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CPT 22610: Thoracic Spinal Fusion (Posterior/Posterolateral Arthrodesis)
CPT code 22610 represents posterior or posterolateral arthrodesis (spinal fusion) of the thoracic spine, a definitive surgical intervention used to stabilize two thoracic vertebrae and relieve pain from degenerative disease, disc pathology, stenosis, or trauma. Nationally, thoracic spinal fusion is a relevant procedure for orthopaedic and neurosurgical practices and for payers managing high-cost surgical episodes.
This analysis addresses coverage and payment benchmarks for major national payers: Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, and how related codes are used for single-level and additional-segment reporting. The publication highlights common billing considerations and associated procedure relationships that affect claims handling and grouping for surgical spine care.
Readers will learn operationally useful information including where CPT code 22610 fits in spine surgery coding (primary single-level thoracic arthrodesis), common clinical indications, and which adjacent CPT codes are used for lumbar procedures and additional segments. The content is designed for coding professionals, revenue cycle leaders, and payers seeking a clear, national-level summary of the code’s clinical meaning and coding neighborhood. Data not available in the input.
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Billing Code Overview
CPT code 22610 describes arthrodesis (spinal fusion) of the thoracic spine, a surgical procedure that permanently joins two vertebrae in the upper back. The provider applies bone graft material to achieve fusion at the posterior elements, posterolateral gutters, or across the vertebral segment to stabilize the thoracic spine and reduce pain from degenerative conditions or injury.
Service type: Surgical — Spinal fusion (thoracic)
Typical site of service: Hospital inpatient or outpatient surgical center, depending on clinical indication and patient status.
National Reimbursement Benchmarks
Medicare's mean rate of $1,267.30 sits notably below BUCA’s average commercial mean of $4,305.90, highlighting a substantial gap between federal reimbursement and a commercial benchmark. That gap of $3,038.60 underscores how commercial contracts can exceed Medicare levels for CPT 22610, with BUCA reflecting higher average commercial pricing compared with Medicare’s $1,267.30 mean.
Dispersion varies across payers: Blue Cross Blue Shield shows the widest interquartile spread with P75–P25 = $6,035.07, indicating substantial variability in negotiated commercial rates. Aetna and Cigna have tighter spreads of $1,132.70 and $1,395.20 respectively, while UnitedHealth Group’s spread of $1,417.80 sits between those groups. BUCA’s interquartile range of $4,012.30 signals broad commercial variability, and Medicare’s IQR is narrow at $116.00, reflecting relatively consistent locality-based payments.