CPT code 22859: Spinal implant, without interbody fusion2026 Medicare rate & RVUs in Missouri
Reports placement of a biomechanical device in a spinal disc space or vertebral body defect when the reconstruction is performed without interbody arthrodesis.
CMS doesn’t publish an office rate for 22859 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 22859 covers
A spine surgeon places a structural device, such as a cage or mesh, in an intervertebral disc space or vertebral body defect to support the anterior column without performing interbody arthrodesis. This may occur during operative reconstruction after a vertebral body resection for a tumor or another condition that leaves a defect. The work is typically performed in an operating room by an orthopedic spine surgeon or neurosurgeon.
Report this as an add-on with an eligible primary procedure, not as a stand-alone service. The device placement must be in a contiguous defect, and the operative report should identify the defect, device placement, and whether interbody arthrodesis was performed. Distinguish it from device placement performed in conjunction with arthrodesis, which is represented by other codes. CMS pays this add-on within the primary procedure’s global period.
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 22859 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $295.19 |
| Metropolitan St. Louis, MO | Unavailable | $297.49 |
| Rest of Missouri | Unavailable | $290.35 |
How the 22859 rate is calculated
Each of 22859’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 · 22859
RVUs × geographic indexes × conversion factor
Work5.36
5.36 RVUs× 1.000 GPCI
Practice expense1.81
1.81 RVUs× 1.000 GPCI
Malpractice1.82
1.82 RVUs× 1.000 GPCI
Adjusted RVUs
8.9900
Conversion factor
$33.4009
Medicare rate
$300.27
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 22859
The CMS indicators that decide how 22859 is paid alongside other services.
CMS payment indicators · 22859
Spinal implant, without interbody fusion
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 2 | Permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 80 · payment effect
With and without the modifier
22859 without 80 · national facility
$300.27
Spinal implant, without interbody fusion
22859-80 · Assistant: 16%
$48.04
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
22859 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 22853Interbody deviceWith interbody arthrodesis
- 22853 applies to device placement in an intervertebral disc space in conjunction with interbody arthrodesis; 22859 is for placement without interbody arthrodesis.
- 22854Spinal cageCorpectomy defect with fusion
- 22854 applies to device placement in a vertebral body defect in conjunction with interbody arthrodesis. Use 22859 when the placement is without interbody arthrodesis.
- 22845Anterior fixationTwo to three vertebral segments
- 22845 reports anterior spinal instrumentation across specified vertebral segments, rather than placement of a biomechanical device into a disc space or vertebral body defect.
22859 billing questions
How does this differ from 22853 or 22854?
Use 22859 when the device is placed without interbody arthrodesis. Codes 22853 and 22854 describe device placement in conjunction with interbody arthrodesis, with the code choice depending on the defect addressed.
Can 22859 be billed by itself?
No. It is an add-on code and must be reported with an eligible primary procedure.
How many units are reported?
The code is reported for each contiguous defect. The operative documentation should support the number and location of the defects treated.
What documentation supports reporting 22859?
Document the spinal disc-space or vertebral-body defect, the biomechanical device placed, and that interbody arthrodesis was not performed. The record should also identify the primary procedure reported with this add-on.
How does Medicare handle the global period?
CMS pays this add-on within the global period of the primary procedure. It does not establish a separate global period.
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
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