Fusion · Spine

Posterior or posterolateral cervical spinal fusion at a single interspace below C2, performed through a posterior approach to achieve bony arthrodesis.

Verified May 8, 2026 · 8 sources ↓

Medicare: $1,282.93
Total RVUs: 38.41
Global, days: 90
Region: Spine

Drawn from CMSMedtronicHealthcareinspiredllcJupitermed

Documentation requirements

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

Source · Editorial brief grounded in 8 cited references ↓

Identify the specific interspace(s) fused by name (e.g., C4-C5), not just 'single level cervical'
Specify the surgical approach — posterior or posterolateral — by name in the operative note
Document bone graft type and source (autograft, allograft, synthetic) and anatomic placement site
Record intraoperative imaging or neuromonitoring used, if applicable, to support separately billed services
Confirm the segment is below C2; C1-C2 fusion routes to 22595, not 22600
Document medical necessity with pre-op imaging, failed conservative treatment history, and the diagnosis driving surgical intervention

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 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 8 cited references ↓

CPT 22600 covers posterior or posterolateral arthrodesis at one cervical interspace below the C2 segment. The surgeon accesses the spine from the back, decortícates the facet joints and/or posterior elements, and places bone graft material to achieve fusion. It does not include anterior approaches, posterior interbody technique (22630), or combined techniques (22633) — those are separate code families.

This is a single-level primary code. For each additional cervical or thoracic interspace fused during the same session using the same posterior or posterolateral technique, add-on code 22614 is reported alongside 22600. If the surgeon also performs a posterior interbody fusion at the same level, that changes the code selection entirely — 22633 plus 22634 represent the combined technique.

22600 carries a 90-day global period. Medicare designates it inpatient-only under OPPS, meaning it cannot be billed to Medicare in a hospital outpatient or ASC setting for Medicare patients. Non-Medicare commercial payers may differ. Neurosurgery and orthopedic surgery are the dominant billing specialties, per CMS Physician Fee Schedule 2026 PUF data.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	16.97
Practice expense RVU	15.37
Malpractice RVU	6.07
Total RVU	38.41
Medicare national rate	$1,282.93
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	$1,282.93
HOPD (APC 5116) Hospital outpatient department	$17,913.59
ASC (PI J8) Ambulatory surgical center (freestanding)	$13,103.27

Common denial reasons

The recurring reasons claims for CPT 22600 get rejected.

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

Billed to Medicare in HOPD or ASC setting — 22600 is inpatient-only for Medicare; claim routes to denial at the facility level
Missing level specificity in the operative note — 'cervical fusion' without the interspace named flags audit reviewers and payers requiring ICD-10 level granularity
22614 billed without 22600 as the primary code — add-on codes cannot stand alone
Incorrect technique code selected — posterior interbody (22630) or combined technique (22633) used when posterior or posterolateral was actually performed, or vice versa
Global period overlap — additional spinal procedures billed within the 90-day global window without modifier 78 or 79 to distinguish related vs. unrelated returns to the OR
Insufficient documentation to support modifier 22 when used for substantially increased procedural complexity

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 8 cited references ↓

01Can 22600 be billed in an ASC or hospital outpatient setting for Medicare patients?

No. Medicare designates 22600 as inpatient-only under OPPS. Billing it to Medicare in an HOPD or ASC will result in a claim denial at the facility level. Commercial payers may not impose the same restriction, so verify coverage by payer before scheduling.

02How do you bill when multiple cervical levels are fused posteriorly in the same session?

Report 22600 for the first interspace and add-on code 22614 for each additional interspace fused using the same posterior or posterolateral technique. 22614 cannot be billed without 22600 or another eligible primary code as the anchor.

03What is the difference between 22600 and 22630?

22600 is posterior or posterolateral technique — bone graft placed along the posterior elements or facets. 22630 is posterior interbody technique — graft placed within the disc space through a posterior approach. If both are performed at the same level, the combined technique codes (22633/22634) apply instead.

04Does 22600 include the bone graft harvest?

No. Autograft harvest from a separate incision site can be reported separately (e.g., 20937 or 20938 for morselized or structural iliac graft). Allograft and local graft preparation are not separately billable. Document graft source explicitly in the operative note.

05When should modifier 62 be used with 22600?

Modifier 62 applies when two surgeons of different specialties each perform distinct portions of the procedure and both independently document their intraoperative work. Both surgeons bill 22600-62 and each receives approximately 62.5% of the allowed amount. The operative notes must reflect each surgeon's distinct role — a shared generic note won't support the modifier.

06What global period applies to 22600, and what does that mean practically?

22600 has a 90-day global period. All routine post-op visits, wound checks, and stitch removals from the day before surgery through post-op day 90 are bundled into the procedure payment. Any E/M service for an unrelated condition in that window requires modifier 24. A return to the OR for a related complication requires modifier 78; an unrelated OR procedure requires modifier 79.

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 operative approach (posterior vs. posterolateral), the exact interspace fused (e.g., C4-C5), graft type and placement, confirmation that the level is below C2, and any add-on levels requiring 22614. That specificity prevents the two most common denial triggers: missing level documentation and wrong technique code selection.

See how Mira captures CPT 22600 documentation