Billing code 22860: Lumbar disc replacementMedicare rate & RVUs in Guam
Reports total disc replacement at an additional lumbar interspace during the same operation as the primary lumbar disc arthroplasty.
CMS doesn’t publish an office rate for 22860 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 22860 covers
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.
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 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $329.53 |
How the 22860 rate is calculated
Each of 22860’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 · 22860
RVUs × geographic indexes × conversion factor
Work6.71
6.71 RVUs× 1.000 GPCI
Practice expense1.92
1.92 RVUs× 1.000 GPCI
Malpractice1.68
1.68 RVUs× 1.000 GPCI
Adjusted RVUs
10.3100
Conversion factor
$33.4009
Medicare rate
$344.36
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 22860
The CMS indicators that decide how 22860 is paid alongside other services.
CMS payment indicators · 22860
Lumbar 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
22860 without 80 · national facility
$344.36
Lumbar disc replacement
22860-80 · Assistant: 16%
$55.10
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
22860 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 22857Lumbar disc replacement
- 22857 reports the primary lumbar interspace replacement. Add 22860 only when a second lumbar interspace is replaced during the same operation.
- 22858Cervical disc replacement
- 22858 is the additional-level arthroplasty code for the cervical spine; 22860 is for an additional lumbar interspace.
- 22853Interbody device
- 22853 concerns placement of an interbody device in fusion surgery. Code 22860 represents an additional level of artificial disc replacement.
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 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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