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CPT code 22858: Cervical disc replacement, second interspace2026 Medicare rate & RVUs

Reports artificial disc replacement at a second cervical interspace during the same operative service as the primary cervical disc arthroplasty.

CMS RVU26DEffective Oct 1, 2026109 payment localities1K Medicare services in 2024

Medicare pays $449.24 for 22858 nationally in a facility.

Medicare rate · 22858

Cervical disc replacement, second interspace

Office or facility?

Work RVUs
8.19
Total RVUs
13.45
Global days
ZZZ

National rate · 2026

$449.24

Facility setting, before claim adjustments.

See every locality for 22858 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 22858 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 22858 covers

A spine surgeon reports this add-on when replacing a damaged cervical disc with an artificial disc at a second interspace during the operative service. The procedure involves an anterior approach, removal of the treated disc, and preparation of the space for the implant. Typical cases involve cervical degenerative disc disease associated with nerve-root or spinal-cord symptoms. The code identifies the second treated interspace, not another service at the first level.

Report 22858 only with the primary cervical disc arthroplasty code, 22856. The operative report should identify both treated cervical interspaces and document the disc replacement performed at each. Routine removal of the disc and preparation of its space are part of the arthroplasty service, not separately counted as another level. Under the CMS rule for this add-on, it is paid within the primary procedure’s global period and cannot be billed by itself.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 22858 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

22858 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$401.07
AlaskaUnavailable$553.83
ArizonaUnavailable$434.21
ArkansasUnavailable$395.29
Atlanta, GAUnavailable$468.57
Austin, TXUnavailable$445.39
Bakersfield, CAUnavailable$429.99
Baltimore area, MDUnavailable$480.36
Beaumont, TXUnavailable$435.04
Brazoria, TXUnavailable$431.95

22858 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
22858 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 22858 rate is calculated

Each of 22858’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 22858

RVUs × geographic indexes × conversion factor

Office or facility?

Work8.19

8.19 RVUs× 1.000 GPCI

Practice expense2.72

2.72 RVUs× 1.000 GPCI

Malpractice2.54

2.54 RVUs× 1.000 GPCI

Adjusted RVUs

13.4500

Conversion factor

$33.4009

Medicare rate

$449.24

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 22858

The CMS indicators that decide how 22858 is paid alongside other services.

CMS payment indicators · 22858

Cervical disc replacement, second interspace

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)2Permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 80 · payment effect

With and without the modifier

22858 without 80 · national facility

$449.24

Cervical disc replacement, second interspace

22858-80 · Assistant: 16%

$71.88

A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.

When to use modifier 80

22858 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 22858

    Cervical disc replacement, second interspace8.19 wRVU

    Not priced

  • 22856

    Artificial disc, single cervical interspace23.45 wRVU

    Not priced

  • 22860

    Lumbar disc replacement, additional interspace6.71 wRVU

    Not priced

  • 22861

    Disc revision, single cervical interspace32.53 wRVU

    Not priced

How to choose

22856Artificial discSingle cervical interspace
22856 reports the primary cervical disc replacement at one interspace. 22858 identifies the second cervical interspace and must accompany the primary code.
22860Lumbar disc replacementAdditional interspace
22860 is the add-on for a second lumbar interspace. Use 22858 for the second cervical interspace.
22861Disc revisionSingle cervical interspace
22861 describes revision or replacement of an existing cervical artificial disc at one interspace; 22858 reports a second level during primary cervical arthroplasty.

Codes related to 22858

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 22858
CodeHow it relatesNational office range
Add-on codes
22856Artificial disc, single cervical interspacePrimary cervical disc arthroplasty code required with this add-on.No office rate
Same family
22857Lumbar disc replacement, single interspaceSingle-interspace lumbar disc arthroplasty; differs by spinal region and level count.No office rate
22860Lumbar disc replacement, additional interspaceAdd-on for a second lumbar disc arthroplasty interspace.No office rate

22858 billing questions

Can 22858 be billed by itself?

No. It is an add-on for a second cervical interspace and must be reported with the primary cervical arthroplasty code, 22856.

When should 22856 be reported instead?

Use 22856 for the primary cervical disc arthroplasty at one interspace. Report 22858 when a second cervical interspace is also treated with disc replacement during the operative service.

How many units of 22858 should be reported?

The code identifies the second cervical interspace. The operative report should support the additional treated level; do not use units to represent work at the primary interspace.

Is disc removal separately reported for the additional level?

Disc removal and preparation of the space for the artificial disc are part of the arthroplasty service. 22858 represents the additional replacement level, not a separate discectomy.

What documentation supports 22858?

Document the cervical interspaces treated and the artificial disc replacement at the second interspace. The record should also support the primary arthroplasty reported with 22856.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 22858PPRRVU2026_Oct_nonQPP.csv, line 2,129 (RVU26D)

Open CMS sourceHow we calculate rates

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