No office rate
Use 22101 for the corresponding partial vertebral-body lesion procedure at a thoracic site. This code is for a cervical segment.
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CMS RVU26D · Effective 2026-10-01
22100 Vertebral lesion excision Medicare reimbursement rates in Pennsylvania
Reports partial removal of an intrinsic bony lesion in one cervical vertebral segment when the procedure does not decompress the spinal cord or nerve roots. Compare 22100 office and facility rates across CMS payment localities in Pennsylvania.
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 22100 in Pennsylvania?
Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$946.26–$1049.77
2 of 2 localities have a supported rate.
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 22100: Cervical vertebral lesion excision, partial
Reports partial removal of an intrinsic bony lesion in one cervical vertebral segment when the procedure does not decompress the spinal cord or nerve roots.
This service involves surgically removing part of a cervical vertebral body to treat an intrinsic bony lesion, without decompressing the spinal cord or nerve roots. It is typically performed by an orthopedic spine surgeon or neurosurgeon in an operating room, often in a hospital facility. The code is specific to one cervical vertebral segment; thoracic and lumbar sites use separate codes in the same family.
Select the code when the operative report supports the cervical location, intrinsic bone lesion, partial vertebral-body removal, absence of neural decompression, and one-segment extent. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others are subject to standard multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 22100
- 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 RVU10.73 · 36%
- Practice expense (office) RVU14.53 · 49%
- Malpractice RVU4.51 · 15%
124
Medicare services in 2024 · #4704 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.
22100 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
22103 is the add-on for each additional vertebral segment; this code represents the primary single-segment service.
No office rate
22110 describes cervical vertebral-body lesion excision through a transpedicular approach, rather than the partial-excision service reported here.
Compare 22100 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.
2 of 2 payment localities
Metropolitan Philadelphia →
Office / nonfacility
Unavailable
Facility
$1049.77
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$946.26
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22100 billing questions
How is this code different from 22110?
This code describes partial removal of an intrinsic cervical bony lesion without neural decompression. Code 22110 describes a different cervical vertebral-body lesion procedure performed through a transpedicular approach.
Can an additional cervical segment be reported?
For additional vertebral segments treated in the same service, consider add-on code 22103 when its requirements are met. Document the number and location of segments treated.
Should modifier 50 be appended for bilateral work?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
What operative details support reporting this code?
Document the cervical vertebral site, intrinsic bony lesion, partial removal of the vertebral body, one-segment extent, and that the service did not decompress the spinal cord or nerve roots.
How does the global period affect postoperative billing?
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.
2,04021936,,Resect back tum 5 cm/>,A,,21.99,11.94,NA,11.94,,5.23,39.16,39.16,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,04122010,,I&d p-spine c/t/cerv-thor,A,,12.43,12.05,NA,12.05,,3.99,28.47,28.47,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,04222015,,I&d abscess p-spine l/s/ls,A,,12.32,11.66,NA,11.66,,3.62,27.60,27.60,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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