No office rate
22853 applies to device placement in an intervertebral disc space in conjunction with interbody arthrodesis; 22859 is for placement without interbody arthrodesis.
On this page
CMS RVU26D · Effective 2026-10-01
22859 Spinal implant Medicare reimbursement rates in Indiana
Reports placement of a biomechanical device in a spinal disc space or vertebral body defect when the reconstruction is performed without interbody arthrodesis. Compare 22859 office and facility rates across CMS payment localities in Indiana.
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.
What does Medicare pay for 22859 in Indiana?
Indiana has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$264.61
1 of 1 localities have a supported rate.
Payment area: Indiana
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Spinal surgery
About 22859: Spinal biomechanical device insertion without fusion
Reports placement of a biomechanical device in a spinal disc space or vertebral body defect when the reconstruction is performed without interbody arthrodesis.
A spine surgeon places a structural device, such as a cage or mesh, in an intervertebral disc space or vertebral body defect to support the anterior column without performing interbody arthrodesis. This may occur during operative reconstruction after a vertebral body resection for a tumor or another condition that leaves a defect. The work is typically performed in an operating room by an orthopedic spine surgeon or neurosurgeon.
Report this as an add-on with an eligible primary procedure, not as a stand-alone service. The device placement must be in a contiguous defect, and the operative report should identify the defect, device placement, and whether interbody arthrodesis was performed. Distinguish it from device placement performed in conjunction with arthrodesis, which is represented by other codes. CMS pays this add-on within the primary procedure’s global period.
CMS billing rules for 22859
- 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 RVU5.36 · 60%
- Practice expense (office) RVU1.81 · 20%
- Malpractice RVU1.82 · 20%
1.1K
Medicare services in 2024 · #2894 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.
22859 compared with similar codes
Office rates for Indiana, from the same CMS release.
No office rate
22854 applies to device placement in a vertebral body defect in conjunction with interbody arthrodesis. Use 22859 when the placement is without interbody arthrodesis.
No office rate
22845 reports anterior spinal instrumentation across specified vertebral segments, rather than placement of a biomechanical device into a disc space or vertebral body defect.
Compare 22859 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Indiana →
Office / nonfacility
Unavailable
Facility
$264.61
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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 22859 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
2,130
- Code
- 22859
- Physician work
- 5.36
- Practice expense
- 1.81
- Malpractice
- 1.82
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.36 | × 1.000 | 5.3600 |
| Practice expense | 1.81 | × 0.927 | 1.6779 |
| Malpractice | 1.82 | × 0.486 | 0.8845 |
| Total RVUs | 7.9224 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Indiana$264.61
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.36 | 1 |
| Practice expense | 1.81 | 0.927 |
| Malpractice | 1.82 | 0.486 |
(5.36 × 1 + 1.81 × 0.927 + 1.82 × 0.486) × $33.4009 = $264.61
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.
22859 billing questions
How does this differ from 22853 or 22854?
Use 22859 when the device is placed without interbody arthrodesis. Codes 22853 and 22854 describe device placement in conjunction with interbody arthrodesis, with the code choice depending on the defect addressed.
Can 22859 be billed by itself?
No. It is an add-on code and must be reported with an eligible primary procedure.
How many units are reported?
The code is reported for each contiguous defect. The operative documentation should support the number and location of the defects treated.
What documentation supports reporting 22859?
Document the spinal disc-space or vertebral-body defect, the biomechanical device placed, and that interbody arthrodesis was not performed. The record should also identify the primary procedure reported with this add-on.
How does Medicare handle the global period?
CMS pays this add-on within the global period of the primary procedure. It does not establish a separate global period.
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.
2,12722856,,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
2,13322862,,Rev rplcm rthrp 1ntrspc lmbr,R,,31.81,22.64,NA,22.64,,13.45,67.90,67.90,0,090,0.10,0.71,0.19,2,0,2,2,2,9,,33.4009,09,0,99,0.00,0.00,0.00
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915