Billing code 22858: Cervical disc replacementMedicare rate & RVUs in Guam
Reports artificial disc replacement at a second cervical interspace during the same operative service as the primary cervical disc arthroplasty.
CMS doesn’t publish an office rate for 22858 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 22858 covers
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.
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 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $425.97 |
How the 22858 rate is calculated
Each of 22858’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 · 22858
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.19Practice expense 2.72Malpractice 2.54
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 22858
The CMS indicators that decide how 22858 is paid alongside other services.
CMS payment indicators · 22858
Cervical disc replacement
| 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) | 2 | Permitted. |
| 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
22858 without 80 · national facility
$449.24
Cervical disc replacement
22858-80 · Assistant: 16%
$71.88
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
22858 compared with similar codes
Compare codes
22858 vs 22856 vs 22860 vs 22861: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 22856Artificial disc
- 22856 reports the primary cervical disc replacement at one interspace. 22858 identifies the second cervical interspace and must accompany the primary code.
- 22860Lumbar disc replacement
- 22860 is the add-on for a second lumbar interspace. Use 22858 for the second cervical interspace.
- 22861Disc revision
- 22861 describes revision or replacement of an existing cervical artificial disc at one interspace; 22858 reports a second level during primary cervical arthroplasty.
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 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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