CPT 22614Surgery

Arthrd pst tq 1ntrspc ea add

CPT code 22614 covers each additional interspace fused during posterior spinal arthrodesis (spinal fusion) after the first level. It's an add-on code used when surgeons fuse more than one segment of the spine from the back approach.

Showing rates for

National Average

Base Medicare rate

$380.39

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

6.43

PE RVU (NF)

3.26

MP RVU

2.07

Total RVU

11.76

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

NCCI bundling edits

Loading bundling edits…

Billing tips

Report 22614 only with primary posterior arthrodesis codes (22600, 22610, 22612) - never as a standalone code
Impact: Prevents automatic denials; billing 22614 alone results in 100% claim rejection and payment delay of 30-60 days
Count interspaces carefully, not vertebral levels - L3-L5 fusion involves TWO interspaces (L3-L4 and L4-L5), so report primary code once plus 22614 once
Impact: Undercoding by one interspace results in $380.39 loss per missed level; overcoding triggers audits and recoupment demands
Document each interspace separately in operative note with specific bone graft placement and preparation details for each level
Impact: Reduces denial rate by approximately 40%; MAC audits focus on verification that distinct work was performed at each claimed interspace
Verify payer-specific unit limits - some commercial payers cap 22614 units at 3-4 per encounter regardless of actual levels fused
Impact: Pre-authorization for >4 levels prevents denials; retroactive denials average $1,141-$1,521 in lost revenue for additional levels
Use modifier 22 conservatively and only when operative time exceeds typical by >50% with compelling documentation of unusual complexity
Impact: Successful modifier 22 appeals increase reimbursement by $76-$114 per level, but unsupported claims trigger prepayment review for 6-12 months
Bill instrumentation codes (22840, 22842, 22843, 22844) separately when applicable - these are not bundled with 22614
Impact: Instrumentation codes add $600-$1,800 per case depending on levels and technique; failure to bill separately forfeits significant revenue

Live Field Datano reports yet

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.

Working with CPT 22614?

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.

Related actions

Frequently asked questions

What is CPT code 22614 used for?

CPT 22614 is an add-on code used to report each additional vertebral interspace fused during posterior spinal arthrodesis beyond the first level. It must be billed with a primary posterior fusion code (22600, 22610, or 22612) and represents the additional work of fusing each extra spinal segment.

How much does Medicare pay for CPT 22614 in 2025?

Medicare pays $380.39 for CPT 22614 in 2025 based on the national average rate. This rate applies to both facility and non-facility settings, with a total RVU value of 11.76 using the 2025 conversion factor of 32.3465.

How many times can you bill CPT 22614?

You can bill CPT 22614 multiple times per encounter based on the actual number of additional interspaces fused beyond the first level. For example, a three-level fusion involves one primary code plus two units of 22614. However, verify payer-specific unit limits as some insurers cap reimbursement at 3-4 units without prior authorization.

What is the difference between vertebral levels and interspaces for billing 22614?

Interspaces are the spaces between vertebrae where fusion occurs. A fusion from L3 to L5 involves three vertebral bodies (L3, L4, L5) but only TWO interspaces (L3-L4 and L4-L5). Bill the primary fusion code for the first interspace and 22614 once for the second interspace, not based on the number of vertebrae.

Can CPT 22614 be billed alone?

No, CPT 22614 is an add-on code and cannot be billed alone. It must always be reported with a primary posterior arthrodesis code such as 22600, 22610, or 22612. Billing 22614 without a primary code will result in automatic claim denial.

What documentation is required to bill CPT 22614?

Documentation must include specific identification of each interspace fused, detailed description of bone preparation and graft placement at each level, the posterior surgical approach, and medical necessity for multilevel fusion. The operative report should clearly describe distinct work performed at each additional interspace to support each unit of 22614 billed.

Does CPT 22614 include instrumentation?

No, CPT 22614 covers only the arthrodesis (fusion) portion of the procedure. Instrumentation such as pedicle screws, rods, and hooks must be billed separately using codes 22840, 22842, 22843, and 22844. These instrumentation codes are not bundled with 22614 and represent additional reimbursement when applicable.