Introduction
Spinal fusion and decompression procedures are commonly performed to relieve pain caused by degenerative disc disease, herniated discs, or spinal stenosis. Proper CPT coding ensures accurate reimbursement and prevents claim denials. This guide covers spinal fusion and decompression CPT codes, including common billing considerations, modifier usage, and a final reference table with CPT descriptions and RVUs.
Understanding Spinal Fusion & Decompression Procedures
Spinal fusion is performed to stabilize the spine by fusing two or more vertebrae together, often using bone grafts or implants. Decompression procedures, such as laminectomy and discectomy, are done to relieve nerve compression. Depending on the approach and number of levels treated, different CPT codes apply.
CPT Codes for Spinal Fusion & Decompression
Primary Spinal Fusion CPT Codes
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22630 – Arthrodesis, posterior interbody technique, lumbar, single level.
- Used for single-level spinal fusion in the lumbar region.
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22632 – Each additional level (list separately in addition to primary procedure).
- Used when multiple levels are fused.
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22551 – Arthrodesis, anterior interbody technique, cervical, single level.
- Used for single-level cervical fusion.
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22552 – Each additional cervical level (list separately in addition to primary procedure).
- Used when multiple cervical levels are fused.
Spinal Decompression (Laminectomy & Discectomy) CPT Codes
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63030 – Laminectomy, single interspace, lumbar, with decompression of nerve root(s).
- Used for lumbar discectomy or nerve root decompression.
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63042 – Laminectomy, single interspace, cervical, with decompression.
- Used for cervical nerve decompression procedures.
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63047 – Laminectomy, lumbar, with decompression of spinal cord, single vertebral segment.
- Used when spinal cord decompression is performed.
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63056 – Laminectomy, two or more interspaces, lumbar.
- Used for multilevel laminectomy procedures.
Instrumentation & Bone Graft Add-On Codes
- 22840 – Posterior non-segmental instrumentation (e.g., rods, screws).
- 22842 – Posterior segmental instrumentation (e.g., rods, screws spanning multiple segments).
- 20930 – Allograft bone used in spinal fusion.
- 20931 – Autograft bone harvested from patient.
Billing Guidelines & Modifier Usage
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Common Modifiers:
- -RT/-LT – Identifies right or left side of the spine.
- -59 – Used when multiple procedures are performed at different sites.
- -22 – For unusually complex procedures requiring additional documentation.
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Bundling Considerations:
- 63030 (discectomy) is often bundled with 22630 (fusion)—check payer guidelines before billing separately.
- Instrumentation and bone graft codes (22840, 20930) are billed as add-on codes.
Common Denials & How to Avoid Them
- Medical Necessity Denials: Ensure documentation includes MRI, CT findings, and failure of conservative treatment.
- Global Surgery Period: Spinal fusion and laminectomy codes have a 90-day global period—subsequent procedures within this timeframe may be denied.
- Incorrect Modifier Use: Ensure correct use of laterality (-RT/-LT) and unbundling (-59) modifiers.
Final CPT Code Table: Descriptions & RVUs
| CPT Code | Description | RVU |
|---|---|---|
| 22630 | Arthrodesis, posterior interbody technique, lumbar, single level | 21.87 |
| 22632 | Arthrodesis, each additional lumbar level | 9.43 |
| 22551 | Arthrodesis, anterior interbody, cervical, single level | 20.15 |
| 22552 | Arthrodesis, each additional cervical level | 8.50 |
| 63030 | Laminectomy, single interspace, lumbar, with decompression | 13.45 |
| 63042 | Laminectomy, single interspace, cervical, with decompression | 12.89 |
| 63047 | Laminectomy, lumbar, with decompression of spinal cord | 15.21 |
| 63056 | Laminectomy, two or more interspaces, lumbar | 18.76 |
| 22840 | Posterior non-segmental instrumentation | 14.75 |
| 22842 | Posterior segmental instrumentation | 18.22 |
| 20930 | Allograft for spinal fusion | 2.50 |
| 20931 | Autograft for spinal fusion | 3.10 |
Conclusion
Spinal fusion and decompression procedures require precise CPT coding to ensure maximum reimbursement and avoid denials. Understanding modifier use, bundling rules, and payer guidelines will help streamline the billing process.
If this guide was useful, check out our other orthopedic CPT coding guides on knee arthroscopy, rotator cuff repair, and hip replacement!