HCPCS Level II S2350: Anterior Lumbar Diskectomy with Decompression - OpenPayer

Summary & Overview

HCPCS Level II S2350: Anterior Lumbar Diskectomy with Decompression

HCPCS Level II code S2350 represents an anterior lumbar diskectomy with decompression of the spinal cord and/or nerve roots, including osteophytectomy at a single interspace. This surgical code captures a common spine procedure intended to relieve nerve compression and associated radiculopathy or myelopathy. Nationally, accurate coding for this service affects hospital and surgical facility billing, utilization tracking, and coverage determinations for spine surgery.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will gain a concise overview of clinical context for the procedure, typical sites of service, and how the code is applied in facility billing. The publication outlines common benchmarking items and policy-relevant topics that influence coverage and payment, such as site-of-service variations and documentation needed to support medical necessity.

This report provides: a clear clinical description of the service captured by S2350; guidance on where the procedure is typically performed; and a summary of payer coverage considerations and benchmarking topics. Data not available in the input are noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareS2350HCPCS Level IIanterior lumbar discectomyspine surgerydecompressionosteophytectomyambulatory surgery centerhospital inpatient

Billing Code Overview

HCPCS Level II code S2350 describes a diskectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; lumbar, single interspace. This procedure involves anterior access to the lumbar spine to remove disc material and bony spurs (osteophytes) to decompress neural elements.

Service type: Surgical procedure — anterior lumbar discectomy with decompression and osteophytectomy
Typical site of service: Inpatient or outpatient hospital operating room; may also occur in an ambulatory surgery center depending on clinical complexity and payer policies

Clinical & Coding Specifications

Clinical Context

A 56-year-old patient presents with progressive low back pain radiating to the anterior thigh and lower leg with associated neurogenic claudication and objective motor weakness. Conservative management including physical therapy, oral analgesics, and epidural steroid injections has failed over 12 weeks. MRI of the lumbar spine demonstrates a large central and foraminal disc herniation at L4-L5 with compression of the thecal sac and L5 nerve roots and associated osteophyte formation. The spine surgeon schedules an anterior lumbar discectomy with decompression of the spinal cord and/or nerve roots, including osteophytectomy at a single lumbar interspace.

Typical clinical workflow:

Preoperative evaluation and clearance by primary care and anesthesia.
Preoperative imaging review (MRI, CT if needed) and informed consent documenting neurologic deficits and indication for anterior approach.
Operating room: patient positioned supine or in lateral decubitus per surgeon preference; anterior retroperitoneal or transperitoneal exposure to the lumbar spine; discectomy performed at a single interspace with removal of herniated disc material and osteophytectomy; decompression of neural elements confirmed.
Closure and transfer to PACU; postoperative inpatient monitoring for neurologic status, hemodynamics, and wound/visceral complications.
Postoperative follow-up includes wound check, activity restrictions, pain management, and progressive rehabilitation as indicated.

Coding Specifications

HCPCS S2230: Implantation of Magnetic Component of Semi-Implantable Hearing Device on Ossicles

HCPCS-S0013-ESKETAMINE-NASAL-SPRAY-1MG

HCPCS S0013: Esketamine Nasal Spray, 1 mg

HCPCS-S9141-DIABETES-MANAGEMENT-FOLLOW-UP-MD-VISIT

HCPCS S9141: Diabetic Management Program Follow-Up Visit to MD Provider

HCPCS-LEVEL-II-S9024-PARANASAL-SINUS-ULTRASOUND

HCPCS Level II S9024: Paranasal Sinus Ultrasound

HCPCS-S9098-HOME-PHOTOTHERAPY-SERVICES

HCPCS S9098: Home Visit Phototherapy Services, Per Diem

HCPCS-S2080-LASER-ASSISTED-UVULOPALATOPLASTY-LAUP

HCPCS S2080: Laser-Assisted Uvulopalatoplasty (LAUP)

HCPCS-S5131-HOMEMAKER-SERVICE-PER-DIEM

HCPCS S5131: Homemaker Service, Per Diem

HCPCS-S5011-5PCT-DEXTROSE-LACTATED-RINGERS-1000ML

HCPCS S5011: 5% Dextrose in Lactated Ringer's, 1000 ml

HCPCS-S9961-AIR-AMBULANCE-NONEMERGENCY-ROTARY-WING-TRANSPORT

HCPCS S9961: Air Ambulance Nonemergency One-Way (Rotary Wing)

HCPCS-S2351-ANTERIOR-LUMBAR-DISKECTOMY-ADDITIONAL-INTERSPACE

HCPCS S2351: Anterior Lumbar Diskectomy, Additional Interspace

Showing 1–10 of 532

Taxonomy Code	Specialty	Notes
`207L00000X`	Orthopedic Surgery	Orthopedic spine surgeons commonly perform lumbar discectomy via anterior or anterior-lateral approaches.
`2080S0002X`	Neurosurgery	Neurosurgeons perform complex spinal decompressions and discectomies.
`2084P0800X`	Physical Medicine & Rehabilitation	PM&R physicians manage preoperative and postoperative rehabilitation and nonsurgical care.
`208D00000X`	Pain Medicine	Pain specialists manage preoperative injection trials and postoperative pain control.
`208100000X`	Anesthesiology	Anesthesiologists provide perioperative anesthesia care, including complex cases requiring special techniques.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M51.26`	Other intervertebral disc displacement, lumbar region	Lumbar disc displacement causing nerve root compression amenable to discectomy.
`M51.27`	Other intervertebral disc displacement, lumbosacral region	Disc pathology at the L5-S1/L4-L5 transition treated with lumbar discectomy.
`M51.36`	Other intervertebral disc degeneration, lumbar region	Degenerative disc disease contributing to foraminal stenosis and osteophyte formation requiring decompression.
`M47.26`	Other spondylosis with radiculopathy, lumbar region	Spondylotic changes and osteophytes causing nerve root compression addressed during osteophytectomy.
`M48.06`	Spinal stenosis, lumbar region	Central canal or foraminal stenosis producing neurogenic claudication and requiring decompression.
`G55.1`	Lumbosacral plexus disorders	Neurologic deficits from compressive lesions treated by decompression when appropriate.
`M54.16`	Radiculopathy, lumbar region	Clinical radiculopathy correlating with imaging that is an indication for surgical decompression.
`M51.17`	Intervertebral disc disorders with radiculopathy, lumbosacral region	Disc herniation with radiculopathy at a lumbosacral level indicating discectomy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`22554`	Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (lumbar)	May be performed in the same session if fusion is required following discectomy or when instability is present.
`22830`	Exploration of spinal fusion (removal of instrumentation) or revision (lumbar) — Note: commonly used for revision cases	Relevant when prior anterior procedures require revision or decompression at the same interspace.
`63030`	Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy (single vertebral segment; lumbar)	Posterior approach decompression that may be performed before or after anterior discectomy in staged or combined approaches.
`72275`	Discography, lumbar, single level	Diagnostic procedure that may be performed preoperatively to correlate pain generator with imaging before surgical discectomy.
`20610`	Arthrocentesis, aspiration and/or injection, major joint or bursa (e.g., for diagnostic or therapeutic injections)	Used preoperatively by pain specialists for diagnostic injections or to trial pain relief prior to surgery.
`77012`	CT guidance for spine procedure	Imaging guidance CPT used intraoperatively or for preoperative planning in complex anterior approaches.

`00`	Other unspecified modifier (local/payer-specific)	Use per payer when a neutral or unspecified modifier field is required by adjudication rules.
`22`	Increased procedural services	Use when work, time, and complexity substantially exceed typical for the procedure and documentation supports unusual operative effort.
`23`	Unusual anesthesia	Use when general anesthesia is contraindicated and a highly unusual anesthesia technique is required due to severe systemic disease.
`26`	Professional component	Use when separating the professional (surgeon) component from a global or technical component billed by another entity (rare for surgical procedures).
`47`	Anesthesia by surgeon	Use when the surgeon personally provides local/ regional anesthesia and billing rules permit reporting.
`50`	Bilateral procedure	Use if an identical procedure is performed bilaterally at paired anatomic sites (rare for single interspace lumbar discectomy).
`51`	Multiple procedures	Use when multiple distinct procedures are performed on the same patient during the same operative session.
`52`	Reduced services	Use when the procedure performed is less than the full described service; document reasons (aborted, limited exposure).
`53`	Discontinued procedure	Use when procedure is terminated before completion for reasons not related to patient improvement; document circumstances.
`59`	Distinct procedural service	Use to indicate a procedure or service was distinct or independent from other services performed on same day when NCCI edits may apply.
`62`	Two surgeons/pairs of surgeons	Use when two surgeons work together as primary surgeons performing distinct portions of a complex procedure.
`66`	Surgical team	Use when a surgical team approach is used for highly complex procedures and payer allows team billing.
`76`	Repeat procedure by same physician	Use when the same physician repeats the procedure subsequent to the original on the same day.
`77`	Repeat procedure by another physician	Use when another physician repeats the procedure on the same day.

OpenPayer