2025 CPT code 22634
(Active) Effective Date: N/A Revision Date: N/A Surgery - Spine Surgery Musculoskeletal System Feed
Add-on code for lumbar arthrodesis; each additional interspace.
Modifiers 51 (multiple procedures) and 62 (two surgeons) may be applicable.Modifier 51 is used when multiple procedures are performed during the same session; 62 is used when two surgeons perform distinct parts of the same procedure.
Medical necessity is established through pre-operative imaging and clinical findings demonstrating instability and/or significant pain and/or neurological compromise related to degenerative disc disease, spondylolisthesis, trauma, or other spinal pathology.The fusion procedure is medically necessary to alleviate pain, improve stability, and prevent further neurological deterioration.
The surgeon visualizes the lumbar spine, incises, exposes transverse processes and facet joints, removes diseased tissues, performs laminectomy and/or discectomy, applies bone graft, and uses internal fixation devices.Drainage and wound closure are also part of the procedure.
- Musculoskeletal System
- Musculoskeletal System > Surgical Procedures on the Musculoskeletal System > Spine Surgery
In simple words: This code is for an additional spinal fusion in the lower back.It's added to the bill only if the doctor already fused one part of the lower spine and needs to fuse another nearby part during the same operation.The doctor joins the bones together permanently to ease pain and prevent further damage.
This CPT code 22634 represents an add-on procedure for lumbar spinal arthrodesis (fusion) using a combined posterior or posterolateral technique with a posterior interbody approach.It includes laminectomy and/or discectomy to prepare the interspace (excluding decompression alone). This code is reported in addition to the primary procedure code (22633 for the initial interspace) and is billed for each additional interspace and segment involved. Decompression performed on the same vertebral segment(s) and/or interspace(s) might necessitate separate reporting using codes 63052 and 63053.The procedure involves accessing the operative site through a combination of approaches, removing diseased cartilage and tissue, and applying bone graft material.Internal fixation devices might also be used.
Example 1: A patient presents with multilevel degenerative disc disease in the lumbar spine (L3-L5).The surgeon performs a posterior lumbar interbody fusion (PLIF) at L4-L5, which requires an initial arthrodesis (22633). During this initial procedure, the surgeon identifies the need for fusion at L3-L4 as well.Code 22634 is added for this additional level., A patient with spondylolisthesis at L4-L5 and L5-S1 undergoes posterior lumbar fusion with pedicle screw instrumentation.The surgeon utilizes a combined posterior and posterior lateral approach. The primary arthrodesis is coded as 22633, and 22634 is used to bill for the second additional interspace/segment fused during the same operative session., A patient with a traumatic fracture-dislocation requiring surgical intervention undergoes open reduction and internal fixation of a lumbar vertebra.During surgery, the surgeon finds unstable segments requiring a posterior lumbar interbody fusion. The primary code represents the open reduction and internal fixation.Code 22634 will be reported for each additional segment fused.
Detailed operative report specifying the surgical approach, levels fused, type of bone graft used (autologous, allograft), instrumentation details (type and number of screws, rods, cages), and intraoperative findings.Pre-operative imaging (X-rays, MRI) demonstrating the need for fusion.
** Bone graft procedures (20930-20938) are reported separately if not inherent to the primary procedure.Instrumentation codes (22840-22855, 22859) may also be separately reportable.
- Revenue Code: P3D (MAJOR PROCEDURE, ORTHOPEDIC - OTHER)
- Payment Status: Active
- Specialties:Orthopedic Surgery, Neurosurgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center