Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.30
    OpenPayerBilling CodesExcision Procedures on the Spine (Vertebral Column)CPT cpt-22100-cervical-vertebral-posterior-excision-bony-lesion
    Ask Trek AI about this page

    CPT 22100: Partial Excision of Posterior Cervical Vertebra for Bony Lesion

    Medicare pays $1006 on average nationally for this procedure.

    CPT code 22100 describes a partial excision of the posterior element of a single cervical vertebra to remove a bony lesion within that vertebra; this surgical service is a cervical laminectomy/laminotomy for lesion removal typically provided as an inpatient or outpatient surgical procedure in an operating room or specialized spine surgery suite and involves removal of bone to access and excise the diseased area within a single cervical vertebral body.

    For related coverage guidance, see recent payer policy updates: Clinical Review Criteria Intraoperative Neurophysiological Monitoring (IONM), Remote Electrical Neuromodulation for Migraines (i.e., Nerivio®), Lumbar Microdiscectomy.

    Customize your policy alerts

    Sign up for cpt 22100 policy alerts

    Get alerted when payer policies referencing 22100 are released or updated.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Table of contents

    Progress1 / 6

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • Facility ComparisonBeds, revenue & payer mix
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Clinical & Coding Specifications

    Clinical Context

    A typical patient is a middle-aged or older adult presenting with localized neck pain, focal cervical spine tenderness, or neurologic symptoms (radiculopathy or myelopathy) attributable to a solitary bony lesion of a single cervical vertebra. Imaging (cervical spine radiographs, CT, and MRI) demonstrates an isolated lytic or sclerotic lesion confined to the posterior elements of one cervical vertebra (lamina or spinous process) suspicious for a benign tumor, bone cyst, metastatic deposit, or osteomyelitic focus. The surgical team—commonly an orthopedic spine surgeon or neurosurgeon—performs a posterior cervical approach under general anesthesia in an operating room. Intraoperative neuromonitoring and fluoroscopy or CT navigation may be used. The provider excises the diseased portion of the posterior vertebral element (laminectomy or partial excision of the lamina/spinous process) to remove the lesion while preserving spinal stability; bone specimens are sent for pathology and microbiology as indicated. Postoperative care includes pain control, wound management, possible cervical immobilization, and follow-up imaging. Typical site of service is an inpatient or outpatient hospital operating room depending on extent of surgery and patient comorbidity.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    20610Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., shoulder, hip, knee, subacromial bursa)May be used preoperatively for diagnostic aspiration of a nearby soft-tissue collection if clinically indicated.
    20930Allograft, morselized, or placement of osteopromotive material into spine defects (separate procedure)May be used to fill a defect after excision if bone grafting is needed to support structural integrity.
    22010Excision of posterior elements, single vertebra, thoracic (laminectomy, etc.)Related anatomic procedure for another spinal region; coding reference when documenting similar techniques in other regions.
    22840Posterior non-segmental instrumentation (e.g., wiring, cables)May be performed if additional stabilization is required after resection of posterior elements.
    76000Fluoroscopy (first image)Intraoperative fluoroscopic imaging is commonly used and may be billed for imaging guidance when not included in facility imaging.
    64999Unlisted procedure, nervous systemUse only when an unusual or atypical excision falls outside existing codes; however 22100 is specific for posterior cervical bony lesion excision.

    Related Modifiers

    10 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    2084P0800X
    207K00000X
    363L00000X
    163W00000X
    372500000X
    320600000X
    152WS0006X
    332BX2000X

    Related Payer Policy Updates

    Specialty: Neurology/Neurosurgery1 / 3

    10 rows

    PolicyPayerEffective Date
    Clinical Review Criteria Intraoperative Neurophysiological Monitoring (IONM)Kaiser Permanente2027-01-01
    Remote Electrical Neuromodulation for Migraines (i.e., Nerivio®)bcbsvermont2026-11-01
    Lumbar Microdiscectomyuniverahealthcare2026-10-15
    Artificial Cervical Intervertebral Discuniverahealthcare2026-10-15
    Lumbar Decompressionuniverahealthcare2026-10-15
    Responsive Neurostimulation for Focal EpilepsyPremera Bluecross2026-10-14
    Intraoperative MonitoringProvidence Health Plan2026-10-01
    Intraoperative MonitoringProvidence Health Plan2026-10-01
    High-Intensity Focused UltrasoundMass General Brigham Health Plan2026-10-01
    Vagal Nerve StimulationAmbetter Nevada2026-10-01

    Related Codes

    CPT-22101-THORACIC-VERTEBRAL-POSTERIOR-EXCISION-BONY-LESION

    CPT 22101: Excision of Posterior Thoracic Vertebral Bony Lesion

    CPT-22102-LUMBAR-VERTEBRAL-BONY-LESION-EXCISION

    CPT 22102: Excision of Lumbar Vertebral Bony Lesion

    CPT-22103-EXCISION-POSTERIOR-VERTEBRAL-BONY-LESION

    CPT 22103: Excision of Posterior Vertebral Element for Bony Lesion

    CPT-22110-CERVICAL-VERTEBRAL-BODY-EXCISION-SINGLE-LEVEL

    CPT 22110: Excision of Portions of Cervical Vertebral Body

    CPT-22112-THORACIC-VERTEBRAL-BODY-RESECTION

    CPT 22112: Excision of Thoracic Vertebral Body, Single Level

    CPT-22114-LUMBAR-VERTEBRAL-BODY-EXCISION

    CPT 22114: Excision of Portions of a Single Lumbar Vertebral Body

    CPT-22116-VERTEBRAL-BODY-EXCISION-SINGLE-VERTEBRA

    CPT 22116: Vertebral Body Excision, Single Vertebra

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
    Published by

    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.