No office rate
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.
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CMS RVU26D · Effective 2026-10-01
22114 Spinal lesion excision Medicare reimbursement rates in Pennsylvania
Reports surgical removal of an extradural lesion in the lumbar spinal canal when the surgeon uses vertebral bone removal to reach the lesion. Compare 22114 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 22114 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
$1117.79–$1237.80
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 22114: Lumbar extradural spinal lesion excision
Reports surgical removal of an extradural lesion in the lumbar spinal canal when the surgeon uses vertebral bone removal to reach the lesion.
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.
CMS billing rules for 22114
- 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 RVU13.72 · 39%
- Practice expense (office) RVU15.57 · 44%
- Malpractice RVU5.77 · 16%
45
Medicare services in 2024 · #5410 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.
22114 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
Both codes address extradural spinal lesion excision; 22112 is for the thoracic region, while 22114 is for the lumbar region.
No office rate
22114 reports the lumbar-region excision; 22116 is the add-on for an additional vertebral segment, not a substitute for the primary code.
Compare 22114 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
$1237.80
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$1117.79
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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 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.
2,04622103,,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
2,04722110,,Remove part of neck vertebra,A,,13.65,12.46,NA,12.46,,4.40,30.51,30.51,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,04822112,,Remove part thorax vertebra,A,,13.72,15.57,NA,15.57,,5.77,35.06,35.06,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,04922114,,Remove part lumbar vertebra,A,,13.72,15.57,NA,15.57,,5.77,35.06,35.06,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,05022116,,Remove extra spine segment,A,,2.26,0.75,NA,0.75,,0.76,3.77,3.77,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,05122206,,Incis spine 3 column thorac,A,,36.25,20.14,NA,20.14,,12.03,68.42,68.42,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,05222207,,Incis spine 3 column lumbar,A,,35.76,19.61,NA,19.61,,10.93,66.30,66.30,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00