Billing code 22114: Spinal lesion excisionMedicare rate & RVUs in Ohio
Reports surgical removal of an extradural lesion in the lumbar spinal canal when the surgeon uses vertebral bone removal to reach the lesion.
CMS doesn’t publish an office rate for 22114 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 22114 covers
This code describes excision of a lesion outside the dura in the lumbar spinal canal. A spine surgeon typically removes or opens vertebral bone to reach and remove the lesion, such as an epidural mass. The relevant distinction is that the target is extradural and within the spinal canal, rather than an intrinsic bony lesion of the vertebra or a lesion inside the dura. These procedures are generally performed in a hospital or other surgical facility.
Select the code by spinal region and the number of vertebral segments treated; 22114 covers the lumbar region, while 22116 is for an additional segment. The operative report should identify the lesion’s extradural location, lumbar level or levels, and the extent of excision. The code has a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation. Bilateral adjustment is inappropriate, and team surgery is not permitted.
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.
22114 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $1,127.33 |
How the 22114 rate is calculated
Each of 22114’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 · 22114
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 13.72Practice expense 15.57Malpractice 5.77
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 22114
22114 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 22114
Spinal lesion excision
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| 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. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 22114
Spinal lesion excision
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
22114 without 51 · national facility
$1,171.04
Spinal lesion excision
22114-51 · Second procedure: 50%
$585.52
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
22114 compared with similar codes
Compare codes
22114 vs 22102 vs 22112 vs 22116: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 22102Vertebral excision
- Choose 22102 for an intrinsic bony lesion of a lumbar vertebra without spinal cord or nerve root decompression. Choose 22114 when the excised target is an extradural lesion in the lumbar spinal canal.
- 22112Vertebral excision
- Both codes address extradural spinal lesion excision; 22112 is for the thoracic region, while 22114 is for the lumbar region.
- 22116Vertebral excision
- 22114 reports the lumbar-region excision; 22116 is the add-on for an additional vertebral segment, not a substitute for the primary code.
22114 billing questions
When should 22114 be selected instead of 22102?
Use 22114 for excision of an extradural lesion in the lumbar spinal canal. Code 22102 addresses an intrinsic bony lesion of a lumbar vertebra without spinal cord or nerve root decompression.
How is an additional lumbar segment reported?
When the excision extends to an additional vertebral segment, 22116 is the add-on code associated with this family. Document the distinct segments treated in the operative report.
Is the approach-related bone removal separately reported?
The vertebral bone removal provides access to the extradural lesion excision described by 22114. Do not separately report the same access work as a second procedure.
What supports reporting 22114?
The operative report should establish that the target was extradural and in the lumbar spinal canal, identify the level or segments, and describe the excision performed.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted for this code.
Does modifier 50 apply to bilateral lumbar lesions?
No. Bilateral adjustment is inappropriate for this code, even when the operative findings involve both sides.
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
Show the CMS file lines behind this rate
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