Surgical · Spine

Partial excision of the vertebral body of a single cervical segment, removing diseased or damaged bone without spinal cord or nerve root decompression.

Verified May 8, 2026 · 5 sources ↓

Medicare: $1,019.06
Total RVUs: 30.51
Global, days: 90
Region: Spine

Drawn from CMSAAPCMdclarityAAOS

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 5 cited references ↓

Specify the exact cervical level(s) operated on (e.g., C4 vertebral body) — do not document only 'cervical spine'.
Confirm the pathology is intrinsic to the vertebral body, not a posterior element lesion; mismatch triggers down-coding to 22100.
State explicitly whether spinal cord or nerve root decompression was performed — if yes, that work requires separate coding.
Document the approach (anterior cervical, anterolateral, etc.) by name; generic 'standard approach' language flags audits.
If multiple vertebral bodies are excised, document each level individually to support add-on code 22116.
Record intraoperative findings, extent of bony excision, and how the diseased segment was confirmed (imaging correlation, frozen section, etc.).

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 51 Multiple procedures 52 Reduced services 59 Distinct service 62 Co-surgeons 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon AS PA/NP/CNS assistant

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

22110 covers partial removal of the vertebral body — the anterior column — of a single cervical vertebra. This is distinct from posterior element excision (22100), which addresses the spinous process, lamina, or facets. The procedure targets intrinsic bony pathology such as tumor, infection, or cyst confined to the body of one cervical segment. Because it does not include decompression of the spinal cord or nerve roots, any neural decompression performed in the same session must be coded separately.

The 90-day global period means all routine post-op cervical spine management through day 90 is bundled. If a fusion is performed at the same session — which is common after vertebral body excision — code the fusion separately; it is not bundled into 22110 by definition, though NCCI edits should be verified for the specific code pair. Add-on code 22116 covers each additional vertebral segment beyond the first when the excision spans multiple levels.

Critically, CMS designates 22110 as an inpatient-only procedure under the Hospital Outpatient Prospective Payment System (OPPS). There is no HOPD payment for this code billed outpatient; the procedure must be performed in the inpatient setting for facility reimbursement under Medicare. Billing 22110 as an outpatient facility claim triggers automatic denial.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	13.65
Practice expense RVU	12.46
Malpractice RVU	4.4
Total RVU	30.51
Medicare national rate	$1,019.06
Global period	90 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$1,019.06
HOPD (APC 5114) Hospital outpatient department	$7,413.38
ASC (PI G2) Ambulatory surgical center (freestanding)	$3,695.53

Common denial reasons

The recurring reasons claims for CPT 22110 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Billed as outpatient facility claim — 22110 is Medicare inpatient-only; OPPS claims deny automatically regardless of clinical justification.
Level mismatch between operative report and diagnosis codes — cervical vertebral body excision requires an ICD-10 diagnosis localized to the cervical spine.
Confusion with 22100 (posterior element excision) — payers audit when the approach documented does not match the anterior body excision expected for 22110.
Missing or insufficient medical necessity documentation — excision of vertebral body tissue requires clear pathology (tumor, infection, structural disease) supported in the record.
Unbundling disputes when fusion is billed same-session without verifying NCCI edit status for the specific fusion code pairing.

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01Can 22110 be billed in an outpatient or ASC setting under Medicare?

No. CMS designates 22110 as inpatient-only under OPPS. Medicare facility payment is only available when the procedure is performed during an inpatient hospital admission. Outpatient or ASC facility claims will deny.

02What is the difference between 22110 and 22100?

22100 covers partial excision of a posterior cervical vertebral component (spinous process, lamina, facet). 22110 covers partial excision of the vertebral body itself — the anterior column. Approach and operative anatomy determine which code applies; using the wrong one is a frequent audit finding.

03If the surgeon excises vertebral body at two cervical levels, how is that coded?

Report 22110 for the first level and add-on code 22116 for each additional vertebral segment. Document each level individually in the operative note.

04Is fusion bundled into 22110 when performed at the same session?

No — fusion is separately reportable. However, verify the specific NCCI edit pairing between 22110 and the applicable fusion code before billing. Modifier 51 may apply depending on payer rules for multiple procedures.

05When is modifier 22 appropriate for 22110?

When the intraoperative complexity is substantially greater than typical — severe ankylosis, prior instrumentation in the field, or unusually extensive disease. The operative note must document the specific factors increasing time and effort; a generic statement of 'increased difficulty' will not hold up to audit.

06Does the 90-day global period affect how post-op visits are billed?

Yes. Routine cervical spine follow-up through day 90 is bundled. If a new, unrelated problem is managed during that window, use modifier 24 (unrelated E/M during global) or modifier 79 (unrelated procedure in the global period) as appropriate.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures the cervical level by name (e.g., C5 vertebral body), the surgical approach, the nature and extent of the bony pathology removed, and an explicit statement on whether neural decompression was or was not performed. That last detail prevents down-coding or upcoding disputes when payers audit whether decompression codes were appropriately added or omitted. The scribe also flags if multiple vertebral levels were addressed, prompting the coder to evaluate add-on code 22116.

See how Mira captures CPT 22110 documentation