2025 CPT code 22114
(Active) Effective Date: N/A Revision Date: N/A Surgery - Excision Procedures on the Spine (Vertebral Column) Surgical Procedures on the Musculoskeletal System Feed
Partial excision of a lumbar vertebral body for an intrinsic bony lesion, without spinal cord or nerve root decompression.
Modifiers 62 (two surgeons) and 51 (multiple procedures) are commonly used with this code, depending on the circumstances of the procedure.Other modifiers might be necessary depending on the specifics of each case.
The procedure must be medically necessary to treat a demonstrable intrinsic bony lesion in the lumbar vertebra. The lesion must be causing significant pain or impacting the patient’s mobility or function.The documentation should clearly justify the need for surgical intervention and why other less invasive treatment options are insufficient.
The surgeon is responsible for pre-operative preparation, making an incision, dissecting to the bone, removing the diseased portion of the vertebra, irrigating the wound, and closing the incision.Anesthesia and any assistance are typically billed separately.
- Surgical Procedures on the Musculoskeletal System
- Surgical Procedures on the Musculoskeletal System > Surgical Procedures on the Spine (Vertebral Column) > Excision Procedures on the Spine (Vertebral Column)
In simple words: This code describes surgery to remove a damaged part of one of the bones in your lower back (a lumbar vertebra).The surgery only removes the damaged part of the bone itself, and doesn't involve relieving pressure on the spinal cord or nerves.
This CPT code encompasses the partial surgical removal of a portion of the vertebral body of a single lumbar vertebra.The procedure is indicated for the treatment of an intrinsic bony lesion within the vertebral body. It specifically excludes decompression of the spinal cord or any nerve roots. The surgeon makes an incision over the affected vertebra, dissects to the bone, removes the diseased or damaged portion of the vertebral body, and closes the incision in layers.The size of the excision is determined by the extent of the lesion.
Example 1: A 60-year-old patient presents with a vertebral compression fracture in the L3 vertebra due to osteoporosis. A partial excision of the L3 vertebral body is performed to remove the compressed portion, stabilize the vertebra, and reduce pain. , A 45-year-old patient has a benign bone tumor in the L4 vertebra. A partial excision is performed to remove the tumor and preserve as much healthy bone as possible. , A patient suffers from a burst fracture in L1.Partial excision of the vertebral body is performed to remove bone fragments impinging on the spinal canal, followed by stabilization with instrumentation (coded separately).
Preoperative imaging (X-ray, CT scan, MRI) demonstrating the lesion, operative report detailing the extent of the excision, and postoperative imaging to confirm the success of the procedure. Pathology report if a tissue sample was taken.Any relevant anesthesia records.
** Always refer to the most current CPT manual and payer-specific guidelines for accurate coding and reimbursement.The clinical documentation must support the medical necessity and justify the use of this code.
- Revenue Code: P3D (MAJOR PROCEDURE, ORTHOPEDIC - OTHER)
- RVU: Information on RVUs is not provided in the source.Consult the CMS Physician Fee Schedule for current RVU values.
- Global Days: The global period for this procedure would need to be determined based on payer-specific guidelines and the specific surgical setting.
- Payment Status: Active (Medicare reimbursement varies based on medical necessity and adherence to guidelines. Consult the MPFS and LCDs.)
- Modifier TC rule: A TC modifier would not be applicable to this code since it describes the complete procedure.
- Fee Schedule: Historical fee schedule data for this code isn't readily available in the provided text. Consult payer-specific fee schedules and historical data for reimbursement information.
- Specialties:Orthopedic Surgery, Neurosurgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center, Outpatient Hospital