22207 Spinal osteotomy Medicare reimbursement rates in Vermont

This code represents a major corrective bone-cutting procedure through the lumbar spine that changes alignment by releasing or removing bone across all three spinal columns at one vertebral segment. A lumbar pedicle subtraction osteotomy is a familiar example, often performed for rigid sagittal imbalance or another fixed deformity that cannot be adequately corrected with a less extensive release. A spine surgeon performs it in the operating room, often as part of a reconstruction that may also include instrumentation or fusion.

Select the code when the operative report identifies a lumbar level and documents work spanning three columns; a posterior osteotomy that does not span all three columns belongs in a different code. Document the approach, vertebral level, extent of bone removal, and corrective objective. CMS assigns a 90-day global period, including the day-before preoperative visit and related care through 90 days after surgery. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. CMS permits assistant-at-surgery payment; co-surgeon payment requires supporting documentation, and team surgery is not permitted.