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Billing code 22110: Vertebral lesion excisionMedicare rate & RVUs

Reports removal of an intrinsic cervical vertebral bone lesion when the operation also decompresses the spinal cord or a nerve root.

CMS RVU26DEffective Oct 1, 2026109 payment localities299 Medicare services in 2024

Medicare pays $1,019.06 for 22110 nationally in a facility.

Medicare rate · 22110

Vertebral lesion excision

Swap in your local Medicare rate.

Work RVUs
13.65
Total RVUs
30.51
Global days
090

National rate · 2026

$1,019.06

Facility setting, before claim adjustments.

See every locality for 22110 → · 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 22110 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 22110 covers

22110 describes excision of an intrinsic bony lesion from a cervical vertebral body together with decompression of the spinal cord or a nerve root. The procedure is typically performed by a spine surgeon or neurosurgeon in an operating room when the lesion and required neural decompression are addressed during the operation. The code distinguishes this service from cervical lesion excision without cord or nerve-root decompression.

Select the code from the operative report: it should identify the cervical vertebral site, the intrinsic bony lesion removed, and the spinal cord or nerve-root decompression performed. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For other procedures performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate. An assistant at surgery may be paid; 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 22110 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

22110 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$903.26
Alaska*Unavailable$1,208.09
ArizonaUnavailable$985.00
ArkansasUnavailable$889.10
AtlantaUnavailable$1,056.63
AustinUnavailable$1,027.36
BakersfieldUnavailable$1,010.21
Baltimore/Surr. CntysUnavailable$1,091.57
BeaumontUnavailable$971.17
BrazoriaUnavailable$986.63

22110 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.

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View every state and territory as a table
22110 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 22110 rate is calculated

Each of 22110’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 · 22110

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 13.65Practice expense 12.46Malpractice 4.40

30.5100 adjusted RVUs×$33.4009 conversion factor=$1,019.06

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

Payment rules and modifiers for 22110

22110 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 22110

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 · 22110

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

22110 without 51 · national facility

$1,019.06

Vertebral lesion excision

22110-51 · Second procedure: 50%

$509.53

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

22110 compared with similar codes

Compare codes

22110 vs 22100 vs 22112 vs 22114 vs 22116: national Medicare rates

Swap in your local Medicare rate.

  • 22110
    Vertebral lesion excision · 13.65 wRVU
    —
  • 22100
    Vertebral lesion excision · 10.73 wRVU
    —
  • 22112
    Vertebral excision · 13.72 wRVU
    —
  • 22114
    Spinal lesion excision · 13.72 wRVU
    —
  • 22116
    Vertebral excision · 2.26 wRVU
    —

How to choose

22100Vertebral lesion excision
Use 22100 for an intrinsic cervical vertebral lesion excised without spinal cord or nerve-root decompression. 22110 applies when the operation includes that decompression.
22112Vertebral excision
22112 is for the thoracic region with decompression; 22110 is for the cervical region.
22114Spinal lesion excision
22114 is for the lumbar region with decompression; 22110 is for the cervical region.
22116Vertebral excision
22116 represents an additional vertebral segment in this decompression family, rather than the primary cervical segment service reported with 22110.

Codes related to 22110

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

Codes related to 22110
CodeHow it relatesNational office range
Used instead
22100Vertebral lesion excisionCervical lesion excision when spinal cord or nerve-root decompression is not performed.No office rate
Same family
22112Vertebral excisionThoracic-site counterpart for lesion excision with neural decompression.No office rate
22114Spinal lesion excisionLumbar-site counterpart for lesion excision with neural decompression.No office rate
Add-on codes
22116Vertebral excisionAdditional-segment code in the vertebral lesion excision family with decompression.No office rate

22110 billing questions

How is 22110 different from 22100?

Both concern an intrinsic bony lesion in the cervical vertebral body. Use 22110 when the operation includes spinal cord or nerve-root decompression; 22100 is for excision without that decompression.

What documentation supports reporting 22110?

The operative report should describe the cervical vertebral lesion and its excision, and identify the spinal cord or nerve-root decompression performed.

Can 22116 be reported with 22110?

22116 is the additional-segment code in the decompression family and may be reported for an additional vertebral segment when its requirements are met. The operative documentation should establish the additional segment treated.

Should modifier 50 be appended for bilateral work?

No. CMS identifies bilateral adjustment as inappropriate for this code based on its descriptor or anatomy.

How are assistants and co-surgeons handled?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, while team surgery is not permitted.

Which postoperative care is included in the global period?

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 22110PPRRVU2026_Oct_nonQPP.csv, line 2,047 (RVU26D)

Open CMS sourceHow we calculate rates

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