Arthrd pst tq atlas-axis
CPT 22595 covers a surgical procedure to fuse the first two bones in the neck (atlas and axis vertebrae) using a posterior approach. This complex spinal fusion stabilizes the upper cervical spine to treat instability, fractures, or degenerative conditions.
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
Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High
NCCI bundling edits
Loading bundling edits…
Billing tips
Document distinct approach and technique differences when billing 22595 with additional spinal instrumentation codes (22840-22848 series)
Impact: Proper documentation of instrumentation can add $1,000-$4,000 in reimbursement for screws, rods, and hooks when medically necessary and separately reportable
Always verify that bone graft harvesting (20936, 20937, 20938) is documented separately with distinct incision site and technique before billing as add-on procedure
Impact: Autograft harvesting codes can add $300-$800 to total reimbursement when properly documented as separate procedure
Code 22595 includes application of posterior C1-C2 fixation; do not separately bill for standard posterior segmental instrumentation at these levels without modifier justification
Impact: Prevents bundling denials that could result in loss of $1,507.35 base payment and potential audit flags
For revision atlantoaxial fusion cases, strongly consider modifier 22 with detailed operative report documenting increased complexity, time, and technical difficulty
Impact: Revision cases with modifier 22 can secure 20-50% additional payment ($301-$754) but require comparison of operative time and specific technical challenges
Verify that pre-operative imaging (MRI, CT, dynamic flexion-extension radiographs) demonstrating instability is documented in medical record before surgery
Impact: Missing pre-operative documentation is leading cause of medical necessity denials, risking entire $1,507.35 payment
When performed with decompression procedures (63001, 63015, 63045), ensure documentation clearly establishes separate and distinct nature of fusion versus decompression
Real billers contribute denial patterns and appeal strategies for this code. Once 5+ reports come in, you’ll see live aggregated data here — the only place this exists, free.
Get the free Revenue Protection Toolkit — the denial triggers, modifier pitfalls, and bundling conflicts that quietly cost you reimbursement. Instant download.
Help build the field knowledge
MedPayIQ gets smarter as billers contribute. If you've had this code denied, share what happened so others learn from it. Anonymous, no patient info.