Use 22100 for an intrinsic cervical vertebral lesion excised without spinal cord or nerve-root decompression. 22110 applies when the operation includes that decompression.
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CMS RVU26D · Effective 2026-10-01
22110 Vertebral lesion excision Medicare reimbursement rates in Kentucky
Reports removal of an intrinsic cervical vertebral bone lesion when the operation also decompresses the spinal cord or a nerve root. Compare 22110 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 22110 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
$960.37
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 22110: Cervical vertebral lesion excision with decompression
Reports removal of an intrinsic cervical vertebral bone lesion when the operation also decompresses the spinal cord or a nerve root.
22110 describes excision of an intrinsic bony lesion from a cervical vertebral body together with decompression of the spinal cord or a nerve root. The procedure is typically performed by a spine surgeon or neurosurgeon in an operating room when the lesion and required neural decompression are addressed during the operation. The code distinguishes this service from cervical lesion excision without cord or nerve-root decompression.
Select the code from the operative report: it should identify the cervical vertebral site, the intrinsic bony lesion removed, and the spinal cord or nerve-root decompression performed. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For other procedures performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 22110
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU13.65 · 45%
- Practice expense (office) RVU12.46 · 41%
- Malpractice RVU4.40 · 14%
299
Medicare services in 2024 · #3995 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.
22110 compared with similar codes
Office rates for Kentucky, from the same CMS release.
22112 is for the thoracic region with decompression; 22110 is for the cervical region.
22114 is for the lumbar region with decompression; 22110 is for the cervical region.
22116 represents an additional vertebral segment in this decompression family, rather than the primary cervical segment service reported with 22110.
Compare 22110 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
$960.37
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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 22110 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
2,047
- Code
- 22110
- Physician work
- 13.65
- Practice expense
- 12.46
- Malpractice
- 4.40
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.65 | × 1.000 | 13.6500 |
| Practice expense | 12.46 | × 0.889 | 11.0769 |
| Malpractice | 4.40 | × 0.915 | 4.0260 |
| Total RVUs | 28.7529 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$960.37
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.65 | 1 |
| Practice expense | 12.46 | 0.889 |
| Malpractice | 4.4 | 0.915 |
(13.65 × 1 + 12.46 × 0.889 + 4.4 × 0.915) × $33.4009 = $960.37
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.
22110 billing questions
How is 22110 different from 22100?
Both concern an intrinsic bony lesion in the cervical vertebral body. Use 22110 when the operation includes spinal cord or nerve-root decompression; 22100 is for excision without that decompression.
What documentation supports reporting 22110?
The operative report should describe the cervical vertebral lesion and its excision, and identify the spinal cord or nerve-root decompression performed.
Can 22116 be reported with 22110?
22116 is the additional-segment code in the decompression family and may be reported for an additional vertebral segment when its requirements are met. The operative documentation should establish the additional segment treated.
Should modifier 50 be appended for bilateral work?
No. CMS identifies bilateral adjustment as inappropriate for this code based on its descriptor or anatomy.
How are assistants and co-surgeons handled?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, while team surgery is not permitted.
Which postoperative care is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
