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CPT 22854: Spinal cageMedicare rate & RVUs

Reports placement of a biomechanical cage or mesh in a vertebral body defect during interbody fusion, such as reconstruction after corpectomy.

CMS RVU26DEffective Oct 1, 2026109 payment localities6.4K Medicare services in 2024

Medicare pays $300.61 for 22854 nationally in a facility.

Medicare rate · 22854

Spinal cage

Swap in your local Medicare rate.

Work RVUs
5.36
Total RVUs
9.00
Global days
ZZZ

National rate · 2026

$300.61

Facility setting, before claim adjustments.

See every locality for 22854 →

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 22854 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 22854 covers

During spinal reconstruction, the surgeon places a biomechanical device, such as a cage or mesh, into a vertebral body defect created by corpectomy. The device spans the defect as part of an interbody fusion. Spine surgeons typically perform this work in an operating room, often with other procedures to remove diseased or damaged vertebral bone and stabilize the spine. This code is for a vertebral body defect, not a device placed in an ordinary disc space.

Report the code for each contiguous defect reconstructed with a device in conjunction with interbody arthrodesis. The operative report should identify the corpectomy defect, its location and extent, the device placement, and the fusion procedure performed. This is an add-on code: report it only with a primary procedure, and Medicare payment is included within that procedure’s global period. It is not reported as a standalone service.

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 22854 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

22854 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$266.42
Alaska*Unavailable$366.44
ArizonaUnavailable$289.89
ArkansasUnavailable$262.32
AtlantaUnavailable$314.46
AustinUnavailable$297.45
BakersfieldUnavailable$285.75
Baltimore/Surr. CntysUnavailable$322.43
BeaumontUnavailable$290.83
BrazoriaUnavailable$287.98

22854 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
22854 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 22854 rate is calculated

Each of 22854’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 · 22854

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 5.36Practice expense 1.80Malpractice 1.84

9.0000 adjusted RVUs×$33.4009 conversion factor=$300.61

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

Payment rules and modifiers for 22854

The CMS indicators that decide how 22854 is paid alongside other services.

CMS payment indicators · 22854

Spinal cage

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

22854 without 80 · national facility

$300.61

Spinal cage

22854-80 · Assistant: 16%

$48.10

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

When to use modifier 80

22854 compared with similar codes

Compare codes

22854 vs 22853 vs 22859 vs 22845: national Medicare rates

Swap in your local Medicare rate.

  • 22854
    Spinal cage · 5.36 wRVU
    —
  • 22853
    Interbody device · 4.14 wRVU
    —
  • 22859
    Spinal implant · 5.36 wRVU
    —
  • 22845
    Anterior fixation · 11.64 wRVU
    —

How to choose

22853Interbody device
22854 applies to a vertebral body defect or corpectomy defect reconstructed during fusion. 22853 applies when the device is placed in an intervertebral disc space.
22859Spinal implant
22859 covers device placement in a disc space or vertebral body defect without interbody arthrodesis; 22854 requires placement in a vertebral body defect with fusion.
22845Anterior fixation
22845 describes anterior spinal instrumentation, while 22854 reports a biomechanical device placed in a vertebral body defect as part of fusion.

Codes related to 22854

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

Codes related to 22854
CodeHow it relatesNational office range
Add-on codes
22554Cervical fusionAnterior cervical interbody fusion may be the primary procedure for this add-on.No office rate
22556Thoracic fusionAnterior thoracic interbody fusion may be the primary procedure for this add-on.No office rate
22558Anterior fusionAnterior lumbar interbody fusion may be the primary procedure for this add-on.No office rate
Used instead
22853Interbody deviceFor a biomechanical device placed in a disc space during interbody fusion.No office rate
22859Spinal implantFor device placement in a disc space or vertebral body defect without interbody fusion.No office rate

22854 billing questions

When should 22854 be chosen instead of 22853?

Use 22854 for a device placed in a vertebral body defect or corpectomy defect during fusion. Use 22853 when the device is placed in an intervertebral disc space.

Is 22854 reported by device, level, or defect?

The unit is each contiguous vertebral body defect reconstructed. The operative documentation should support the number and location of the contiguous defects.

Can 22854 be billed by itself?

No. It is an add-on code and must be reported with a primary procedure; its Medicare payment falls within that procedure’s global period.

Does 22854 describe fusion or only device placement?

It describes device placement into a vertebral body defect in conjunction with interbody arthrodesis. Report the applicable primary fusion procedure as well.

How does 22854 differ from 22859?

22854 is for device placement in a vertebral body defect with interbody fusion. 22859 is for placement in a disc space or vertebral body defect without interbody arthrodesis.

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 22854PPRRVU2026_Oct_nonQPP.csv, line 2,125 (RVU26D)

Open CMS sourceHow we calculate rates

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