ASC leaders ask CMS to pay separately for different levels of spine procedures 

On Sept. 13, the Ambulatory Surgery Center Association submitted comments to CMS on the Medicare 2023 proposed payment rule, including asking that CMS pay separately for different levels of spine procedures. 

The packaging of different levels for spine codes, the letter reads, impedes Medicare beneficiaries' access to ASCs for procedures with significant device costs. 

Anterior cervical discectomy and fusion and lumbar spine fusion procedures, for example, involve multiple levels. However, add-on CPT codes — such as implants, hardware and grafts — for these procedures are packaged with no additional payment. 

Here are the impacted codes:  

  • Allograft CPT codes: 20390, 20931 
  • Autograft CPT codes: 20936-20938 
  • Each additional interspace (cervical fusion): 22552, 22585 
  • Each additional vertebral space (lumbar fusion): 22614 
  • Instrumentation: 22840, 22842, 22845 
  • Application of cage: 22853, 22845, 22859

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