Summary & Overview
CPT 22857: Lumbar Total Disc Arthroplasty, Anterior Approach
CPT code 22857 represents a lumbar total disc arthroplasty performed at a single interspace using an anterior approach. Nationally, this procedure is a specialized surgical option for selected patients with degenerative disc disease or discogenic pain who are candidates for motion-preserving spine surgery. The code identifies a distinct operative service with implications for surgical planning, device use, and site-of-service considerations.
Key payers commonly covering or adjudicating claims for this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for the procedure, typical sites of service, and the payer landscape relevant to coding and billing. The publication summarizes common modifiers and coding considerations, highlights where data is not available in the input, and outlines related procedural groupings for reference.
This analysis is national in scope and useful for coding staff, revenue cycle teams, and policy analysts seeking a concise reference to the clinical intent of CPT code 22857, how it is documented, and what to expect when it appears on a surgical claim. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 22857 describes a total disc arthroplasty of a single lumbar interspace performed via an anterior approach. The procedure involves excision of the native intervertebral disc in the lower back and placement of an artificial disc prosthesis to restore disc height and motion.
Service Type: Surgical — Lumbar total disc replacement (anterior approach)
Typical Site of Service: Inpatient or outpatient hospital operating room or ambulatory surgery center, approached from the anterior (front) abdomen to the lumbar spine.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 35–55-year-old adult with chronic axial low back pain and unilateral or bilateral radiculopathy refractory to conservative care (physical therapy, medications, and epidural steroid injections) for at least 6–12 months. Imaging (MRI and upright/lateral radiographs) demonstrates symptomatic single-level lumbar degenerative disc disease with preserved segmental stability, preserved facet joints, and no significant spondylolisthesis or severe osteoporosis.
The clinical workflow begins with outpatient evaluation by a spine surgeon (orthopedic spine or neurosurgery), review of imaging, and nonoperative treatment documentation. Preoperative clearance includes medical optimization, anesthesia evaluation, and informed consent discussing risks and benefits of total disc arthroplasty. The procedure is performed in an operating room with an anterior retroperitoneal or transperitoneal approach to the lumbar spine; the diseased disc is excised and replaced with an artificial lumbar disc prosthesis at a single interspace. Typical postoperative care includes brief inpatient observation or same-day discharge depending on institutional protocols, standardized pain management, early mobilization, and outpatient follow-up for wound check and rehabilitation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
62 | Two Surgeons | When two surgeons work together as primary surgeons performing distinct parts of the procedure. |