No office rate
22856 reports the primary cervical disc replacement at one interspace. 22858 identifies the second cervical interspace and must accompany the primary code.
On this page
CMS RVU26D · Effective 2026-10-01
22858 Cervical disc replacement Medicare reimbursement rates
Reports artificial disc replacement at a second cervical interspace during the same operative service as the primary cervical disc arthroplasty. Compare 22858 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 22858?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 22858 pays more and less
Spine surgery
About 22858: Second-level cervical disc replacement
Reports artificial disc replacement at a second cervical interspace during the same operative service as the primary cervical disc arthroplasty.
A spine surgeon reports this add-on when replacing a damaged cervical disc with an artificial disc at a second interspace during the operative service. The procedure involves an anterior approach, removal of the treated disc, and preparation of the space for the implant. Typical cases involve cervical degenerative disc disease associated with nerve-root or spinal-cord symptoms. The code identifies the second treated interspace, not another service at the first level.
Report 22858 only with the primary cervical disc arthroplasty code, 22856. The operative report should identify both treated cervical interspaces and document the disc replacement performed at each. Routine removal of the disc and preparation of its space are part of the arthroplasty service, not separately counted as another level. Under the CMS rule for this add-on, it is paid within the primary procedure’s global period and cannot be billed by itself.
CMS billing rules for 22858
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU8.19 · 61%
- Practice expense (office) RVU2.72 · 20%
- Malpractice RVU2.54 · 19%
1K
Medicare services in 2024 · #2930 by national volume
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.
22858 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
22860 is the add-on for a second lumbar interspace. Use 22858 for the second cervical interspace.
No office rate
22861 describes revision or replacement of an existing cervical artificial disc at one interspace; 22858 reports a second level during primary cervical arthroplasty.
See how rates vary across the country
22858 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Compare 22858 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office Unavailable | Facility $401.07 |
| Alaska* | Office Unavailable | Facility $553.83 |
| Arizona | Office Unavailable | Facility $434.21 |
| Arkansas | Office Unavailable | Facility $395.29 |
| Atlanta | Office Unavailable | Facility $468.57 |
| Austin | Office Unavailable | Facility $445.39 |
| Bakersfield | Office Unavailable | Facility $429.99 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $480.36 |
| Beaumont | Office Unavailable | Facility $435.04 |
| Brazoria | Office Unavailable | Facility $431.95 |
| Chicago | Office Unavailable | Facility $561.48 |
| Chico | Office Unavailable | Facility $423.25 |
| Colorado | Office Unavailable | Facility $439.76 |
| Connecticut | Office Unavailable | Facility $479.52 |
| Dallas | Office Unavailable | Facility $439.29 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $489.77 |
| Delaware | Office Unavailable | Facility $440.95 |
| Detroit | Office Unavailable | Facility $504.26 |
| East St. Louis | Office Unavailable | Facility $528.00 |
| El Centro | Office Unavailable | Facility $423.67 |
| Fort Lauderdale | Office Unavailable | Facility $518.97 |
| Fort Worth | Office Unavailable | Facility $439.49 |
| Fresno | Office Unavailable | Facility $423.25 |
| Galveston | Office Unavailable | Facility $436.20 |
| Hanford-Corcoran | Office Unavailable | Facility $423.25 |
| Hawaii, Guam | Office Unavailable | Facility $425.97 |
| Houston | Office Unavailable | Facility $482.69 |
| Idaho | Office Unavailable | Facility $397.26 |
| Indiana | Office Unavailable | Facility $399.00 |
| Iowa | Office Unavailable | Facility $390.36 |
| Kansas | Office Unavailable | Facility $398.44 |
| Kentucky | Office Unavailable | Facility $431.95 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $448.58 |
| Madera | Office Unavailable | Facility $423.25 |
| Manhattan | Office Unavailable | Facility $531.18 |
| Merced | Office Unavailable | Facility $423.25 |
| Metropolitan Boston | Office Unavailable | Facility $468.75 |
| Metropolitan Kansas City | Office Unavailable | Facility $441.75 |
| Metropolitan Philadelphia | Office Unavailable | Facility $474.26 |
| Metropolitan St. Louis | Office Unavailable | Facility $445.05 |
| Miami | Office Unavailable | Facility $582.68 |
| Minnesota | Office Unavailable | Facility $392.15 |
| Mississippi | Office Unavailable | Facility $414.47 |
| Modesto | Office Unavailable | Facility $423.25 |
| Montana** | Office Unavailable | Facility $449.07 |
| Napa | Office Unavailable | Facility $453.63 |
| Nebraska | Office Unavailable | Facility $389.48 |
| Nevada** | Office Unavailable | Facility $435.16 |
| New Hampshire | Office Unavailable | Facility $442.36 |
| New Mexico | Office Unavailable | Facility $458.75 |
| New Orleans | Office Unavailable | Facility $455.42 |
| North Carolina | Office Unavailable | Facility $412.53 |
| North Dakota** | Office Unavailable | Facility $398.85 |
| Northern Nj | Office Unavailable | Facility $486.78 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $556.63 |
| Ohio | Office Unavailable | Facility $442.02 |
| Oklahoma | Office Unavailable | Facility $420.60 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $441.45 |
| Portland | Office Unavailable | Facility $441.98 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $488.00 |
| Puerto Rico | Office Unavailable | Facility $448.97 |
| Queens | Office Unavailable | Facility $520.78 |
| Redding | Office Unavailable | Facility $423.25 |
| Rest Of California | Office Unavailable | Facility $423.25 |
| Rest Of Florida | Office Unavailable | Facility $487.92 |
| Rest Of Georgia | Office Unavailable | Facility $455.72 |
| Rest Of Illinois | Office Unavailable | Facility $489.10 |
| Rest Of Louisiana | Office Unavailable | Facility $435.23 |
| Rest Of Maine | Office Unavailable | Facility $409.91 |
| Rest Of Maryland | Office Unavailable | Facility $446.11 |
| Rest Of Massachusetts | Office Unavailable | Facility $441.21 |
| Rest Of Michigan | Office Unavailable | Facility $452.28 |
| Rest Of Missouri | Office Unavailable | Facility $434.50 |
| Rest Of New Jersey | Office Unavailable | Facility $476.77 |
| Rest Of New York | Office Unavailable | Facility $419.50 |
| Rest Of Oregon | Office Unavailable | Facility $423.68 |
| Rest Of Pennsylvania | Office Unavailable | Facility $437.13 |
| Rest Of Texas | Office Unavailable | Facility $436.38 |
| Rest Of Washington | Office Unavailable | Facility $437.34 |
| Rhode Island | Office Unavailable | Facility $448.28 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $450.42 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $434.53 |
| Salinas | Office Unavailable | Facility $432.80 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $436.40 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $466.58 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $463.70 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $480.12 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $468.33 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $427.16 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $435.15 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $432.62 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $438.80 |
| Seattle (King Cnty) | Office Unavailable | Facility $468.02 |
| South Carolina | Office Unavailable | Facility $429.61 |
| South Dakota** | Office Unavailable | Facility $392.91 |
| Southern Maine | Office Unavailable | Facility $417.12 |
| Stockton | Office Unavailable | Facility $423.25 |
| Suburban Chicago | Office Unavailable | Facility $519.11 |
| Tennessee | Office Unavailable | Facility $401.69 |
| Utah | Office Unavailable | Facility $435.14 |
| Vallejo | Office Unavailable | Facility $449.47 |
| Vermont | Office Unavailable | Facility $406.42 |
| Virgin Islands | Office Unavailable | Facility $448.97 |
| Virginia | Office Unavailable | Facility $422.76 |
| Visalia | Office Unavailable | Facility $423.25 |
| West Virginia | Office Unavailable | Facility $473.91 |
| Wisconsin | Office Unavailable | Facility $386.72 |
| Wyoming** | Office Unavailable | Facility $427.18 |
| Yuba City | Office Unavailable | Facility $423.25 |
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
22858 billing questions
Can 22858 be billed by itself?
No. It is an add-on for a second cervical interspace and must be reported with the primary cervical arthroplasty code, 22856.
When should 22856 be reported instead?
Use 22856 for the primary cervical disc arthroplasty at one interspace. Report 22858 when a second cervical interspace is also treated with disc replacement during the operative service.
How many units of 22858 should be reported?
The code identifies the second cervical interspace. The operative report should support the additional treated level; do not use units to represent work at the primary interspace.
Is disc removal separately reported for the additional level?
Disc removal and preparation of the space for the artificial disc are part of the arthroplasty service. 22858 represents the additional replacement level, not a separate discectomy.
What documentation supports 22858?
Document the cervical interspaces treated and the artificial disc replacement at the second interspace. The record should also support the primary arthroplasty reported with 22856.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
2,12622855,,Removal anterior instrmj,A,,15.46,11.10,NA,11.10,,4.90,31.46,31.46,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,12722856,,Tot disc arthrp 1ntrspc crv,A,,23.45,14.72,NA,14.72,,7.40,45.57,45.57,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,12822857,,Tot disc arthrp 1ntrspc lmbr,A,,26.45,14.89,NA,14.89,,5.63,46.97,46.97,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,12922858,,Tot disc arthrp 2nd lvl crv,A,,8.19,2.72,NA,2.72,,2.54,13.45,13.45,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,13022859,,Insj biomechanical device,A,,5.36,1.81,NA,1.81,,1.82,8.99,8.99,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,13122860,,Tot disc arthrp 2ntrspc lmbr,A,,6.71,1.92,NA,1.92,,1.68,10.31,10.31,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,13222861,,Rev rplcm arthrp 1ntrspc crv,A,,32.53,21.07,NA,21.07,,13.73,67.33,67.33,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00