Billing code 22100: Vertebral lesion excisionMedicare rate & RVUs in Utah
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.
CMS doesn’t publish an office rate for 22100 in Utah.
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 22100 covers
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.
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 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | Unavailable | $949.86 |
How the 22100 rate is calculated
Each of 22100’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 · 22100
RVUs × geographic indexes × conversion factor
Work10.73
10.73 RVUs× 1.000 GPCI
Practice expense14.53
14.53 RVUs× 1.000 GPCI
Malpractice4.51
4.51 RVUs× 1.000 GPCI
Adjusted RVUs
29.7700
Conversion factor
$33.4009
Medicare rate
$994.34
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 22100
22100 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 22100
Vertebral 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 · 22100
Vertebral 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
22100 without 51 · national facility
$994.34
Vertebral lesion excision
22100-51 · Second procedure: 50%
$497.17
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%).
22100 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 22101Vertebral excision
- Use 22101 for the corresponding partial vertebral-body lesion procedure at a thoracic site. This code is for a cervical segment.
- 22103Spine lesion excision
- 22103 is the add-on for each additional vertebral segment; this code represents the primary single-segment service.
- 22110Vertebral lesion excision
- 22110 describes cervical vertebral-body lesion excision through a transpedicular approach, rather than the partial-excision service reported here.
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 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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