2025 CPT code 22836
(New) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Surgical Procedures on the Musculoskeletal System Musculoskeletal System Feed
Anterior thoracic vertebral body tethering; up to 7 vertebral segments.
Modifiers 51 (multiple procedures), 62 (two surgeons), and possibly others as indicated by the specific circumstances of the procedure, may be appended to code 22836.
Medical necessity for vertebral body tethering is typically established based on the severity of the scoliosis curve (generally greater than 40 degrees), the patient's age and skeletal maturity, and the potential for curve progression.Specific payer guidelines should be consulted to determine medical necessity criteria.
The surgeon accesses the anterior thoracic spine, typically through a small incision or thoracoscopic approach. Screws are inserted into the vertebral bodies, and a flexible cable is used to connect them and apply controlled compression to correct the scoliosis. The surgeon closes the incision after the procedure.
In simple words: This surgery uses screws and a flexible cable to straighten the spine in children with scoliosis (curvature of the spine). Screws are placed in the front of the middle back bones, connected by a cable that puts gentle pressure on the bones to correct the curve gradually as the child grows.
Anterior thoracic vertebral body tethering, including thoracoscopy when performed, for up to seven vertebral segments. This procedure involves the placement of screws into the anterior thoracic vertebrae, connecting them with a flexible cable to correct spinal curvature (scoliosis).The technique involves accessing the anterior thoracic spine, inserting screws at each target vertebral level, connecting them with a strong cord, and applying tension to partially straighten the spine. Growth is inhibited on the tethered side while allowing continued growth on the other side, potentially correcting scoliosis over time.
Example 1: A 12-year-old female patient presents with adolescent idiopathic scoliosis (AIS) with a thoracic curve measuring 40 degrees.The patient is a candidate for vertebral body tethering, and the surgeon performs an anterior thoracic tethering using code 22836, involving 5 vertebral segments., A 14-year-old male patient with AIS has a thoracic curve of 55 degrees.The surgeon performs an anterior thoracic vertebral body tethering, including thoracoscopy, involving seven vertebral segments. Code 22836 is used to report this procedure., A 13-year-old patient with AIS requires anterior thoracic vertebral body tethering for a curve affecting six segments.The procedure is performed using a minimally invasive approach with the assistance of thoracoscopy.Code 22836 is reported.
** The use of thoracoscopy is included in the description of this code; however, if it's not used, the code still applies.
- Revenue Code: P3D (MAJOR PROCEDURE, ORTHOPEDIC - OTHER)
- RVU: RVUs are not provided in the source data.Consult the CMS Physician Fee Schedule for current RVU values and payment rates.
- Global Days: The global period for this procedure is not specified in the source data.Refer to the specific payer's guidelines for the applicable global period.
- Payment Status: Active
- Modifier TC rule: A Technical Component (TC) modifier is not typically applicable to this code, as the procedure is performed by the surgeon.
- Fee Schedule: Fee schedule data is not available from the source.Consult fee schedules from relevant payers.
- Specialties:Orthopedic Surgery, Pediatric Orthopedic Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center