2025 CPT code 22630
(Active) Effective Date: N/A Revision Date: N/A Surgery - Arthrodesis Musculoskeletal System Feed
Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; lumbar.
Modifiers such as 51 (multiple procedures), 59 (distinct procedural service), and 76 (repeat procedure by the same physician) may be applicable depending on the circumstances of the case.
Medical necessity for 22630 is established when a patient presents with chronic, disabling low back pain and/or instability caused by degenerative disc disease, spondylolisthesis, or other conditions that compromise spinal integrity.The fusion must be determined medically necessary to alleviate pain and improve function.
The surgeon performs the posterior approach to the lumbar spine,excising the lamina and/or intervertebral disc to prepare the area for fusion. Bone graft material is then inserted, and the area is closed. The surgeon is responsible for pre-operative planning, intra-operative precision, and post-operative care.
- Musculoskeletal System
- Musculoskeletal System > Surgical Procedures on the Musculoskeletal System > Arthrodesis
In simple words: This code describes a surgery to fuse two vertebrae in your lower back.The surgeon removes some bone and disc material to make it easier to fuse the vertebrae, but this isn't done to relieve pressure on nerves. The surgery only covers one section of your lower back.
This CPT code, 22630, represents a surgical procedure involving lumbar spine arthrodesis (spinal fusion) using a posterior interbody technique.The procedure includes laminectomy and/or discectomy to prepare the interspace for fusion, but this preparation is specifically for fusion and not for decompression.The code applies to a single lumbar interspace.
Example 1: A 50-year-old patient with degenerative disc disease at L4-L5 presents with chronic low back pain.A posterior lumbar interbody fusion (PLIF) is performed using 22630 to address the pain by stabilizing the affected vertebrae., A 60-year-old patient experiences instability and pain in the L5-S1 region following a previous laminectomy.A PLIF is conducted using 22630 to enhance stability. The previous laminectomy is not coded separately, as the current procedure is not for decompression., A 45-year-old patient with spondylolisthesis at L4-L5 undergoes a posterior lumbar interbody fusion using 22630. The fusion is necessary to correct the vertebral misalignment and reduce pain.
* Preoperative imaging (X-rays, CT, MRI) showing the specific level of degeneration or instability.* Operative report detailing the surgical technique, including the specific level(s) fused, bone graft used, and any additional procedures performed.* Postoperative imaging to confirm fusion.* Patient's medical history and physical examination notes.
** This code should not be reported with code 22612 for the same interspace and segment.If decompression is also performed, appropriate decompression codes from the Nervous System section should be used.Ensure proper documentation supports the medical necessity of the procedure.Always verify payer-specific coverage and coding policies.
- Payment Status: Active
- Modifier TC rule: A technical component (TC) modifier would not generally apply to this code, as it encompasses the entire procedure.
- Specialties:Orthopedic Surgery, Neurosurgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center