2025 CPT code 22867
(Active) Effective Date: N/A Revision Date: N/A Surgery - Spinal Instrumentation Procedures Musculoskeletal System Feed
Insertion of interlaminar/interspinous process stabilization/distraction device, with open decompression, lumbar spine; single level.
Modifiers 22 (increased procedural services), 50 (bilateral procedure), 51 (multiple procedures), and 62 (two surgeons) may be applicable depending on the circumstances of the case.
Medical necessity for 22867 is established by documentation of symptomatic lumbar spinal stenosis causing significant neurogenic claudication or radiculopathy refractory to conservative management.Imaging evidence of stenosis should be present.
The surgeon performs an open surgical approach, dissects through tissue layers,elevates and retracts muscles, preserves the supraspinous ligament, and may use image guidance to confirm the stenosis level.The surgeon assesses the space to determine the correct implant size, inserts the device (interlaminar or interspinous), and locks it in place. Hemostasis is achieved, tissues are closed, and a sterile dressing applied.
- Musculoskeletal System
- Surgical Procedures on the Spine (Vertebral Column) > Spinal Instrumentation Procedures
In simple words: The doctor inserts a device into the lower back to relieve pressure on nerves and improve stability. This involves an open surgical approach with decompression and does not permanently join the vertebrae.
This CPT code describes the open surgical insertion of an interlaminar or interspinous process stabilization/distraction device in a single lumbar vertebral level.The procedure involves open decompression to relieve pressure on the nerve roots, followed by placement of the device to stabilize the spine and/or distract the neural foramina. Image guidance may be used.Fusion of the vertebrae is not performed.
Example 1: A 60-year-old patient presents with lumbar spinal stenosis at L4-L5, causing significant leg pain and weakness.An open decompression and insertion of an interlaminar stabilization device at L4-L5 is performed using 22867., A 55-year-old patient with degenerative disc disease and spinal stenosis undergoes a laminectomy and foraminotomy at L3-L4 followed by the placement of an interspinous distraction device using code 22867., A 70-year-old patient with severe lumbar spinal stenosis and instability at L4-L5 requires a bilateral laminectomy, with insertion of an interlaminar device (22867) and application of modifier 50 (bilateral procedure).
Preoperative imaging (MRI, CT), operative report detailing the surgical approach, decompression techniques used, type and location of the implanted device, and postoperative imaging to confirm placement.Details regarding any intraoperative complications or significant blood loss should be documented.
** This code is specific to open decompression with device placement.If a percutaneous approach is used, a different code should be reported.Always verify payer-specific coverage policies and local coding guidelines for accurate billing practices.