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    v1.0.30
    OpenPayerBilling CodesOsteotomy Procedures on the Spine (Vertebral Column)CPT cpt-22222-thoracic-vertebral-osteotomy-disk-excision
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    CPT 22222: Thoracic Vertebral Osteotomy with Disk Excision

    Medicare pays $1783 on average nationally for this procedure.

    CPT code 22222 describes a surgical procedure in which the provider performs an osteotomy of a thoracic vertebra with excision of adjacent disc material to correct an abnormal curvature of the upper spine; this is a spine reconstructive surgery (thoracic vertebral osteotomy with disk excision) typically performed as an inpatient operative procedure in an operating room setting under general anesthesia.

    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.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adolescent or young adult presenting with progressive thoracic spinal curvature (kyphoscoliosis) causing pain, pulmonary compromise, or cosmetic concern refractory to conservative management. The patient has undergone full preoperative evaluation including standing scoliosis radiographs, MRI to assess neural elements and disk pathology, pulmonary function testing, and routine pre-anesthesia assessment. The surgical plan is a thoracic posterior or anterior approach osteotomy and disk excision to correct spinal alignment; intraoperative neuromonitoring and fluoroscopy are employed. The workflow includes preoperative clearance, anesthesia induction, positioning in prone or lateral decubitus depending on approach, exposure of the affected vertebrae, performance of the osteotomy (incising and removing portions of the vertebral body and adjacent disk material), deformity correction with instrumentation and fusion as indicated, hemostasis, closure, and postoperative monitoring in PACU with planned inpatient admission for pain control, neurologic checks, and physical therapy initiation. Typical sites of service are the operating room within a hospital inpatient setting or an ambulatory surgery center when appropriate for limited procedures.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    22842Posterior segmental instrumentation (e.g., pedicle fixation), 3 to 6 vertebral segmentsOften used to instrument and stabilize the thoracic spine after osteotomy and deformity correction.
    22853Insertion of interbody biomechanical device(s) with posterior instrumentation, lumbar (single level) — (used conceptually for interbody support)May be performed if interbody support is required at an adjacent level during deformity correction.
    20680Removal of implanted device (deep)Performed if prior hardware is removed as part of the deformity correction surgery.
    22830Exploration of spinal fusion pseudarthrosis, thoracic, requiring instrumentation revisionRelevant when revision of prior thoracic fusion accompanies the osteotomy.
    95822Intraoperative neurophysiologic monitoring (limited)Used to monitor spinal cord function during complex thoracic osteotomy to reduce neurologic risk.

    Related Modifiers

    10 rows

    ModifierDescriptionWhen to Use
    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…
    63Modifier‑63 is appended to surgical CPT codes (20000–69990) when a procedure is performed on a neonate or infant weighing ≤ 4 kg (about 8.8 lbs). The AMA/AAPC definition specifies this use and notes…- Use modifier -63 only for surgical procedures in the CPT 20000–69990 series performed on a neonate or infant who weighs ≤ 4 kg at the time of the procedure; it indicates increased complexity due 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…
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
    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…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    2084P0800X
    207K00000X
    207L00000X
    333600000X
    363LG0600X
    133VN1101X
    2080H0002X
    111N00000X

    Related ICD-10-CM Codes

    22 rows

    ICD-10-CM CodeDescription
    M40.10Other secondary kyphosis, site unspecified
    M41.04Infantile idiopathic scoliosis, thoracic region
    M41.23Other idiopathic scoliosis, cervicothoracic region
    M41.24Other idiopathic scoliosis, thoracic region
    M41.43Neuromuscular scoliosis, cervicothoracic region
    M41.53Other secondary scoliosis, cervicothoracic region
    M41.9Scoliosis, unspecified
    M43.12Spondylolisthesis, cervical region
    M43.13Spondylolisthesis, cervicothoracic region
    M43.14Spondylolisthesis, thoracic region

    Showing 1–10 of 22

    Related Payer Policy Updates

    Specialty: Neurology/Neurosurgery1 / 2

    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-22206-THORACIC-VERTEBRAL-OSTEOTOMY-KYPHOSIS-CORRECTION

    CPT 22206: Thoracic Vertebral Three-Column Osteotomy for Kyphosis

    CPT-22207-LUMBAR-SPINAL-OSTEOTOMY-CORRECTION

    CPT 22207: Lumbar Vertebral Wedge Osteotomy

    CPT-22208-VERTEBRAL-OSTEOTOMY-WEDGE-RESECTION-SPINAL-ALIGNMENT

    CPT 22208: Spinal Osteotomy with Wedge Resection, Additional Segment

    CPT-22210-CERVICAL-SPINE-WEDGE-OSTEOTOMY

    CPT 22210: Cervical Vertebral Wedge Osteotomy

    CPT-22212-THORACIC-VERTEBRAL-OSTEOTOMY-POSTERIOR-APPROACH

    CPT 22212: Posterior Thoracic Vertebral Osteotomy

    CPT-22214-LUMBAR-VERTEBRAL-OSTEOTOMY-POSTERIOR-APPROACH

    CPT 22214: Lumbar Vertebral Osteotomy, Posterior/Posterolateral

    CPT-22216-CERVICAL-VERTEBRAL-OSTEOTOMY-ADDITIONAL-SEGMENT

    CPT 22216: Cervical Osteotomy, Additional Vertebral Segment

    CPT-22220-CERVICAL-SPINE-OSTEOTOMY-DISK-EXCISION

    CPT 22220: Cervical Vertebrectomy with Disk Excision for Spinal Deformity

    CPT-22224-LUMBAR-VERTEBRAL-OSTEOTOMY-SPINAL-DEFORMITY-CORRECTION

    CPT 22224: Lumbar Vertebral Osteotomy with Disk Excision

    CPT-22226-SPINAL-OSTEOTOMY-DISCECTOMY-ADDITIONAL-SEGMENT

    CPT 22226: Spinal Osteotomy with Disk Excision, Additional Segment

    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.
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