CPT code 22865: Disc removal, single lumbar interspace2026 Medicare rate & RVUs in Montana

In Montana, Medicare pays $2,216.61 for 22865 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 22865 nationwide

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

What 22865 covers

This code describes removal of an artificial disc prosthesis from a single lumbar interspace through an anterior approach. It applies when the surgeon explants the lumbar device without performing the revision or replacement service described by a different code. Spine surgeons typically perform the procedure in a hospital operating room; the record should identify the lumbar level, the existing prosthesis, the removal performed, and the clinical reason for explantation.

Medicare lists this service as restricted coverage, so payment is available only in specific circumstances. The major-surgery global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the other procedures are paid at 50%. Modifier 50 is inappropriate for this code. Medicare may pay for an assistant at surgery, and co-surgeons and team surgery are permitted when their use is supported and applicable.

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.

How Montana compares for 22865

Across 109 of 109 payment localities, the facility rate for 22865 runs from $1,883.81 in Wisconsin to $2,916.09 in Miami, FL. Montana pays $2,216.61. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

22865 rates by state

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

See 22865 in every payment locality

How the 22865 rate is calculated

Each of 22865’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.

Payment rules and modifiers for 22865

22865 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

Codes related to 22865

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

How 22865 has changed in Montana

Price 22865 for an earlier date of service

Where the Montana rate applies

Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.

• Absarokee
• Acton
• Alberton
• Alder
• Alzada
• Amsterdam
• Anaconda-Deer Lodge County
• Antelope

Browse all communities in Montana

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

Open CMS sourceHow we calculate rates