Billing code 22103: Spine lesion excisionMedicare rate & RVUs in Ohio
Reports an additional vertebral level when a surgeon excises posterior bone to treat a lesion after the first segment is coded.
CMS doesn’t publish an office rate for 22103 in Ohio.
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 22103 covers
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.
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 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $114.03 |
How the 22103 rate is calculated
Each of 22103’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 · 22103
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.28Practice expense 0.69Malpractice 0.50
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 22103
The CMS indicators that decide how 22103 is paid alongside other services.
CMS payment indicators · 22103
Spine lesion excision
| 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) | 1 | Permitted with supporting documentation. |
| 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
22103 without 80 · national facility
$115.90
Spine lesion excision
22103-80 · Assistant: 16%
$18.54
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
22103 compared with similar codes
Compare codes
22103 vs 22100 vs 22102 vs 22110 vs 22116: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 22100Vertebral lesion excision
- 22100 reports the first cervical segment treated for a posterior-element bone lesion; 22103 reports an additional segment after the primary segment.
- 22102Vertebral excision
- 22102 reports the first lumbar segment treated for a posterior-element bone lesion; 22103 captures additional treated segments.
- 22110Vertebral lesion excision
- 22110 applies to the first cervical segment when the lesion excision involves the vertebral body, rather than posterior vertebral elements.
- 22116Vertebral excision
- 22116 is the additional-segment code for vertebral-body lesion excision; 22103 is for additional segments involving posterior elements.
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 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
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