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CPT 22614: Lumbar Spinal Arthrodesis, Additional Interspace
Headline: CPT code 22614: Add-on lumbar spinal arthrodesis for each additional interspace
Lead: CPT code 22614 is an add‑on spinal fusion code used when an additional interspace is fused during a lumbar arthrodesis procedure. It captures the incremental work of applying bone graft material to join adjacent vertebrae beyond the primary level, and is centrally relevant to hospital billing, surgical quality reporting, and payer coverage policies nationwide.
CPT code 22614 represents an incremental surgical service — arthrodesis of an additional interspace — commonly reported with primary lumbar fusion codes. It matters nationally because spinal fusion procedures are frequent, resource‑intensive, and subject to payer scrutiny for medical necessity and bundling. Accurate use of this add‑on code affects reimbursement, claims processing, and procedural complexity documentation.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find context on clinical indications for lumbar arthrodesis, where this add‑on code fits relative to primary fusion codes, and the operational implications for hospital and ambulatory surgery billing. The publication also outlines typical sites of service, common diagnoses that justify fusion, and related CPT codes to consider when coding multi‑level procedures.
This summary equips coding managers, billing teams, and clinical leaders with a concise reference on the purpose and clinical placement of CPT code 22614 and what to review when it appears on a surgical claim.
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Billing Code Overview
CPT code 22614 describes an arthrodesis (spinal fusion) procedure performed to permanently join two vertebrae using bone graft material applied to an additional interspace at the same operative encounter. The procedure is performed to relieve persistent spinal pain from conditions such as herniated intervertebral discs, spinal stenosis, and spinal injuries by achieving fusion of adjacent vertebral segments.
Service Type: Surgical — spinal arthrodesis (add-on for each additional interspace)
Typical Site of Service: Hospital inpatient or outpatient surgical center; specialized spine surgery units, where operative spinal fusion procedures are performed under general anesthesia.
National Reimbursement Benchmarks
Medicare’s mean of $348.40 sits well below BUCA’s average commercial mean of $3,383.40, illustrating a substantial gap between public and that commercial benchmark for CPT 22614. The midpoint measures also reflect this split: Medicare’s interquartile band is narrow (P25 $329 to P75 $360) while BUCA’s P25 $1,159.10 to P75 $5,242.30 is much wider, reinforcing the broad dispersion among commercial contracts compared with Medicare.
Assessing dispersion via the P75–P25 range identifies the tightest and widest payers: Medicare’s range is $31.00, the tightest. Blue Cross Blue Shield shows the widest spread with a range of $6,810.20. Other commercial payers fall between these extremes: Aetna range $473.60, Cigna range $441.00, UnitedHealth Group range $381.60, and BUCA range $4,083.20, indicating substantial variability across commercial markets.