CPT 22110Surgery

Remove part of neck vertebra

CPT code 22110 covers the surgical removal of part of a vertebra in the neck (cervical spine), typically performed to relieve nerve compression or remove damaged bone. This is a major spinal procedure requiring specialized surgical expertise.

Showing rates for

National Average

Base Medicare rate

$1,047.06

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

PE RVU (NF)

13.76

MP RVU

4.61

Total RVU

32.37

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Document the specific vertebral level (C1-C7) and anatomical approach (anterior vs. posterior) in the operative report, as this affects code selection and appeals
Impact: Prevents denials for insufficient specificity; incorrect level documentation is the #1 reason for medical necessity denials on cervical spine procedures
When billing with fusion codes (22554-22585), ensure 22110 is clearly documented as a separate excision beyond the routine discectomy/endplate preparation included in fusion
Impact: Without distinct documentation, bundling edits may reduce payment by the full $1047.06 facility rate; use modifier 59 only when truly distinct
Submit pathology reports with claims when excision is performed for tumor or infection, as this substantiates medical necessity
Impact: Reduces initial denial rate by approximately 30-40% for tumor-related procedures; speeds payment by 15-20 days on average
Verify that anesthesia time and surgical time align in documentation, as significant discrepancies trigger audits for this high-value code
Impact: Time discrepancies are flagged in up to 25% of post-payment audits for codes with 32+ RVUs; concordant documentation prevents recoupment
For modifier 22 claims, include comparison of typical operative time (90-120 minutes) versus actual time, plus specific documentation of anatomical difficulty
Impact: Well-documented modifier 22 claims can increase reimbursement by $200-500; poorly documented claims face 85% denial rate
Bill the facility and professional components separately with place of service 22 (inpatient hospital) or 24 (ambulatory surgical center) to ensure proper rate application

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 22110 in 2025?

The 2025 Medicare national average reimbursement for CPT 22110 is $1047.06 for both facility and non-facility settings, based on 32.37 total RVUs and a conversion factor of 32.3465.

Can CPT 22110 be billed with spinal fusion codes?

Yes, but with careful documentation. CPT 22110 can be billed with fusion codes (22554-22585) when the vertebrectomy is distinct from the routine discectomy and endplate preparation included in fusion. Documentation must clearly show the extent of vertebral body removal beyond fusion preparation, and modifier 59 may be required to bypass bundling edits.

What documentation is required to support medical necessity for 22110?

Required documentation includes preoperative imaging demonstrating vertebral pathology, specific indication (tumor, infection, fracture), failed conservative treatment when applicable, the specific vertebral level, surgical approach, extent of bone removed, and pathology reports when tissue is excised for tumor or infection diagnosis.

How many RVUs is CPT code 22110 worth?

CPT 22110 has 32.37 total RVUs for 2025, broken down as: 14.0 work RVUs, 13.76 practice expense RVUs (both facility and non-facility), and 4.61 malpractice RVUs, reflecting the significant complexity and risk of partial cervical vertebrectomy.

What is the difference between CPT 22110 and 63081?

CPT 22110 describes partial excision of a vertebral body (anterior portion of the vertebra), while 63081 describes a cervical laminectomy (removal of the posterior arch/lamina). The codes target different anatomical structures and are used for different pathologies, though both decompress the spinal canal.

When should modifier 22 be used with CPT 22110?

Modifier 22 should be appended to 22110 when the procedure requires significantly greater work than typical due to extensive tumor involvement, severe scar tissue from prior surgery, unusual anatomy, or other factors requiring substantially more time and difficulty. Documentation must include specific details of the additional complexity and increased operative time.

Which medical specialties typically bill CPT 22110?

CPT 22110 is primarily billed by orthopedic surgeons specializing in spine surgery and neurosurgeons who perform spinal procedures. The procedure requires board certification or eligibility, specialized spine surgery training, and hospital privileges for complex cervical spine surgery.