No office rate
22857 reports the primary lumbar interspace replacement. Add 22860 only when a second lumbar interspace is replaced during the same operation.
On this page
CMS RVU26D · Effective 2026-10-01
22860 Lumbar disc replacement Medicare reimbursement rates
Reports total disc replacement at an additional lumbar interspace during the same operation as the primary lumbar disc arthroplasty. Compare 22860 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 22860?
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 22860 pays more and less
Spine surgery
About 22860: Second-level lumbar disc replacement
Reports total disc replacement at an additional lumbar interspace during the same operation as the primary lumbar disc arthroplasty.
Code 22860 represents artificial disc replacement at a second lumbar interspace during the same operation. A spine surgeon removes the diseased disc, prepares the vertebral endplates, and places a motion-preserving prosthesis at this additional level. The procedure is generally performed through an anterior approach in a hospital or ambulatory surgical setting for selected patients with lumbar disc disease.
Report 22860 only as an add-on to 22857 when the surgeon replaces a second lumbar interspace in the same operative session. The operative report should identify both treated levels and support disc removal, endplate preparation, and prosthesis placement at the additional level. CMS treats this add-on as paid within the primary procedure’s global period; it is not a standalone service.
CMS billing rules for 22860
- 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 RVU6.71 · 65%
- Practice expense (office) RVU1.92 · 19%
- Malpractice RVU1.68 · 16%
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.
22860 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
22858 is the additional-level arthroplasty code for the cervical spine; 22860 is for an additional lumbar interspace.
No office rate
22853 concerns placement of an interbody device in fusion surgery. Code 22860 represents an additional level of artificial disc replacement.
See how rates vary across the country
22860 · 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 22860 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 $311.99 |
| Alaska* | Office Unavailable | Facility $435.40 |
| Arizona | Office Unavailable | Facility $334.29 |
| Arkansas | Office Unavailable | Facility $308.11 |
| Atlanta | Office Unavailable | Facility $357.34 |
| Austin | Office Unavailable | Facility $342.13 |
| Bakersfield | Office Unavailable | Facility $332.84 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $365.93 |
| Beaumont | Office Unavailable | Facility $334.61 |
| Brazoria | Office Unavailable | Facility $333.23 |
| Chicago | Office Unavailable | Facility $418.92 |
| Chico | Office Unavailable | Facility $328.29 |
| Colorado | Office Unavailable | Facility $338.87 |
| Connecticut | Office Unavailable | Facility $365.57 |
| Dallas | Office Unavailable | Facility $338.16 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $374.22 |
| Delaware | Office Unavailable | Facility $339.05 |
| Detroit | Office Unavailable | Facility $380.61 |
| East St. Louis | Office Unavailable | Facility $396.13 |
| El Centro | Office Unavailable | Facility $328.57 |
| Fort Lauderdale | Office Unavailable | Facility $390.54 |
| Fort Worth | Office Unavailable | Facility $338.24 |
| Fresno | Office Unavailable | Facility $328.29 |
| Galveston | Office Unavailable | Facility $336.06 |
| Hanford-Corcoran | Office Unavailable | Facility $328.29 |
| Hawaii, Guam | Office Unavailable | Facility $329.53 |
| Houston | Office Unavailable | Facility $366.81 |
| Idaho | Office Unavailable | Facility $309.66 |
| Indiana | Office Unavailable | Facility $310.84 |
| Iowa | Office Unavailable | Facility $305.08 |
| Kansas | Office Unavailable | Facility $310.37 |
| Kentucky | Office Unavailable | Facility $332.48 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $346.43 |
| Madera | Office Unavailable | Facility $328.29 |
| Manhattan | Office Unavailable | Facility $401.98 |
| Merced | Office Unavailable | Facility $328.29 |
| Metropolitan Boston | Office Unavailable | Facility $359.82 |
| Metropolitan Kansas City | Office Unavailable | Facility $339.16 |
| Metropolitan Philadelphia | Office Unavailable | Facility $361.86 |
| Metropolitan St. Louis | Office Unavailable | Facility $341.40 |
| Miami | Office Unavailable | Facility $432.79 |
| Minnesota | Office Unavailable | Facility $306.72 |
| Mississippi | Office Unavailable | Facility $320.80 |
| Modesto | Office Unavailable | Facility $328.29 |
| Montana** | Office Unavailable | Facility $344.25 |
| Napa | Office Unavailable | Facility $351.27 |
| Nebraska | Office Unavailable | Facility $304.52 |
| Nevada** | Office Unavailable | Facility $335.06 |
| New Hampshire | Office Unavailable | Facility $339.98 |
| New Mexico | Office Unavailable | Facility $350.32 |
| New Orleans | Office Unavailable | Facility $348.21 |
| North Carolina | Office Unavailable | Facility $319.81 |
| North Dakota** | Office Unavailable | Facility $311.03 |
| Northern Nj | Office Unavailable | Facility $372.56 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $418.92 |
| Ohio | Office Unavailable | Facility $339.23 |
| Oklahoma | Office Unavailable | Facility $324.99 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $341.16 |
| Portland | Office Unavailable | Facility $340.70 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $372.32 |
| Puerto Rico | Office Unavailable | Facility $344.23 |
| Queens | Office Unavailable | Facility $395.18 |
| Redding | Office Unavailable | Facility $328.29 |
| Rest Of California | Office Unavailable | Facility $328.29 |
| Rest Of Florida | Office Unavailable | Facility $369.77 |
| Rest Of Georgia | Office Unavailable | Facility $348.21 |
| Rest Of Illinois | Office Unavailable | Facility $370.38 |
| Rest Of Louisiana | Office Unavailable | Facility $334.63 |
| Rest Of Maine | Office Unavailable | Facility $318.02 |
| Rest Of Maryland | Office Unavailable | Facility $342.77 |
| Rest Of Massachusetts | Office Unavailable | Facility $339.96 |
| Rest Of Michigan | Office Unavailable | Facility $346.02 |
| Rest Of Missouri | Office Unavailable | Facility $334.05 |
| Rest Of New Jersey | Office Unavailable | Facility $364.67 |
| Rest Of New York | Office Unavailable | Facility $324.49 |
| Rest Of Oregon | Office Unavailable | Facility $327.44 |
| Rest Of Pennsylvania | Office Unavailable | Facility $336.02 |
| Rest Of Texas | Office Unavailable | Facility $335.65 |
| Rest Of Washington | Office Unavailable | Facility $337.26 |
| Rhode Island | Office Unavailable | Facility $344.68 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $346.31 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $336.85 |
| Salinas | Office Unavailable | Facility $335.47 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $337.96 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $361.59 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $359.68 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $371.33 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $363.53 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $331.05 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $336.82 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $335.25 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $339.67 |
| Seattle (King Cnty) | Office Unavailable | Facility $359.86 |
| South Carolina | Office Unavailable | Facility $331.07 |
| South Dakota** | Office Unavailable | Facility $307.10 |
| Southern Maine | Office Unavailable | Facility $323.08 |
| Stockton | Office Unavailable | Facility $328.29 |
| Suburban Chicago | Office Unavailable | Facility $390.98 |
| Tennessee | Office Unavailable | Facility $312.55 |
| Utah | Office Unavailable | Facility $334.79 |
| Vallejo | Office Unavailable | Facility $348.52 |
| Vermont | Office Unavailable | Facility $316.00 |
| Virgin Islands | Office Unavailable | Facility $344.23 |
| Virginia | Office Unavailable | Facility $326.78 |
| Visalia | Office Unavailable | Facility $328.29 |
| West Virginia | Office Unavailable | Facility $360.15 |
| Wisconsin | Office Unavailable | Facility $302.84 |
| Wyoming** | Office Unavailable | Facility $329.77 |
| Yuba City | Office Unavailable | Facility $328.29 |
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22860 billing questions
When should 22860 be reported instead of 22857?
Use 22857 for the primary lumbar interspace and 22860 for a second lumbar interspace replaced during the same operation. A single-level replacement is reported with 22857 alone.
Can 22860 be billed without 22857?
No. It is an add-on code and must be reported with the primary lumbar disc replacement code, 22857.
What documentation supports the additional-level code?
The operative report should identify the second lumbar interspace and document disc removal, endplate preparation, and placement of the artificial disc at that level.
Is 22860 for a second cervical level?
No. It applies to an additional lumbar interspace. Code 22858 is the corresponding additional-level code for cervical disc arthroplasty.
How does the CMS global-period rule affect 22860?
CMS pays this add-on within the primary procedure’s global period. It is not reported as a separate standalone procedure.
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.
2,12822857,,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
2,13322862,,Rev rplcm rthrp 1ntrspc lmbr,R,,31.81,22.64,NA,22.64,,13.45,67.90,67.90,0,090,0.10,0.71,0.19,2,0,2,2,2,9,,33.4009,09,0,99,0.00,0.00,0.00
2,13422864,,Rmvl tot arthrp 1ntrspc crv,A,,28.67,19.72,NA,19.72,,12.12,60.51,60.51,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00