No office rate
22100 reports the first cervical segment treated for a posterior-element bone lesion; 22103 reports an additional segment after the primary segment.
On this page
CMS RVU26D · Effective 2026-10-01
22103 Spine lesion excision Medicare reimbursement rates in Kentucky
Reports an additional vertebral level when a surgeon excises posterior bone to treat a lesion after the first segment is coded. Compare 22103 office and facility rates across CMS payment localities in Kentucky.
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 22103 in Kentucky?
Kentucky 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
$111.92
1 of 1 localities have a supported rate.
Payment area: Kentucky
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.
Spine surgery
About 22103: Additional posterior vertebral lesion excision
Reports an additional vertebral level when a surgeon excises posterior bone to treat a lesion after the first segment is coded.
Code 22103 represents additional-level work when a surgeon removes posterior bony elements of another vertebral segment to excise a bone lesion. The work may involve the lamina, spinous process, facet, or pars; it is not a general code for bone removal during routine decompression. Spine surgeons typically perform this procedure in an operating room, with the target level and lesion established through imaging and operative planning.
Report 22103 with the applicable primary code for the first treated segment: 22100 for cervical, 22101 for thoracic, or 22102 for lumbar. Report an additional unit for each separately treated extra segment supported by the operative report, identifying the levels and lesion-directed removal. This is an add-on code, not a stand-alone service, and CMS pays it within the primary procedure’s global period. Documentation should distinguish removal to excise a lesion from bone removal performed only for access or neural decompression.
CMS billing rules for 22103
- 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 RVU2.28 · 66%
- Practice expense (office) RVU0.69 · 20%
- Malpractice RVU0.50 · 14%
363
Medicare services in 2024 · #3817 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.
22103 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
22102 reports the first lumbar segment treated for a posterior-element bone lesion; 22103 captures additional treated segments.
No office rate
22110 applies to the first cervical segment when the lesion excision involves the vertebral body, rather than posterior vertebral elements.
No office rate
22116 is the additional-segment code for vertebral-body lesion excision; 22103 is for additional segments involving posterior elements.
Compare 22103 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
Kentucky →
Office / nonfacility
Unavailable
Facility
$111.92
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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 22103 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
2,046
- Code
- 22103
- Physician work
- 2.28
- Practice expense
- 0.69
- Malpractice
- 0.50
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.28 | × 1.000 | 2.2800 |
| Practice expense | 0.69 | × 0.889 | 0.6134 |
| Malpractice | 0.50 | × 0.915 | 0.4575 |
| Total RVUs | 3.3509 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$111.92
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.28 | 1 |
| Practice expense | 0.69 | 0.889 |
| Malpractice | 0.5 | 0.915 |
(2.28 × 1 + 0.69 × 0.889 + 0.5 × 0.915) × $33.4009 = $111.92
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.
22103 billing questions
Which primary code is reported with 22103?
Pair it with 22100, 22101, or 22102 for the first segment, choosing the primary code by cervical, thoracic, or lumbar location.
How many units of 22103 should be reported?
Report an additional unit for each separately treated vertebral segment beyond the first. The operative report should identify each level and the lesion-directed bone removal.
Can 22103 be reported by itself?
No. It is an add-on code and must accompany the applicable primary procedure for the first segment.
Does routine decompression support 22103?
Not by itself. The additional posterior-element removal must be for excision of a bone lesion, rather than bone removal solely to access or decompress neural structures.
How does 22103 differ from 22116?
22103 covers additional segments when the lesion excision involves posterior vertebral elements. 22116 is the additional-segment code in the vertebral-body excision family.
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.
2,04322100,,Remove part of neck vertebra,A,,10.73,14.53,NA,14.53,,4.51,29.77,29.77,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,04422101,,Remove part thorax vertebra,A,,10.80,11.75,NA,11.75,,3.43,25.98,25.98,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,04522102,,Remove part lumbar vertebra,A,,10.80,8.47,NA,8.47,,1.75,21.02,21.02,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,04622103,,Remove extra spine segment,A,,2.28,0.69,NA,0.69,,0.50,3.47,3.47,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,04722110,,Remove part of neck vertebra,A,,13.65,12.46,NA,12.46,,4.40,30.51,30.51,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,04822112,,Remove part thorax vertebra,A,,13.72,15.57,NA,15.57,,5.77,35.06,35.06,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,04922114,,Remove part lumbar vertebra,A,,13.72,15.57,NA,15.57,,5.77,35.06,35.06,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631