CPT 22864 Cervical Disk Removal Reimbursement | OpenPayer

Summary & Overview

CPT 22864: Removal of Single Cervical Artificial Disk

CPT code 22864 denotes the surgical removal of a single artificial disk in the cervical spine that was placed during a previous total disk arthroplasty. This code captures a targeted revision procedure aimed at alleviating symptoms related to degenerative disk disease or other cervical disk pathology when an implanted disk requires explantation. Nationally, such procedures are important for managing device-related complications, persistent pain, or neurologic deficits following arthroplasty.

Key payers addressed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for explantation of cervical artificial disks, common sites of service, and the types of benchmarks and payment policy topics typically associated with this service line. The publication outlines reimbursement benchmarks, utilization patterns, coding nuances relevant to surgical revision of cervical arthroplasty, and recent policy updates that affect coverage and payment determinations.

This summary is intended to orient clinicians, coding professionals, and policy analysts to the clinical intent of CPT code 22864, payer coverage considerations, and the areas of operational focus that affect billing and authorization for single-level cervical artificial disk removal.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare22864CPTcervical spinedisk arthroplastydevice explantationspine surgeryrevision surgeryinpatient-outpatient

Billing Code Overview

CPT code 22864 describes the removal of a single artificial cervical disk that was previously implanted during a total disk arthroplasty procedure. This procedure is performed to address persistent or recurrent symptoms related to degenerative disk disease or other symptomatic cervical disk conditions.

Service type: Surgical explantation of a single cervical artificial disk
Typical site of service: Hospital inpatient or outpatient surgical center, depending on clinical factors and surgical complexity

Clinical & Coding Specifications

Clinical Context

A 52-year-old patient with a prior cervical total disc arthroplasty presents with progressive neck pain, radicular arm pain, and neurologic deficit after several years of device-related pain and possible implant failure. Imaging (cervical radiographs and CT/MRI) demonstrates loosening, subsidence, heterotopic ossification with recurrent neural compression, or severe adjacent-segment degeneration requiring removal of the previously placed artificial cervical disc. The clinical workflow includes preoperative evaluation by a spine surgeon, informed consent detailing risks and alternatives including revision instrumentation or fusion, preoperative clearance (medical history, cardiac evaluation as needed), perioperative antibiotic prophylaxis, intraoperative identification and careful explantation of the prosthetic device via an anterior cervical approach, neurophysiologic monitoring as indicated, possible conversion to anterior cervical discectomy and fusion if clinically required, postoperative pain control and wound care, and outpatient follow-up with imaging and rehabilitation as appropriate.

Coding Specifications

Modifier	Description	When to Use
`62`	Two surgeons	Use when two surgeons with distinct specialties work together during the explantation and reconstruction.
`73`

CPT 22857: Lumbar Total Disc Arthroplasty, Anterior Approach

CPT-22865-LUMBAR-ARTIFICIAL-DISK-REMOVAL

CPT 22865: Lumbar Artificial Disk Removal

CPT-22842-POSTERIOR-SPINAL-INSTRUMENTATION-3-TO-6-LEVELS

CPT 22842: Posterior Spinal Instrumentation, 3–6 Levels

CPT-22867-INTERSPINOUS-STABILIZATION-DEVICE-LUMBAR

CPT 22867: Lumbar Interspinous Stabilization or Distraction Device Insertion

CPT-22861-REVISION-CERVICAL-DISK-ARTHROPLASTY

CPT 22861: Revision of Cervical Total Disk Arthroplasty

CPT-22838-THORACIC-VERTEBRAL-BODY-TETHER-REVISION-REPLACEMENT-REMOVAL

CPT 22838: Thoracic Vertebral Body Tether Revision/Replacement/Removal

CPT-22841-SPINAL-WIRING-VERTEBRAL-FIXATION

CPT 22841: Spinal Wiring for Vertebral Fixation

CPT-22844-POSTERIOR-SPINAL-INSTRUMENTATION-13-PLUS-SEGMENTS

CPT 22844: Posterior Spinal Instrumentation, 13+ Vertebral Segments

CPT-22850-REMOVAL-NONSEGMENTAL-SPINAL-INSTRUMENTATION-POSTERIOR

CPT 22850: Removal of Nonsegmental Spinal Instrumentation, Posterior

CPT-22843-POSTERIOR-SPINAL-INSTRUMENTATION-7-TO-12-LEVELS

CPT 22843: Posterior Spinal Instrumentation, 7–12 Levels

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Taxonomy Code	Specialty	Notes
`207RX0400X`	Orthopedic Spine Surgery	Orthopedic surgeons who perform complex cervical spine revisions and hardware removal.
`207XS0113X`	Neurosurgery	Neurosurgeons who perform cervical disc arthroplasty removal and neural decompression.
`2085S0102X`	Physical Medicine & Rehabilitation	May be involved in postoperative rehabilitation planning and nonoperative care planning.
`207K00000X`	Orthopedic Surgery	General orthopedic spine practitioners involved in revision spine procedures.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M50.20`	Cervical disc disorder with radiculopathy, unspecified cervical region	Common indication for initial arthroplasty and for revision when radiculopathy recurs due to device failure or adjacent disease.
`M50.30`	Other cervical disc displacement, with myelopathy	Myelopathy may prompt device removal and conversion to decompression and fusion.
`M50.10`	Cervical disc disorder with myelopathy, high cervical region	Severe neurologic compromise related to prosthesis failure or heterotopic ossification may require removal.
`M99.03`	Segmental and somatic dysfunction of cervical region	Chronic segmental dysfunction and pain related to prior arthroplasty leading to revision.
`T84.7X5A`	Infection and inflammatory reaction due to internal joint prosthesis, initial encounter (Note: adapt to spinal prosthesis context)	Periprosthetic infection around an artificial disc can necessitate explantation and debridement.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`63075`	Laminectomy with exploration and decompression of the spinal canal, cervical; single segment	May be performed if additional posterior decompression is required after prosthesis removal.
`22551`	Arthrodesis, anterior interbody, including disc space preparation, cervical; each additional level (used with primary code)	Often used when removal of an artificial disc is converted to an anterior cervical discectomy and fusion construct.
`22845`	Anterior instrumentation for cervical spine, 2 to 3 vertebral segments	Used when internal fixation is placed after removal of a cervical disc prosthesis to achieve fusion and stability.
`63020`	Laminotomy (hemilaminectomy), unilateral or bilateral, single vertebral segment, cervical	May be used for targeted neural decompression if indicated in the same surgical episode.
`76942`	Ultrasonic guidance for needle placement (Note: often imaging-guided procedures)	May be used intraoperatively for localization or perioperative image guidance when applicable.

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