No office rate
22854 applies to a vertebral body defect or corpectomy defect reconstructed during fusion. 22853 applies when the device is placed in an intervertebral disc space.
On this page
CMS RVU26D · Effective 2026-10-01
22854 Spinal cage Medicare reimbursement rates in Nevada
Reports placement of a biomechanical cage or mesh in a vertebral body defect during interbody fusion, such as reconstruction after corpectomy. Compare 22854 office and facility rates across CMS payment localities in Nevada.
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 22854 in Nevada?
Nevada 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
$290.40
1 of 1 localities have a supported rate.
Payment area: Nevada**
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 22854: Vertebral body defect cage placement
Reports placement of a biomechanical cage or mesh in a vertebral body defect during interbody fusion, such as reconstruction after corpectomy.
During spinal reconstruction, the surgeon places a biomechanical device, such as a cage or mesh, into a vertebral body defect created by corpectomy. The device spans the defect as part of an interbody fusion. Spine surgeons typically perform this work in an operating room, often with other procedures to remove diseased or damaged vertebral bone and stabilize the spine. This code is for a vertebral body defect, not a device placed in an ordinary disc space.
Report the code for each contiguous defect reconstructed with a device in conjunction with interbody arthrodesis. The operative report should identify the corpectomy defect, its location and extent, the device placement, and the fusion procedure performed. This is an add-on code: report it only with a primary procedure, and Medicare payment is included within that procedure’s global period. It is not reported as a standalone service.
CMS billing rules for 22854
- 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) RVU1.80 · 20%
- Malpractice RVU1.84 · 20%
6.4K
Medicare services in 2024 · #1721 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.
22854 compared with similar codes
Office rates for Nevada, from the same CMS release.
No office rate
22859 covers device placement in a disc space or vertebral body defect without interbody arthrodesis; 22854 requires placement in a vertebral body defect with fusion.
No office rate
22845 describes anterior spinal instrumentation, while 22854 reports a biomechanical device placed in a vertebral body defect as part of fusion.
Compare 22854 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
Nevada** →
Office / nonfacility
Unavailable
Facility
$290.40
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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 22854 in Nevada**.
PPRRVU2026_Oct_nonQPP.csv
2,125
- Code
- 22854
- Physician work
- 5.36
- Practice expense
- 1.80
- Malpractice
- 1.84
GPCI2026.csv
73
- Locality
- Nevada**
- Physician work
- 1.000
- Practice expense
- 1.001
- Malpractice
- 0.833
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.36 | × 1.000 | 5.3600 |
| Practice expense | 1.80 | × 1.001 | 1.8018 |
| Malpractice | 1.84 | × 0.833 | 1.5327 |
| Total RVUs | 8.6945 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nevada**$290.40
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.36 | 1 |
| Practice expense | 1.8 | 1.001 |
| Malpractice | 1.84 | 0.833 |
(5.36 × 1 + 1.8 × 1.001 + 1.84 × 0.833) × $33.4009 = $290.40
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.
22854 billing questions
When should 22854 be chosen instead of 22853?
Use 22854 for a device placed in a vertebral body defect or corpectomy defect during fusion. Use 22853 when the device is placed in an intervertebral disc space.
Is 22854 reported by device, level, or defect?
The unit is each contiguous vertebral body defect reconstructed. The operative documentation should support the number and location of the contiguous defects.
Can 22854 be billed by itself?
No. It is an add-on code and must be reported with a primary procedure; its Medicare payment falls within that procedure’s global period.
Does 22854 describe fusion or only device placement?
It describes device placement into a vertebral body defect in conjunction with interbody arthrodesis. Report the applicable primary fusion procedure as well.
How does 22854 differ from 22859?
22854 is for device placement in a vertebral body defect with interbody fusion. 22859 is for placement in a disc space or vertebral body defect without interbody arthrodesis.
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.
2,12222850,,Remove spine fixation device,A,,9.57,8.88,NA,8.88,,3.01,21.46,21.46,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,12322852,,Remove spine fixation device,A,,9.14,8.73,NA,8.73,,2.85,20.72,20.72,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,12422853,,Insj biomechanical device,A,,4.14,1.38,NA,1.38,,1.33,6.85,6.85,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,12522854,,Insj biomechanical device,A,,5.36,1.80,NA,1.80,,1.84,9.00,9.00,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,12622855,,Removal anterior instrmj,A,,15.46,11.10,NA,11.10,,4.90,31.46,31.46,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,12722856,,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
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068
7612402,NJ,99,REST OF NEW JERSEY,1.040,1.092,1.097