Billing code 22116: Vertebral excisionMedicare rate & RVUs in Guam
Reports removal of a vertebral body lesion at an additional spinal segment, alongside the appropriate primary code for the region treated.
CMS doesn’t publish an office rate for 22116 in Guam.
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 22116 covers
This add-on code describes excision of an intrinsic bony lesion from an additional vertebral body, without decompression of the spinal cord or nerve roots. A spine surgeon may perform this during surgery to remove a lesion involving more than one vertebral segment. The service is distinguished by the vertebral body being treated, rather than removal of posterior elements such as the lamina or facet.
Report it only with the matching primary procedure for the first treated segment: 22110 for cervical, 22112 for thoracic, or 22114 for lumbar. The operative report should identify the lesion, spinal region, and each additional vertebral segment from which tissue was removed, and support that the work was lesion excision rather than neural decompression. CMS classifies this as an add-on code: it is billed only with a primary procedure and its payment falls within that procedure’s global period.
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.
22116 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $118.67 |
How the 22116 rate is calculated
Each of 22116’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 · 22116
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.26Practice expense 0.75Malpractice 0.76
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 22116
The CMS indicators that decide how 22116 is paid alongside other services.
CMS payment indicators · 22116
Vertebral excision
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 80 · payment effect
With and without the modifier
22116 without 80 · national facility
$125.92
Vertebral excision
22116-80 · Assistant: 16%
$20.15
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
22116 compared with similar codes
Compare codes
22116 vs 22110 vs 22114 vs 22103: national Medicare rates
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How to choose
- 22110Vertebral lesion excision
- 22110 reports lesion excision at the first cervical vertebral segment; 22116 reports each additional segment and requires an eligible primary code.
- 22114Spinal lesion excision
- 22114 is the primary code for the first lumbar segment. Use 22116 for additional treated segments, not as a stand-alone lumbar code.
- 22103Spine lesion excision
- 22103 concerns additional-segment excision of a posterior vertebral component, such as a lamina or facet. 22116 concerns an intrinsic vertebral body lesion.
22116 billing questions
Which primary code should accompany 22116?
Use 22110 for the cervical region, 22112 for the thoracic region, or 22114 for the lumbar region. The primary code reports the first treated segment.
Can 22116 be reported by itself?
No. It is an add-on code and must be billed with the appropriate primary procedure for the first segment.
What documentation supports reporting an additional segment?
The operative report should identify the lesion and specify each additional vertebral body segment treated. It should show excision of the lesion, not just decompression of neural structures.
Is removal of a lamina or facet reported with 22116?
22116 describes excision of a vertebral body lesion. Removal of posterior elements such as the lamina or facet is a different service and should be evaluated under the applicable code.
How does the global-period rule affect 22116?
CMS treats 22116 as an add-on paid within the primary procedure’s global period. Report it only alongside that primary 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 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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