramercy Surgery CenterBryan Tsao, Access Center, Loma Linda University HealthJason Zepeda, Northridge Hospital Medical Center, CommonSpirit HealthGreg DeConciliis, PA-C, CASC, Boston Out­Patient Surgical Suites

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