© Copyright 2025 American Medical Association. All rights reserved.
The procedure described by CPT® Code 22853 involves the insertion of an interbody biomechanical device, which may include synthetic cages or meshes, into the intervertebral disc space. This procedure is typically performed in conjunction with interbody arthrodesis, which is a surgical technique aimed at fusing adjacent vertebrae to stabilize the spine. The primary goal of this intervention is to decompress the spinal cord and nerves, thereby restoring the intervertebral disc space and achieving proper anatomic alignment of the spine. Conditions such as degenerative disc disease, spinal stenosis, or the presence of bone spurs (osteophytes) may necessitate this procedure. The biomechanical device used in this procedure is often designed in a cylindrical or square shape and can be filled with autogenous bone material to facilitate the fusion process. The surgical approach varies depending on the location of the procedure; for cervical placements, a horizontal incision is made on the side of the neck, while for lumbar placements, an incision is made on the left side of the abdomen. During the procedure, the surgeon may need to remove all or part of the intervertebral disc, which is a separate procedure that can be reported independently. The insertion of the biomechanical device is accompanied by integral anterior instrumentation, such as screws or flanges, to secure the device in place. This code is reported separately in addition to the primary procedure code for interbody arthrodesis, ensuring accurate billing and documentation of the surgical intervention.
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The procedure associated with CPT® Code 22853 is indicated for various spinal conditions that require stabilization and decompression of the spinal cord and nerves. The specific indications include:
The procedure for the insertion of an interbody biomechanical device involves several critical steps, which are detailed as follows:
After the procedure, patients typically require monitoring for any complications related to the surgery. Post-operative care may include pain management, physical therapy, and follow-up appointments to assess the healing process and the effectiveness of the device. Recovery time can vary based on the individual and the extent of the surgery performed. It is essential for patients to adhere to their physician's instructions regarding activity restrictions and rehabilitation to ensure optimal recovery and successful outcomes.
| Short Descr | INSJ BIOMECHANICAL DEVICE | Medium Descr | INSJ BIOMCHN DEV INTERVERTEBRAL DSC SPC W/ARTHRD | Long Descr | 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) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 2 - Co-surgeons permitted and no documentation required if the two- specialty requirement is met. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Items and Services Packaged into APC Rates | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5B - Ambulatory procedures - musculoskeletal | MUE | 4 |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 22100 | MPFS Status: Active Code APC J1 CPT Assistant Article Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; cervical | 22101 | MPFS Status: Active Code APC J1 CPT Assistant Article Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; thoracic | 22102 | MPFS Status: Active Code APC J1 ASC G2 CPT Assistant Article Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; lumbar | 22110 | MPFS Status: Active Code APC C PUB 100 CPT Assistant Article Illustration for Code Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; cervical | 22112 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; thoracic | 22114 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; lumbar | 22206 | MPFS Status: Active Code APC C CPT Assistant Article Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral body subtraction); thoracic | 22207 | MPFS Status: Active Code APC C CPT Assistant Article Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral body subtraction); lumbar | 22210 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; cervical | 22212 | MPFS Status: Active Code APC C CPT Assistant Article Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; thoracic | 22214 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; lumbar | 22220 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; cervical | 22222 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; thoracic | 22224 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; lumbar | 22310 | MPFS Status: Active Code APC T ASC A2 Physician Quality Reporting CPT Assistant Article Illustration for Code Closed treatment of vertebral body fracture(s), without manipulation, requiring and including casting or bracing | 22315 | MPFS Status: Active Code APC J1 ASC A2 Physician Quality Reporting CPT Assistant Article 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 | 22318 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article 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 | 22319 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article 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 | 22325 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; lumbar | 22326 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; cervical | 22327 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; thoracic | 22532 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic | 22533 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar | 22548 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Arthrodesis, anterior transoral or extraoral technique, clivus-C1-C2 (atlas-axis), with or without excision of odontoid process | 22551 | MPFS Status: Active Code APC J1 ASC J8 Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2 | 22552 | Addon Code MPFS Status: Active Code APC N ASC N1 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 primary procedure) | 22554 | MPFS Status: Active Code APC J1 ASC J8 Physician Quality Reporting CPT Assistant Article Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); cervical below C2 | 22556 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic | 22558 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar | 22590 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Arthrodesis, posterior technique, craniocervical (occiput-C2) | 22595 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Arthrodesis, posterior technique, atlas-axis (C1-C2) | 22600 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code Arthrodesis, posterior or posterolateral technique, single interspace; cervical below C2 segment | 22610 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Arthrodesis, posterior or posterolateral technique, single interspace; thoracic (with lateral transverse technique, when performed) | 22612 | MPFS Status: Active Code APC J1 ASC J8 Physician Quality Reporting CPT Assistant Article Illustration for Code Arthrodesis, posterior or posterolateral technique, single interspace; lumbar (with lateral transverse technique, when performed) | 22630 | MPFS Status: Active Code APC J1 Physician Quality Reporting CPT Assistant Article Illustration for Code Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace, lumbar; | 22633 | MPFS Status: Active Code APC J1 Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace, lumbar; | 22634 | Addon Code MPFS Status: Active Code APC N Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace, lumbar; each additional interspace (List separately in addition to code for primary procedure) | 22800 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Arthrodesis, posterior, for spinal deformity, with or without cast; up to 6 vertebral segments | 22802 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Arthrodesis, posterior, for spinal deformity, with or without cast; 7 to 12 vertebral segments | 22804 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Arthrodesis, posterior, for spinal deformity, with or without cast; 13 or more vertebral segments | 22808 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Arthrodesis, anterior, for spinal deformity, with or without cast; 2 to 3 vertebral segments | 22810 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Arthrodesis, anterior, for spinal deformity, with or without cast; 4 to 7 vertebral segments | 22812 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code Arthrodesis, anterior, for spinal deformity, with or without cast; 8 or more vertebral segments | 63001 | MPFS Status: Active Code APC J1 ASC G2 Physician Quality Reporting CPT Assistant Article Illustration for Code 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 | 63003 | MPFS Status: Active Code APC J1 ASC G2 Physician Quality Reporting Illustration for Code 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; thoracic | 63005 | MPFS Status: Active Code APC J1 ASC G2 Physician Quality Reporting Illustration for Code 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; lumbar, except for spondylolisthesis | 63011 | MPFS Status: Active Code APC J1 Physician Quality Reporting 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; sacral | 63012 | MPFS Status: Active Code APC J1 Physician Quality Reporting Laminectomy with removal of abnormal facets and/or pars inter-articularis with decompression of cauda equina and nerve roots for spondylolisthesis, lumbar (Gill type procedure) | 63015 | MPFS Status: Active Code APC J1 Physician Quality Reporting 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 | 63016 | MPFS Status: Active Code APC J1 Physician Quality Reporting 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; thoracic | 63017 | MPFS Status: Active Code APC J1 Physician Quality Reporting 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; lumbar | 63020 | MPFS Status: Active Code APC J1 ASC G2 Physician Quality Reporting CPT Assistant Article Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, cervical | 63030 | MPFS Status: Active Code APC J1 ASC G2 Physician Quality Reporting CPT Assistant Article Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar | 63040 | MPFS Status: Active Code APC J1 Physician Quality Reporting CPT Assistant Article Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; cervical | 63042 | MPFS Status: Active Code APC J1 ASC G2 Physician Quality Reporting CPT Assistant Article Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumbar | 63045 | MPFS Status: Active Code APC J1 ASC G2 Physician Quality Reporting CPT Assistant Article 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 | 63046 | MPFS Status: Active Code APC J1 ASC G2 Physician Quality Reporting 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; thoracic | 63047 | MPFS Status: Active Code APC J1 ASC G2 Physician Quality Reporting CPT Assistant Article 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; lumbar | 63050 | MPFS Status: Active Code APC C Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; | 63051 | MPFS Status: Active Code APC C Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments; with reconstruction of the posterior bony elements (including the application of bridging bone graft and non-segmental fixation devices [eg, wire, suture, mini-plates], when performed) | 63052 | Add-on Code Resequenced Code MPFS Status: Active Code APC N Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; single vertebral segment (List separately in addition to code for primary procedure) | 63053 | Add-on Code Resequenced Code MPFS Status: Active Code APC N Laminectomy, facetectomy, or foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s] [eg, spinal or lateral recess stenosis]), during posterior interbody arthrodesis, lumbar; each additional vertebral segment (List separately in addition to code for primary procedure) | 63055 | MPFS Status: Active Code APC J1 ASC G2 Physician Quality Reporting CPT Assistant Article Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; thoracic | 63056 | MPFS Status: Active Code APC J1 ASC G2 Physician Quality Reporting CPT Assistant Article Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; lumbar (including transfacet, or lateral extraforaminal approach) (eg, far lateral herniated intervertebral disc) | 63064 | MPFS Status: Active Code APC J1 Physician Quality Reporting CPT Assistant Article Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, herniated intervertebral disc), thoracic; single segment | 63075 | MPFS Status: Active Code APC J1 Physician Quality Reporting CPT Assistant Article Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; cervical, single interspace | 63077 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, single interspace | 63081 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, single segment | 63085 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, single segment | 63087 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; single segment | 63090 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Vertebral corpectomy (vertebral body resection), partial or complete, transperitoneal or retroperitoneal approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic, lumbar, or sacral; single segment | 63101 | MPFS Status: Active Code APC C Physician Quality Reporting Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments); thoracic, single segment | 63102 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments); lumbar, single segment | 63170 | MPFS Status: Active Code APC C Physician Quality Reporting Laminectomy with myelotomy (eg, Bischof or DREZ type), cervical, thoracic, or thoracolumbar | 63172 | MPFS Status: Active Code APC C Physician Quality Reporting Laminectomy with drainage of intramedullary cyst/syrinx; to subarachnoid space | 63173 | MPFS Status: Active Code APC C Physician Quality Reporting Laminectomy with drainage of intramedullary cyst/syrinx; to peritoneal or pleural space | 63185 | MPFS Status: Active Code APC C Physician Quality Reporting Laminectomy with rhizotomy; 1 or 2 segments | 63190 | MPFS Status: Active Code APC C Physician Quality Reporting Laminectomy with rhizotomy; more than 2 segments | 63191 | MPFS Status: Active Code APC C Physician Quality Reporting Laminectomy with section of spinal accessory nerve | 63197 | MPFS Status: Active Code APC C Physician Quality Reporting Laminectomy with cordotomy, with section of both spinothalamic tracts, 1 stage, thoracic | 63200 | MPFS Status: Active Code APC C Physician Quality Reporting Laminectomy, with release of tethered spinal cord, lumbar | 63250 | MPFS Status: Active Code APC C Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; cervical | 63251 | MPFS Status: Active Code APC C Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracic | 63252 | MPFS Status: Active Code APC C Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracolumbar | 63265 | MPFS Status: Active Code APC J1 Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; cervical | 63266 | MPFS Status: Active Code APC J1 Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; thoracic | 63267 | MPFS Status: Active Code APC J1 Physician Quality Reporting Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; lumbar | 63268 | MPFS Status: Active Code APC J1 Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; sacral | 63270 | MPFS Status: Active Code APC C Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; cervical | 63271 | MPFS Status: Active Code APC C Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; thoracic | 63272 | MPFS Status: Active Code APC C Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; lumbar | 63273 | MPFS Status: Active Code APC C Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; sacral | 63275 | MPFS Status: Active Code APC C Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, cervical | 63276 | MPFS Status: Active Code APC C Physician Quality Reporting Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, thoracic | 63277 | MPFS Status: Active Code APC C Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, lumbar | 63278 | MPFS Status: Active Code APC C Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, sacral | 63280 | MPFS Status: Active Code APC C Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, cervical | 63281 | MPFS Status: Active Code APC C Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, thoracic | 63282 | MPFS Status: Active Code APC C Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, lumbar | 63283 | MPFS Status: Active Code APC C Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, sacral | 63285 | MPFS Status: Active Code APC C Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, cervical | 63286 | MPFS Status: Active Code APC C Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracic | 63287 | MPFS Status: Active Code APC C Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracolumbar | 63290 | MPFS Status: Active Code APC C Laminectomy for biopsy/excision of intraspinal neoplasm; combined extradural-intradural lesion, any level | 63300 | MPFS Status: Active Code APC C CPT Assistant Article Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, cervical | 63301 | MPFS Status: Active Code APC C Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by transthoracic approach | 63302 | MPFS Status: Active Code APC C Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by thoracolumbar approach | 63303 | MPFS Status: Active Code APC C Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, lumbar or sacral by transperitoneal or retroperitoneal approach | 63304 | MPFS Status: Active Code APC C Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, cervical | 63305 | MPFS Status: Active Code APC C Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by transthoracic approach | 63306 | MPFS Status: Active Code APC C Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by thoracolumbar approach | 63307 | MPFS Status: Active Code APC C Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, lumbar or sacral by transperitoneal or retroperitoneal approach | 20705 | Add-on Code MPFS Status: Active Code APC N Removal of drug-delivery device(s), intra-articular (List separately in addition to code for primary procedure) |
| AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | GC | This service has been performed in part by a resident under the direction of a teaching physician | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | CR | Catastrophe/disaster related | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | SG | Ambulatory surgical center (asc) facility service | 81 | Minimum assistant surgeon: minimum surgical assistant services are identified by adding modifier 81 to the usual procedure number. | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 93 | Synchronous telemedicine service rendered via telephone or other real-time interactive audio-only telecommunications system : synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located away at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that is sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. | 95 | Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system. | AG | Primary physician | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | ET | Emergency services | GJ | "opt out" physician or practitioner emergency or urgent service | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | GZ | Item or service expected to be denied as not reasonable and necessary | KX | Requirements specified in the medical policy have been met | LT | Left side (used to identify procedures performed on the left side of the body) | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | QJ | Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b) | RT | Right side (used to identify procedures performed on the right side of the body) | SA | Nurse practitioner rendering service in collaboration with a physician | TV | Special payment rates, holidays/weekends | U7 | Medicaid level of care 7, as defined by each state | X3 | Episodic/broad services: for reporting services by clinicians who have broad responsibility for the comprehensive needs of the patient that is limited to a defined period and circumstance such as a hospitalization; reporting clinician service examples include but are not limited to the hospitalist's services rendered providing comprehensive and general care to a patient while admitted to the hospital | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner |
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| 2017-01-01 | Added | Added |
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