Billing code 22861: Disc revisionMedicare rate & RVUs in Delaware
Reports anterior revision or replacement of an existing cervical artificial disc at one interspace, rather than initial implantation or removal alone.
CMS doesn’t publish an office rate for 22861 in Delaware.
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 9 sections
What 22861 covers
During this anterior cervical operation, the surgeon revises or replaces an existing artificial disc at one intervertebral level. The work addresses the existing implant; it is distinct from placing a new disc for the first time. An orthopedic spine surgeon or neurosurgeon typically performs the procedure in an operating room, such as a hospital or ambulatory surgical facility.
Select the code based on the cervical location, single interspace, and revision or replacement performed. The operative report should identify the existing artificial disc, level, anterior approach, and work performed. Medicare treats this as major surgery: the day-before preoperative visit and 90 days of related postoperative care are included. For multiple procedures in the same session, the highest-valued procedure is paid in full and others are subject to a 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made, and co-surgeons are permitted; 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.
22861 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $2,199.55 |
How the 22861 rate is calculated
Each of 22861’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 · 22861
RVUs × geographic indexes × conversion factor
Work32.53
32.53 RVUs× 1.000 GPCI
Practice expense21.07
21.07 RVUs× 1.000 GPCI
Malpractice13.73
13.73 RVUs× 1.000 GPCI
Adjusted RVUs
67.3300
Conversion factor
$33.4009
Medicare rate
$2,248.88
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 22861
22861 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 22861
Disc revision
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 2 | Permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 22861
Disc revision
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
22861 without 51 · national facility
$2,248.88
Disc revision
22861-51 · Second procedure: 50%
$1,124.44
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%).
22861 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 22856Artificial disc
- Use 22856 for initial cervical disc arthroplasty. Use 22861 when the surgeon revises or replaces an existing cervical artificial disc.
- 22862Rev rplcm rthrp 1ntrspc lmbr
- Both describe revision or replacement of an existing artificial disc, but 22862 is for a lumbar interspace; 22861 is cervical.
- 22864Disc removal
- 22864 reports removal of a cervical artificial disc without replacement. Choose 22861 when revision or replacement of the disc is performed.
22861 billing questions
How is this different from 22856?
22861 is for revision or replacement of an existing cervical artificial disc at one interspace. 22856 describes initial cervical disc arthroplasty, not revision of a prior implant.
Can this code be used when the artificial disc is only removed?
No. For removal of a cervical artificial disc without replacement, consider 22864. Report 22861 when the surgeon revises or replaces the existing disc.
Does this code cover more than one cervical interspace?
This code is for one cervical interspace. Document the level treated and the revision or replacement performed there.
Should modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What postoperative care is included?
The major-surgery global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction.
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
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