Fusion · Spine

Anterior spinal arthrodesis for deformity correction spanning 4 to 7 vertebral segments, including minimal discectomy to prepare each interspace.

Verified May 8, 2026 · 7 sources ↓

Medicare: $1,795.97
Total RVUs: 53.77
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 7 cited references ↓

Specify the exact vertebral levels fused (e.g., T6–T12) — range must fall within 4 to 7 segments
Confirm anterior approach and document the surgical access technique by name (thoracotomy, retroperitoneal, transperitoneal, VATS, etc.)
Record that interspace preparation (minimal discectomy) was performed at each level
State the primary deformity diagnosis (scoliosis, kyphosis, flatback, etc.) with corresponding ICD-10 code
If co-surgeon is involved, each surgeon's operative note must document their distinct role and the work they personally performed
If staging a subsequent procedure, document intent for staged surgery in the initial operative note to support modifier 58

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 51 Multiple procedures 58 Staged or related 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 7 cited references ↓

CPT 22810 covers anterior interbody fusion performed to correct spinal deformity — scoliosis, kyphosis, or similar conditions — across 4 to 7 vertebral segments. The work includes the minimal discectomy required to prepare each interspace before graft or implant placement. This is a high-intensity procedure carrying a 90-day global period and among the highest RVU values in the spine surgery family.

The anterior approach frequently involves a second surgeon — a general or vascular surgeon — to perform the approach and closure. When two surgeons each perform a distinct portion of the procedure, both bill 22810 with modifier 62. The co-surgeon billing only instrumentation codes is wrong; each surgeon reports only the work they personally performed. Both surgeons' operative notes must independently document their distinct roles.

Staged deformity correction is common. If a posterior procedure is planned at a separate session, document that intent in the initial operative note and use modifier 58 on the subsequent claim — this resets the global period clock. For an unplanned return to the OR for a related complication, use modifier 78. For an unrelated procedure during the global, use modifier 79.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	30.71
Practice expense RVU	16.51
Malpractice RVU	6.55
Total RVU	53.77
Medicare national rate	$1,795.97
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	$1,795.97
HOPD (APC 5116) Hospital outpatient department	$17,913.59
ASC (PI J8) Ambulatory surgical center (freestanding)	$13,933.19

Common denial reasons

The recurring reasons claims for CPT 22810 get rejected.

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

Segment count mismatch between operative note and claim — 22808 covers 2–3 segments, 22810 covers 4–7; using the wrong code triggers automatic denial
Co-surgeon claims denied when both surgeons submit identical operative notes without distinct role documentation
Instrumentation codes denied when billed by the co-surgeon (approach/closure surgeon) rather than the primary spine surgeon
Claim denied for services rendered in the global period without appropriate modifier (24, 58, 78, or 79) to establish separate billable event
Missing or vague deformity diagnosis — payers require a documented spinal deformity indication, not just 'spinal stenosis' or 'back pain'

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 7 cited references ↓

01What is the difference between 22808 and 22810?

Segment count. CPT 22808 is for anterior deformity arthrodesis covering 2 to 3 vertebral segments. CPT 22810 covers 4 to 7 segments. Count the segments fused, not the interspaces, and select accordingly. Billing 22810 when only 3 segments were fused is a common audit flag.

02How does modifier 62 work when a general surgeon performs the approach?

Both the spine surgeon and the access surgeon bill 22810 with modifier 62. Each surgeon submits their own claim with their own operative note documenting their distinct work. The access surgeon does not bill the instrumentation codes — those belong to the spine surgeon. Payers split the allowed amount between the two co-surgeons.

03If a posterior fusion is planned as a second stage, how do I bill the follow-up procedure during the global period?

Use modifier 58 on the second procedure's claim. Document the staging intent in the first operative note. Modifier 58 resets the global period clock from the date of the second surgery. Do not use modifier 78 for a planned staged procedure — modifier 78 is for unplanned returns to the OR for a related complication.

04Is modifier 22 ever appropriate for 22810?

Yes, when the procedure is substantially more work than typical — severe rigid deformity, high blood loss, significantly prolonged operative time, or unusual patient complexity. Document the specific factors in the operative note. Modifier 22 without supporting documentation will be ignored or trigger a request for records.

05Can 22810 be billed with posterior fusion codes on the same date?

Anterior and posterior fusions performed at the same session can both be reported. NCCI edits and payer policies vary on which code pairs require modifier 59 to bypass bundling. Check current NCCI PTP edits for the specific combination before submitting. Document each approach separately in the operative note.

06What global period applies to 22810 and what does it cover?

The global period is 90 days. It includes the day before surgery, the day of surgery, and all routine post-op care through day 90. E/M visits during that window for the surgery itself are not separately billable. Unrelated visits need modifier 24; a separate significant procedure on the same day as the surgery needs modifier 25 on the E/M.

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 exact vertebral levels treated, the anterior approach technique, confirmation of interspace preparation at each level, and the deformity diagnosis from dictation. For co-surgeon cases, it flags whether distinct role language is present in each surgeon's note. This prevents the two most common denials for 22810: segment count mismatches that trigger the wrong code, and co-surgeon rejections caused by duplicate or undifferentiated operative documentation.

See how Mira captures CPT 22810 documentation