No office rate
22856 reports the primary cervical disc replacement at one interspace. 22858 identifies the second cervical interspace and must accompany the primary code.
On this page
CMS RVU26D · Effective 2026-10-01
22858 Cervical disc replacement Medicare reimbursement rates in Wyoming
Reports artificial disc replacement at a second cervical interspace during the same operative service as the primary cervical disc arthroplasty. Compare 22858 office and facility rates across CMS payment localities in Wyoming.
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 22858 in Wyoming?
Wyoming has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$427.18
1 of 1 localities have a supported rate.
Payment area: Wyoming**
One mapped payment locality.
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 22858: Second-level cervical disc replacement
Reports artificial disc replacement at a second cervical interspace during the same operative service as the primary cervical disc arthroplasty.
A spine surgeon reports this add-on when replacing a damaged cervical disc with an artificial disc at a second interspace during the operative service. The procedure involves an anterior approach, removal of the treated disc, and preparation of the space for the implant. Typical cases involve cervical degenerative disc disease associated with nerve-root or spinal-cord symptoms. The code identifies the second treated interspace, not another service at the first level.
Report 22858 only with the primary cervical disc arthroplasty code, 22856. The operative report should identify both treated cervical interspaces and document the disc replacement performed at each. Routine removal of the disc and preparation of its space are part of the arthroplasty service, not separately counted as another level. Under the CMS rule for this add-on, it is paid within the primary procedure’s global period and cannot be billed by itself.
CMS billing rules for 22858
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU8.19 · 61%
- Practice expense (office) RVU2.72 · 20%
- Malpractice RVU2.54 · 19%
1K
Medicare services in 2024 · #2930 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.
22858 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
22860 is the add-on for a second lumbar interspace. Use 22858 for the second cervical interspace.
No office rate
22861 describes revision or replacement of an existing cervical artificial disc at one interspace; 22858 reports a second level during primary cervical arthroplasty.
Compare 22858 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.
1 of 1 payment localities
Wyoming** →
Office / nonfacility
Unavailable
Facility
$427.18
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 22858 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
2,129
- Code
- 22858
- Physician work
- 8.19
- Practice expense
- 2.72
- Malpractice
- 2.54
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.19 | × 1.000 | 8.1900 |
| Practice expense | 2.72 | × 1.000 | 2.7200 |
| Malpractice | 2.54 | × 0.740 | 1.8796 |
| Total RVUs | 12.7896 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$427.18
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.19 | 1 |
| Practice expense | 2.72 | 1 |
| Malpractice | 2.54 | 0.74 |
(8.19 × 1 + 2.72 × 1 + 2.54 × 0.74) × $33.4009 = $427.18
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
22858 billing questions
Can 22858 be billed by itself?
No. It is an add-on for a second cervical interspace and must be reported with the primary cervical arthroplasty code, 22856.
When should 22856 be reported instead?
Use 22856 for the primary cervical disc arthroplasty at one interspace. Report 22858 when a second cervical interspace is also treated with disc replacement during the operative service.
How many units of 22858 should be reported?
The code identifies the second cervical interspace. The operative report should support the additional treated level; do not use units to represent work at the primary interspace.
Is disc removal separately reported for the additional level?
Disc removal and preparation of the space for the artificial disc are part of the arthroplasty service. 22858 represents the additional replacement level, not a separate discectomy.
What documentation supports 22858?
Document the cervical interspaces treated and the artificial disc replacement at the second interspace. The record should also support the primary arthroplasty reported with 22856.
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.
2,12622855,,Removal anterior instrmj,A,,15.46,11.10,NA,11.10,,4.90,31.46,31.46,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,12722856,,Tot disc arthrp 1ntrspc crv,A,,23.45,14.72,NA,14.72,,7.40,45.57,45.57,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,12822857,,Tot disc arthrp 1ntrspc lmbr,A,,26.45,14.89,NA,14.89,,5.63,46.97,46.97,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,12922858,,Tot disc arthrp 2nd lvl crv,A,,8.19,2.72,NA,2.72,,2.54,13.45,13.45,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,13022859,,Insj biomechanical device,A,,5.36,1.81,NA,1.81,,1.82,8.99,8.99,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,13122860,,Tot disc arthrp 2ntrspc lmbr,A,,6.71,1.92,NA,1.92,,1.68,10.31,10.31,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,13222861,,Rev rplcm arthrp 1ntrspc crv,A,,32.53,21.07,NA,21.07,,13.73,67.33,67.33,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,