Billing code 22857: Lumbar disc replacementMedicare rate & RVUs in Texas
Reports anterior placement of an artificial disc at one lumbar interspace after discectomy and endplate preparation, preserving motion rather than fusing the segment.
CMS doesn’t publish an office rate for 22857 in Texas.
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 22857 covers
A spine surgeon, commonly an orthopedic spine surgeon or neurosurgeon, removes the lumbar disc through an anterior approach, prepares the vertebral endplates, and places an artificial disc prosthesis at one interspace. The operation is generally performed in a hospital or ambulatory surgery setting for selected patients with symptomatic lumbar degenerative disc disease. The work includes the discectomy, endplate preparation, and associated osteophyte removal described for the procedure.
Report 22857 for the primary lumbar interspace; use 22860 for each additional lumbar interspace when applicable. The operative report should identify the lumbar level, anterior approach, disc removal and endplate preparation, and prosthesis placement. CMS includes the day-before preoperative visit and 90 days of related postoperative care in the 90-day global period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this single spinal interspace. Assistant-at-surgery payment may be made, co-surgeons are permitted, and team-surgery payment 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.
Where 22857 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $1,578.02 |
| Beaumont | Unavailable | $1,510.73 |
| Brazoria | Unavailable | $1,530.06 |
| Dallas | Unavailable | $1,548.10 |
| Fort Worth | Unavailable | $1,545.57 |
| Galveston | Unavailable | $1,540.08 |
| Houston | Unavailable | $1,643.13 |
| Rest Of Texas | Unavailable | $1,525.24 |
How the 22857 rate is calculated
Each of 22857’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 · 22857
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 26.45Practice expense 14.89Malpractice 5.63
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 22857
22857 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 22857
Lumbar disc replacement
| 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) | 2 | Permitted. |
| 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 · 22857
Lumbar disc replacement
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
22857 without 51 · national facility
$1,568.84
Lumbar disc replacement
22857-51 · Second procedure: 50%
$784.42
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%).
22857 compared with similar codes
Compare codes
22857 vs 22860 vs 22558 vs 22862 vs 22856: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 22860Lumbar disc replacement
- 22857 is the primary code for one lumbar interspace; 22860 is the add-on for each additional lumbar interspace.
- 22558Anterior fusion
- 22857 places an artificial disc to preserve motion. 22558 describes anterior lumbar interbody fusion.
- 22862Rev rplcm rthrp 1ntrspc lmbr
- 22857 describes primary artificial disc placement. 22862 is for revision or replacement of a lumbar artificial disc.
- 22856Artificial disc
- 22856 is the primary artificial disc replacement code for a cervical interspace; 22857 is for a lumbar interspace.
22857 billing questions
When is 22860 reported with 22857?
Report 22857 for the primary lumbar interspace and 22860 for each additional lumbar interspace treated during the same operation. The documentation should identify the treated levels.
How is 22857 different from lumbar fusion?
22857 describes placement of an artificial disc after discectomy and endplate preparation. A lumbar fusion code such as 22558 describes arthrodesis rather than motion-preserving disc replacement.
Can modifier 50 be used for 22857?
No. The code represents treatment of one spinal interspace, not a paired body structure, and the CMS bilateral adjustment is unavailable.
What work is included in 22857?
The service includes disc removal, endplate preparation, and the associated osteophyte removal described for the procedure, along with placement of the artificial disc. Document these operative steps and the lumbar level.
What are the assistant and co-surgeon rules?
CMS allows assistant-at-surgery payment and permits co-surgeons for 22857. Team-surgery payment is not permitted.
What postoperative care is included?
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 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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