CPT® Coding Examples for

Common Spine Procedures

This list presents Current Procedural Terminology (CPT®) coding examples for common spine procedures.
CERVICAL
Anterior Cervical Discectomy with Interbody Fusion (ACDF)
Procedure Description Code Modifier Comments
Anterior interbody fusion, with discectomy and decompression;
cervical below C2 22551 1st interspace
cervical below C2, each additional interspace 22552 apply 59 modifier for 3+ interspace(s)
Insertion of interbody biomechanical device (e.g., cages)
To intervertebral disc space in conjunction with interbody fusion 22853 1st interspace, if applicable
22853 59 each additional interspace
Anterior instrumentation (select applicable code)
(Do not report when anterior instrumentation is considered integral 22845 2-3 vertebral segments
to an interbody device and for the purpose of device anchoring 22846 4-7 vertebral segments
(e.g., screws, flanges) 22847 8+ vertebral segments
Application of bone graft (select applicable code)
Allograft, morselized, or placement of osteopromotive material 20930
Allograft, structural 20931
Autograft, local 20936
Autograft, morselized 20937
Autograft, structural 20938

Anterior Cervical Fusion without Decompression

Procedure Description Code Modifier Comments
Arthrodesis, anterior interbody technique, including minimal discectomy
to prepare interspace (other than for decompression); cervical below C2 22554 1st interspace
each additional interspace 22585 apply 59 modifier for 3+ interspace(s)
Insertion of interbody biomechanical device (e.g., cages) 22853 1st interspace, if applicable
To intervertebral disc space in conjunction with interbody fusion 22853 59 each additional interspace
Anterior instrumentation (select applicable code)
(Do not report when anterior instrumentation is considered integral 22845 2-3 vertebral segments
to an interbody device and for the purpose of device anchoring 22846 4-7 vertebral segments
(e.g., screws, flanges) 22847 8+ vertebral segments
Application of bone graft (select applicable code)
Allograft, morselized, or placement of osteopromotive material 20930
Allograft, structural 20931
Autograft, local 20936
Autograft, morselized 20937
Autograft, structural 20938

Cervical Arthroplasty/Cervical Disc Replacement

Procedure Description Code Modifier Comments
Total disc arthroplasty (artificial disc), anterior approach, including
discectomy with end plate preparation (includes osteophytectomy
for nerve root or spinal cord decompression and microdissection);
single interspace, cervical 22856 1st interspace
second level, cervical 22858 2nd interspace
Posterior Craniocervical Fusion
Procedure Description Code Modifier Comments
Arthrodesis, posterior technique, craniocervical (occiput-C2) 22590 Occiput – C2
Arthrodesis, posterior or posterolateral technique, single level;
cervical below C2 segment 22600 51 1st segment below C2
each additional vertebral segment 22614 apply 59 modifier for 3+ vertebral segment(s)
Posterior instrumentation (select applicable code)
Posterior non-segmental instrumentation 22840
Internal spinal fixation by wiring of spinous processes 22841
Posterior segmental instrumentation; 3-6 vertebral segments 22842 3 to 6 vertebral segments
Posterior segmental instrumentation; 7-12 vertebral segments 22843 7 to 12 vertebral segments
Posterior segmental instrumentation; 13 or more vertebral segments 22844 13+ vertebral segments
Application of bone graft (select applicable code)
Allograft, morselized, or placement of osteopromotive material 20930
Allograft, structural 20931
Autograft, local 20936
Autograft, morselized 20937
Autograft, structural 20938

Cervical Laminoplasty
Procedure Description Code Modifier Comments
(select applicable code)
Laminoplasty, cervical, with decompression of the spinal cord, 2 or more
vertebral segments; 63050 2 or more vertebral segments
with reconstruction of the posterior bony elements (including the
application of bridging bone graft and non-segmental fixation devices
[eg, wire, suture, mini-plates], when performed) 63051

LUMBAR
Anterior Lumbar Interbody Fusion (ALIF)
Procedure Description Code Modifier Comments
Arthrodesis, anterior interbody technique, including minimal discectomy
to prepare interspace (other than for decompression); lumbar 22558 1st interspace
each additional interspace 22585 apply 59 modifier for 3+ interspace(s)
Insertion of interbody biomechanical device (e.g., cages) 22853 1st interspace, if applicable
to intervertebral disc space in conjunction with interbody fusion 22853 59 each additional interspace
Anterior instrumentation (select applicable code)
(Do not report when anterior instrumentation is considered integral 22845 2-3 vertebral segments
to an interbody device and for the purpose of device anchoring 22846 4-7 vertebral segments
(e.g., screws, flanges) 22847 8+ vertebral segments
Application of bone graft (select applicable code)
Allograft, morselized, or placement of osteopromotive material 20930
Allograft, structural 20931
Autograft, local 20936
Autograft, morselized 20937
Autograft, structural 20938
Lateral Lumbar Interbody Fusion (LLIF) (aka: DLIF, XLIF, transpsoas interbody)
Procedure Description Code Modifier Comments
Arthrodesis, anterior interbody technique, including minimal discectomy
to prepare interspace (other than for decompression); lumbar 22558 1st interspace
each additional interspace 22585 apply 59 modifier for 3+ interspace(s)
Insertion of interbody biomechanical device (e.g., cages) 22853 1st interspace, if applicable
to intervertebral disc space in conjunction with interbody fusion 22853 59 each additional interspace
Anterior instrumentation (select applicable code)
(Do not report when anterior instrumentation is considered integral 22845 2-3 vertebral segments
to an interbody device and for the purpose of device anchoring 22846 4-7 vertebral segments
(e.g., screws, flanges) 22847 8+ vertebral segments
Application of bone graft (select applicable code)
Allograft, morselized, or placement of osteopromotive material 20930
Allograft, structural 20931
Autograft, local 20936
Autograft, morselized 20937
Autograft, structural 20938

ALIF/LLIF and Posterolateral Fusion

Procedure Description Code Modifier Comments
Arthrodesis, posterior or posterolateral technique, single level; lumbar
(with lateral transverse technique, when performed) 22612 1st interspace
each additional vertebral segment 22614 apply 59 modifier for 3+ vertebral segment(s)
Arthrodesis, anterior interbody technique, including minimal discectomy
to prepare interspace (other than for decompression); lumbar 22558 51 1st interspace
each additional interspace 22585 apply 59 modifier for 3+ interspace(s)
Insertion of interbody biomechanical device (e.g., cages) 22853 1st interspace, if applicable
to intervertebral disc space in conjunction with interbody fusion 22853 59 each additional interspace
Posterior instrumentation (select applicable code)
Posterior non-segmental instrumentation 22840
Internal spinal fixation by wiring of spinous processes 22841
Posterior segmental instrumentation; 3-6 vertebral segments 22842 3 to 6 vertebral segments
Posterior segmental instrumentation; 7-12 vertebral segments 22843 7 to 12 vertebral segments
Posterior segmental instrumentation; 13 or more vertebral segments 22844 13+ vertebral segments
Application of bone graft (select applicable code)
Allograft, morselized, or placement of osteopromotive material 20930
Allograft, structural 20931
Autograft, local 20936
Autograft, morselized 20937
Autograft, structural 20938

Posterolateral Fusion (PLF) with Posterior Instrumentation

Procedure Description Code Modifier Comments
Arthrodesis, posterior or posterolateral technique, single level; lumbar
(with lateral transverse technique, when performed) 22612 1st interspace
each additional vertebral segment 22614 apply 59 modifier for 3+ vertebral segment(s)
Posterior instrumentation (select applicable code)
Posterior non-segmental instrumentation 22840
Internal spinal fixation by wiring of spinous processes 22841
Posterior segmental instrumentation; 3-6 vertebral segments 22842 3 to 6 vertebral segments
Posterior segmental instrumentation; 7-12 vertebral segments 22843 7 to 12 vertebral segments
Posterior segmental instrumentation; 13 or more vertebral segments 22844 13+ vertebral segments
Application of bone graft (select applicable code)
Allograft, morselized, or placement of osteopromotive material 20930
Allograft, structural 20931
Autograft, local 20936
Autograft, morselized 20937
Autograft, structural 20938
 Posterior Lumbar Interbody Fusion (PLIF)/Transforaminal Lumbar Interbody Fusion (TLIF) with Posterior Instrumentation
Procedure Description Code Modifier Comments
Arthrodesis, posterior interbody technique, including laminectomy and/or
discectomy to prepare interspace (other than for decompression), single
interspace; lumbar 22630 1st interspace
each additional interspace 22632 apply 59 modifier for 3+ interspace(s)
Report applicable code if decompression is performed:
Laminotomy (hemilaminectomy), with decompression of nerve root(s);
1 interspace, lumbar 63030 51, 59 1st interspace
each additional interspace 63035 apply 59 modifier for 3+ interspace(s)
Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with
decompression of spinal cord, cauda equina and/or nerve root[s], single
vertebral segment; lumbar 63047 51, 59 1st vertebral segment
each additional segment 63048 apply 59 modifier for 3+ vertebral segment(s)
Insertion of interbody biomechanical device (e.g., cages) 22853 1st interspace, if applicable
to intervertebral disc space in conjunction with interbody fusion 22853 59 each additional interspace
Posterior instrumentation (select applicable code)
Posterior non-segmental instrumentation 22840
Internal spinal fixation by wiring of spinous processes 22841
Posterior segmental instrumentation; 3-6 vertebral segments 22842 3 to 6 vertebral segments
Posterior segmental instrumentation; 7-12 vertebral segments 22843 7 to 12 vertebral segments
Posterior segmental instrumentation; 13 or more vertebral segments 22844 13+ vertebral segments
Application of bone graft (select applicable code)
Allograft, morselized, or placement of osteopromotive material 20930
Allograft, structural 20931
Autograft, local 20936
Autograft, morselized 20937
Autograft, structural 20938
NOTE: CPT codes 63030 and 63047 are bundled per National Correct Coding Initiative (NCCI) edits with code 22630. CPT ® Assistant (January 2001, page 12) states that these codes
can be reported in addition to the fusion code if performed for decompression (apply modifier -59 to the decompression code).

PLIF/TLIF with Posterolateral Fusion and Instrumentation

Procedure Description Code Modifier Comments
Arthrodesis, combined posterior or posterolateral technique with posterior
interbody technique including laminectomy and/or discectomy sufficient
to prepare interspace (other than for decompression), single interspace
and segment; lumbar 22633 1st interspace and segment
each additional interspace and segment 22634 apply 59 modifier for 3+ interspace(s)
and segments(s)
Report applicable code if decompression is performed:
Laminotomy (hemilaminectomy), with decompression of nerve root(s);
1 interspace, lumbar 63030 51, 59 1st interspace
each additional interspace 63035 apply 59 modifier for 3+ interspace(s)
Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with
decompression of spinal cord, cauda equina and/or nerve root[s], single
vertebral segment; lumbar 63047 51, 59 1st vertebral segment
each additional segment 63048 apply 59 modifier for 3+ vertebral segment(s)
Insertion of interbody biomechanical device (e.g., cages) 22853 1st interspace, if applicable
to intervertebral disc space in conjunction with interbody fusion 22853 59 each additional interspace
Posterior instrumentation (select applicable code)
Posterior non-segmental instrumentation 22840
Internal spinal fixation by wiring of spinous processes 22841
Posterior segmental instrumentation; 3-6 vertebral segments 22842 3 to 6 vertebral segments
Posterior segmental instrumentation; 7-12 vertebral segments 22843 7 to 12 vertebral segments
Posterior segmental instrumentation; 13 or more vertebral segments 22844 13+ vertebral segments
Application of bone graft (select applicable code)
Allograft, morselized, or placement of osteopromotive material 20930
Allograft, structural 20931
Autograft, local 20936
Autograft, morselized 20937
Autograft, structural 20938
NOTE: CPT codes 63030 and 63047 are bundled per National Correct Coding Initiative (NCCI) edits with code 22633. CPT ® Assistant (January 2001, page 12) states that these codes
can be reported in addition to the fusion code if performed for decompression (apply modifier -59 to the decompression code).
 Discectomy, Lumbar
Procedure Description Code Modifier Comments
Laminotomy (hemilaminectomy), with decompression of nerve root(s),
including partial facetectomy, foraminotomy and/or excision of herniated
intervertebral disc; 1 interspace, lumbar 63030 1st interspace
each additional interspace 63035 apply 59 modifier for 3+ interspace(s)
NOTE: If procedure is performed bilaterally, report modifier 50.

Laminotomy/Laminectomy, Lumbar
Procedure Description Code Modifier Comments
Laminectomy with exploration and/or decompression of spinal cord
and/or cauda equina, without facetectomy, foraminotomy or discectomy
(eg, spinal stenosis),
1 or 2 vertebral segments; lumbar, except for spondylolisthesis 63005 1st or 2nd vertebral segments
more than 2 vertebral segments; lumbar 63017 more than 2 vertebral segments
Laminectomy with removal of abnormal facets and/or pars inter-articularis
with decompression of cauda equina and nerve roots for spondylolisthesis,
lumbar (Gill type procedure) 63012 Gill type procedure
Laminotomy (hemilaminectomy), with decompression of nerve root(s),
including partial facetectomy, foraminotomy and/or excision of herniated
intervertebral disc; 1 interspace, lumbar 63030 1st interspace
each additional interspace 63035 apply 59 modifier for 3+ interspace(s)
Laminotomy (hemilaminectomy), with decompression of nerve root(s),
including partial facetectomy, foraminotomy and/or excision of herniated
intervertebral disc, reexploration, single interspace; lumbar 63042 1st interspace
each additional lumbar interspace 63044 apply 59 modifier for 3+ interspace(s)
Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with
decompression of spinal cord, cauda equina and/or nerve root[s], single
vertebral segment; lumbar 63047 1st vertebral segment
each additional segment 63048 apply 59 modifier for 3+ vertebral segment(s)

Interlaminar/Interspinous Process Device Insertion

Procedure Description Code Modifier Comments
Insertion of interlaminar/interspinous process stabilization/distraction
device, without fusion, including image guidance when performed, with
open decompression, lumbar; single level 22867 1st level
second level 22868 2nd level

Insertion of interlaminar/interspinous process stabilization/distraction

device, without open decompression or fusion, including image guidance
when performed, lumbar; single level 22869 1st level
second level 22870 2nd level

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or [email protected], or visit our reimbursement web site at zimmerbiomet.com/reimbursement.

Current Procedural Terminology (CPT ®) copyright 2017 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

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The information in this document was obtained from third party sources and is subject to change without notice, including as a result in changes in reimbursement laws, regulations, rules and
policies. All content in this document is informational only, general in nature and does not cover all situations or all payers’ rules or policies. The service and the product must be reasonable and
necessary for the care of the patient to support reimbursement. Providers should report the procedure and related codes that most accurately describe the patients’ medical condition, procedures
performed and the products used. This document represents no promise or guarantee by Zimmer Biomet regarding coverage or payment for products or procedures by Medicare or other payers.
Providers should check Medicare bulletins, manuals, program memoranda, and Medicare guidelines to ensure compliance with Medicare requirements. Inquiries can be directed to the provider’s
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