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Billing code 22100: Vertebral lesion excisionMedicare rate & RVUs

Reports partial removal of an intrinsic bony lesion in one cervical vertebral segment when the procedure does not decompress the spinal cord or nerve roots.

CMS RVU26DEffective Oct 1, 2026109 payment localities124 Medicare services in 2024

Medicare pays $994.34 for 22100 nationally in a facility.

Medicare rate · 22100

Vertebral lesion excision

Swap in your local Medicare rate.

Work RVUs
10.73
Total RVUs
29.77
Global days
090

National rate · 2026

$994.34

Facility setting, before claim adjustments.

See every locality for 22100 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 22100 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 22100 covers

This service involves surgically removing part of a cervical vertebral body to treat an intrinsic bony lesion, without decompressing the spinal cord or nerve roots. It is typically performed by an orthopedic spine surgeon or neurosurgeon in an operating room, often in a hospital facility. The code is specific to one cervical vertebral segment; thoracic and lumbar sites use separate codes in the same family.

Select the code when the operative report supports the cervical location, intrinsic bone lesion, partial vertebral-body removal, absence of neural decompression, and one-segment extent. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others are subject to standard multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

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 22100 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

22100 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$868.30
Alaska*Unavailable$1,137.45
ArizonaUnavailable$957.61
ArkansasUnavailable$852.86
AtlantaUnavailable$1,033.46
AustinUnavailable$1,006.04
BakersfieldUnavailable$988.85
Baltimore/Surr. CntysUnavailable$1,071.21
BeaumontUnavailable$939.97
BrazoriaUnavailable$959.70

22100 rates by state

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

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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
22100 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 22100 rate is calculated

Each of 22100’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 · 22100

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 10.73Practice expense 14.53Malpractice 4.51

29.7700 adjusted RVUs×$33.4009 conversion factor=$994.34

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 22100

22100 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 22100

Vertebral lesion excision

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 22100

Vertebral lesion excision

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

22100 without 51 · national facility

$994.34

Vertebral lesion excision

22100-51 · Second procedure: 50%

$497.17

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

22100 compared with similar codes

Compare codes

22100 vs 22101 vs 22103 vs 22110: national Medicare rates

Swap in your local Medicare rate.

  • 22100
    Vertebral lesion excision · 10.73 wRVU
    —
  • 22101
    Vertebral excision · 10.8 wRVU
    —
  • 22103
    Spine lesion excision · 2.28 wRVU
    —
  • 22110
    Vertebral lesion excision · 13.65 wRVU
    —

How to choose

22101Vertebral excision
Use 22101 for the corresponding partial vertebral-body lesion procedure at a thoracic site. This code is for a cervical segment.
22103Spine lesion excision
22103 is the add-on for each additional vertebral segment; this code represents the primary single-segment service.
22110Vertebral lesion excision
22110 describes cervical vertebral-body lesion excision through a transpedicular approach, rather than the partial-excision service reported here.

Codes related to 22100

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

Codes related to 22100
CodeHow it relatesNational office range
Same family
22101Vertebral excisionCorresponding partial vertebral-body lesion procedure for a thoracic segment.No office rate
22102Vertebral excisionCorresponding partial vertebral-body lesion procedure for a lumbar segment.No office rate
22112Vertebral excisionTranspedicular vertebral-body lesion excision for a thoracic segment.No office rate
Add-on codes
22103Spine lesion excisionAdd-on code for each additional vertebral segment in this procedure family.No office rate
Used instead
22110Vertebral lesion excisionCervical vertebral-body lesion excision by a transpedicular approach.No office rate

22100 billing questions

How is this code different from 22110?

This code describes partial removal of an intrinsic cervical bony lesion without neural decompression. Code 22110 describes a different cervical vertebral-body lesion procedure performed through a transpedicular approach.

Can an additional cervical segment be reported?

For additional vertebral segments treated in the same service, consider add-on code 22103 when its requirements are met. Document the number and location of segments treated.

Should modifier 50 be appended for bilateral work?

No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.

What operative details support reporting this code?

Document the cervical vertebral site, intrinsic bony lesion, partial removal of the vertebral body, one-segment extent, and that the service did not decompress the spinal cord or nerve roots.

How does the global period affect postoperative billing?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

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 22100PPRRVU2026_Oct_nonQPP.csv, line 2,043 (RVU26D)

Open CMS sourceHow we calculate rates

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