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 in Merced
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$423.25
Base rate per service
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.
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 rates for Merced, 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.
The same code, a different location
How does Merced compare?
22858 across payment areas
Same release and payment basis · bars start at $0
Merced · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
No comparable rate is available in this setting.
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Madera
California · 22858
Office
Unavailable
Facility
$423.25
No comparable office rate is available.
Modesto
California · 22858
Office
Unavailable
Facility
$423.25
No comparable office rate is available.
Napa
California · 22858
Office
Unavailable
Facility
$453.63
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 22858
Office
Unavailable
Facility
$441.45
No comparable office rate is available.
Redding
California · 22858
Office
Unavailable
Facility
$423.25
No comparable office rate is available.
Rest Of California
California · 22858
Office
Unavailable
Facility
$423.25
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 22858
Office
Unavailable
Facility
$450.42
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 22858
Office
Unavailable
Facility
$434.53
No comparable office rate is available.
Salinas
California · 22858
Office
Unavailable
Facility
$432.80
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 22858
Office
Unavailable
Facility
$436.40
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 22858
Office
Unavailable
Facility
$466.58
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 22858
Office
Unavailable
Facility
$463.70
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 22858
Office
Unavailable
Facility
$480.12
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 22858
Office
Unavailable
Facility
$468.33
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 22858
Office
Unavailable
Facility
$427.16
No comparable office rate is available.
Santa Cruz-Watsonville
California · 22858
Office
Unavailable
Facility
$435.15
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 22858
Office
Unavailable
Facility
$432.62
No comparable office rate is available.
Santa Rosa-Petaluma
California · 22858
Office
Unavailable
Facility
$438.80
No comparable office rate is available.
Stockton
California · 22858
Office
Unavailable
Facility
$423.25
No comparable office rate is available.
Vallejo
California · 22858
Office
Unavailable
Facility
$449.47
No comparable office rate is available.
Visalia
California · 22858
Office
Unavailable
Facility
$423.25
No comparable office rate is available.
Yuba City
California · 22858
Office
Unavailable
Facility
$423.25
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 22858
Office
Unavailable
Facility
$489.77
No comparable office rate is available.
Miami
Florida · 22858
Office
Unavailable
Facility
$582.68
No comparable office rate is available.
Chicago
Illinois · 22858
Office
Unavailable
Facility
$561.48
No comparable office rate is available.
Manhattan
New York · 22858
Office
Unavailable
Facility
$531.18
No comparable office rate is available.
Alaska*
Alaska · 22858
Office
Unavailable
Facility
$553.83
No comparable office rate is available.
Alabama
Alabama · 22858
Office
Unavailable
Facility
$401.07
No comparable office rate is available.
Arkansas
Arkansas · 22858
Office
Unavailable
Facility
$395.29
No comparable office rate is available.
Arizona
Arizona · 22858
Office
Unavailable
Facility
$434.21
No comparable office rate is available.
Colorado
Colorado · 22858
Office
Unavailable
Facility
$439.76
No comparable office rate is available.
Connecticut
Connecticut · 22858
Office
Unavailable
Facility
$479.52
No comparable office rate is available.
Delaware
Delaware · 22858
Office
Unavailable
Facility
$440.95
No comparable office rate is available.
Fort Lauderdale
Florida · 22858
Office
Unavailable
Facility
$518.97
No comparable office rate is available.
Rest Of Florida
Florida · 22858
Office
Unavailable
Facility
$487.92
No comparable office rate is available.
Atlanta
Georgia · 22858
Office
Unavailable
Facility
$468.57
No comparable office rate is available.
Rest Of Georgia
Georgia · 22858
Office
Unavailable
Facility
$455.72
No comparable office rate is available.
Hawaii, Guam
Hawaii · 22858
Office
Unavailable
Facility
$425.97
No comparable office rate is available.
Iowa
Iowa · 22858
Office
Unavailable
Facility
$390.36
No comparable office rate is available.
Idaho
Idaho · 22858
Office
Unavailable
Facility
$397.26
No comparable office rate is available.
East St. Louis
Illinois · 22858
Office
Unavailable
Facility
$528.00
No comparable office rate is available.
Rest Of Illinois
Illinois · 22858
Office
Unavailable
Facility
$489.10
No comparable office rate is available.
Suburban Chicago
Illinois · 22858
Office
Unavailable
Facility
$519.11
No comparable office rate is available.
Indiana
Indiana · 22858
Office
Unavailable
Facility
$399.00
No comparable office rate is available.
Kansas
Kansas · 22858
Office
Unavailable
Facility
$398.44
No comparable office rate is available.
Kentucky
Kentucky · 22858
Office
Unavailable
Facility
$431.95
No comparable office rate is available.
New Orleans
Louisiana · 22858
Office
Unavailable
Facility
$455.42
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 22858
Office
Unavailable
Facility
$435.23
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 22858
Office
Unavailable
Facility
$468.75
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 22858
Office
Unavailable
Facility
$441.21
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 22858
Office
Unavailable
Facility
$480.36
No comparable office rate is available.
Rest Of Maryland
Maryland · 22858
Office
Unavailable
Facility
$446.11
No comparable office rate is available.
Rest Of Maine
Maine · 22858
Office
Unavailable
Facility
$409.91
No comparable office rate is available.
Southern Maine
Maine · 22858
Office
Unavailable
Facility
$417.12
No comparable office rate is available.
Detroit
Michigan · 22858
Office
Unavailable
Facility
$504.26
No comparable office rate is available.
Rest Of Michigan
Michigan · 22858
Office
Unavailable
Facility
$452.28
No comparable office rate is available.
Minnesota
Minnesota · 22858
Office
Unavailable
Facility
$392.15
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 22858
Office
Unavailable
Facility
$441.75
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 22858
Office
Unavailable
Facility
$445.05
No comparable office rate is available.
Rest Of Missouri
Missouri · 22858
Office
Unavailable
Facility
$434.50
No comparable office rate is available.
Mississippi
Mississippi · 22858
Office
Unavailable
Facility
$414.47
No comparable office rate is available.
Montana**
Montana · 22858
Office
Unavailable
Facility
$449.07
No comparable office rate is available.
North Carolina
North Carolina · 22858
Office
Unavailable
Facility
$412.53
No comparable office rate is available.
North Dakota**
North Dakota · 22858
Office
Unavailable
Facility
$398.85
No comparable office rate is available.
Nebraska
Nebraska · 22858
Office
Unavailable
Facility
$389.48
No comparable office rate is available.
New Hampshire
New Hampshire · 22858
Office
Unavailable
Facility
$442.36
No comparable office rate is available.
Northern Nj
New Jersey · 22858
Office
Unavailable
Facility
$486.78
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 22858
Office
Unavailable
Facility
$476.77
No comparable office rate is available.
New Mexico
New Mexico · 22858
Office
Unavailable
Facility
$458.75
No comparable office rate is available.
Nevada**
Nevada · 22858
Office
Unavailable
Facility
$435.16
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 22858
Office
Unavailable
Facility
$556.63
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 22858
Office
Unavailable
Facility
$488.00
No comparable office rate is available.
Queens
New York · 22858
Office
Unavailable
Facility
$520.78
No comparable office rate is available.
Rest Of New York
New York · 22858
Office
Unavailable
Facility
$419.50
No comparable office rate is available.
Ohio
Ohio · 22858
Office
Unavailable
Facility
$442.02
No comparable office rate is available.
Oklahoma
Oklahoma · 22858
Office
Unavailable
Facility
$420.60
No comparable office rate is available.
Portland
Oregon · 22858
Office
Unavailable
Facility
$441.98
No comparable office rate is available.
Rest Of Oregon
Oregon · 22858
Office
Unavailable
Facility
$423.68
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 22858
Office
Unavailable
Facility
$474.26
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 22858
Office
Unavailable
Facility
$437.13
No comparable office rate is available.
Puerto Rico
Puerto Rico · 22858
Office
Unavailable
Facility
$448.97
No comparable office rate is available.
Rhode Island
Rhode Island · 22858
Office
Unavailable
Facility
$448.28
No comparable office rate is available.
South Carolina
South Carolina · 22858
Office
Unavailable
Facility
$429.61
No comparable office rate is available.
South Dakota**
South Dakota · 22858
Office
Unavailable
Facility
$392.91
No comparable office rate is available.
Tennessee
Tennessee · 22858
Office
Unavailable
Facility
$401.69
No comparable office rate is available.
Austin
Texas · 22858
Office
Unavailable
Facility
$445.39
No comparable office rate is available.
Beaumont
Texas · 22858
Office
Unavailable
Facility
$435.04
No comparable office rate is available.
Brazoria
Texas · 22858
Office
Unavailable
Facility
$431.95
No comparable office rate is available.
Dallas
Texas · 22858
Office
Unavailable
Facility
$439.29
No comparable office rate is available.
Fort Worth
Texas · 22858
Office
Unavailable
Facility
$439.49
No comparable office rate is available.
Galveston
Texas · 22858
Office
Unavailable
Facility
$436.20
No comparable office rate is available.
Houston
Texas · 22858
Office
Unavailable
Facility
$482.69
No comparable office rate is available.
Rest Of Texas
Texas · 22858
Office
Unavailable
Facility
$436.38
No comparable office rate is available.
Utah
Utah · 22858
Office
Unavailable
Facility
$435.14
No comparable office rate is available.
Virginia
Virginia · 22858
Office
Unavailable
Facility
$422.76
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 22858
Office
Unavailable
Facility
$448.97
No comparable office rate is available.
Vermont
Vermont · 22858
Office
Unavailable
Facility
$406.42
No comparable office rate is available.
Rest Of Washington
Washington · 22858
Office
Unavailable
Facility
$437.34
No comparable office rate is available.
Seattle (King Cnty)
Washington · 22858
Office
Unavailable
Facility
$468.02
No comparable office rate is available.
Wisconsin
Wisconsin · 22858
Office
Unavailable
Facility
$386.72
No comparable office rate is available.
West Virginia
West Virginia · 22858
Office
Unavailable
Facility
$473.91
No comparable office rate is available.
Wyoming**
Wyoming · 22858
Office
Unavailable
Facility
$427.18
No comparable office rate is available.
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 |
Where does this rate apply?
Merced is a Medicare payment area. Our Census mapping connects it to 24 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 22858 in Merced. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$465.58
$423.25 × 110% = $465.58
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 22858 in Merced.
PPRRVU2026_Oct_nonQPP.csv
2,129
- Code
- 22858
- Physician work
- 8.19
- Practice expense
- 2.72
- Malpractice
- 2.54
GPCI2026.csv
15
- Locality
- Merced
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.19 | × 1.017 | 8.3292 |
| Practice expense | 2.72 | × 1.096 | 2.9811 |
| Malpractice | 2.54 | × 0.536 | 1.3614 |
| Total RVUs | 12.6718 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Merced$423.25
Open 22858 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.19 | 1.017 |
| Practice expense | 2.72 | 1.096 |
| Malpractice | 2.54 | 0.536 |
(8.19 × 1.017 + 2.72 × 1.096 + 2.54 × 0.536) × $33.4009 = $423.25
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
22858 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $423.25 | RVU26D |
| 2026-07-01 | Not available in this setting | $423.25 | RVU26C |
| 2026-04-01 | Not available in this setting | $423.25 | RVU26B |
| 2026-01-01 | Not available in this setting | $423.25 | RVU26A |
| 2025-10-01 | Not available in this setting | $472.85 | RVU25D |
| 2025-07-01 | Not available in this setting | $472.85 | RVU25C |
| 2025-04-01 | Not available in this setting | $472.85 | RVU25B |
| 2025-01-01 | Not available in this setting | $472.85 | RVU25A |
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
1201112,CA,57,HANFORD-CORCORAN,1.017,1.096,0.536
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664
1401112,CA,58,MADERA,1.017,1.096,0.536
1501112,CA,59,MERCED,1.017,1.096,0.536
1601112,CA,60,MODESTO,1.017,1.096,0.536
1701112,CA,51,NAPA,1.063,1.318,0.508
1801182,CA,17,OXNARD-THOUSAND OAKS-VENTURA,1.028,1.182,0.623