Summary & Overview
CPT 22854: Vertebral Body Corpectomy Reconstruction with Cage or Mesh
CPT code 22854 denotes the surgical insertion of a metallic cage or mesh device to cover defects from partial or complete vertebral body removal (corpectomy) performed during a spinal interbody arthrodesis. This procedure supports vertebral spacing and stability after resection and is a key component of complex spinal fusion operations. Nationally, the code matters because corpectomy with cage or mesh reconstruction is used in tumor resection, trauma, infection, and advanced degenerative disease when segmental vertebral support is required.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication summarizes payment and coverage benchmarks, common clinical contexts for use, and policy considerations affecting authorization and coding practice.
Readers will learn the clinical intent of CPT code 22854, typical sites of service, common procedural elements and how payers commonly approach coverage and reimbursement for implant-supported corpectomy reconstructions. The report also highlights benchmarks and notable policy updates where available. Data not available in the input is noted explicitly where applicable.
Billing Code Overview
CPT code 22854 describes insertion of a metallic cage or mesh device to cover one or more defects created by the complete or partial removal (corpectomy) of a vertebral body as part of a spinal interbody arthrodesis. The device may be affixed with screws or flanges to the anterior aspects of adjacent vertebrae to help maintain vertebral spacing following a partial or complete vertebral body resection.
Service type: Surgical implant placement during spinal fusion (spinal interbody arthrodesis)
Typical site of service: Hospital inpatient or outpatient surgery setting (operating room), or ambulatory surgery center when spinal fusion procedures are performed.
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient presents with progressive thoracolumbar back pain, lower extremity weakness, and radiographic evidence of a destructive vertebral body tumor with collapse at T12. Conservative care failed and imaging (MRI/CT) shows spinal instability and neural element compression from a partial corpectomy defect. The surgical team plans an anterior thoracolumbar corpectomy with placement of a metallic expandable interbody cage to reconstruct the anterior column and restore vertebral height, followed by instrumented posterior fusion. The procedure is performed in an operating room under general anesthesia with intraoperative neuromonitoring. The surgeon performs corpectomy, prepares endplates, inserts a metallic cage or mesh device 22854 to span the defect and secures it as needed with flanges or anterior screws, then completes fusion with bone graft. The typical site of service is an inpatient hospital or ambulatory surgical center for complex spine surgery depending on patient comorbidities and length of stay.
Coding Specifications
- Use the following modifiers and provider taxonomies as applicable for
22854.
| Modifier | Description | When to Use |
|---|---|---|
62 | Two surgeons |