| Code | Description | States | Median rate |
|---|---|---|---|
| 22010 | Open drainage of a deep spine abscess, neck or mid-back | 47 | $733.09 |
| 22015 | Open drainage of a deep spine abscess, lower back | 47 | $714.52 |
| 22505 | Spine manipulation under anesthesia | 47 | $120.05 |
| 22510 | Vertebroplasty (bone cement), neck or mid-back, first | 46 | $1,395.03 |
| 22511 | Vertebroplasty (bone cement), lower back, first | 46 | $1,380.41 |
| 22512 | Vertebroplasty (bone cement), each added vertebra | 44 | $617.25 |
| 22513 | Kyphoplasty (balloon and cement), mid-back, first | 45 | $4,881.67 |
| 22514 | Kyphoplasty (balloon and cement), lower back, first | 44 | $4,866.47 |
| 22515 | Kyphoplasty (balloon and cement), each added vertebra | 43 | $2,459.95 |
| 22526 | Heat treatment of a disc through a needle (IDET), one level | 25 | $1,368.85 |
| 22527 | Heat treatment of a disc by needle (IDET), added level | 24 | $1,113.91 |
| 22551 | Neck spine fusion from the front with disc removal | 48 | $1,389.98 |
| 22552 | Neck spine fusion from the front, each added level | 47 | $308.06 |
| 22554 | Neck spine fusion from the front, single level | 47 | $1,072.43 |
| 22556 | Mid-back spine fusion from the front, single level | 46 | $1,338.22 |
| 22558 | Lower back spine fusion from the front, single level | 46 | $1,245.76 |
| 22585 | Spine fusion from the front, each added level | 47 | $270.43 |
| 22595 | C1-C2 neck spine fusion from the back | 46 | $1,195.50 |
| 22600 | Neck spine fusion from the back, single level | 46 | $1,012.48 |
| 22610 | Mid-back spine fusion from the back, single level | 46 | $997.90 |
| 22612 | Low back spine fusion from the back, one level | 48 | $1,240.64 |
| 22614 | Spine fusion from the back, each added level | 47 | $320.44 |
| 22630 | Lower back interbody fusion from the back, single level | 46 | $1,192.67 |
| 22632 | Interbody fusion from the back, each added level | 45 | $262.63 |
| 22634 | Combined back and interbody fusion, each added level | 45 | $377.43 |
| 22800 | Spine fusion for deformity, up to 6 segments | 47 | $1,099.17 |
| 22802 | Spine fusion for deformity, 7 to 12 segments | 46 | $1,705.70 |
| 22804 | Spine fusion for deformity, 13 or more segments | 46 | $1,929.68 |
| 22808 | Front spine fusion for deformity, 2 to 3 segments | 46 | $1,467.46 |
| 22810 | Front spine fusion for deformity, 4 to 7 segments | 46 | $1,510.67 |
| 22812 | Front spine fusion for deformity, 8 or more segments | 47 | $1,666.79 |
| 22830 | Exploration of a spinal fusion | 47 | $664.08 |
| 22836 | Spine tethering for scoliosis, up to 7 segments | 31 | $1,420.70 |
| 22837 | Spine tethering for scoliosis, 8 or more segments | 30 | $1,429.41 |
| 22838 | Spine tether revision | 30 | $1,448.30 |
| 22841 | Spine wiring of spinous processes (add-on) | 22 | $580.29 |
| 22842 | Spine rods and screws from the back, 3 to 6 segments | 47 | $613.79 |
| 22843 | Spine rods and screws from the back, 7 to 12 segments | 46 | $642.44 |
| 22844 | Spine rods and screws from the back, 13 or more segments | 47 | $795.04 |
| 22845 | Spine plates and screws from the front, 2 to 3 segments | 47 | $584.72 |
| 22846 | Spine plates and screws from the front, 4 to 7 segments | 47 | $606.00 |
| 22847 | Spine plates and screws from the front, 8 or more segments | 47 | $641.25 |
| 22849 | Re-insertion of spine hardware | 47 | $1,034.22 |
| 22852 | Removal of spine rods and screws from the back | 47 | $547.09 |
| 22853 | Spine cage placement in a disc space, each level | 47 | $207.71 |
| 22855 | Removal of spine plates and screws from the front | 47 | $823.17 |
| 22856 | Artificial disc replacement, neck, single level | 45 | $1,283.71 |
| 22857 | Artificial disc replacement, lower back, single level | 39 | $1,320.61 |
| 22858 | Artificial disc replacement, neck, second level (add-on) | 42 | $408.29 |
| 22860 | Artificial disc replacement, lower back, second level | 26 | $291.93 |
| 22861 | Artificial disc revision, neck, single level | 40 | $1,714.46 |
| 22862 | Artificial disc revision, lower back, single level | 31 | $1,733.63 |
| 22864 | Artificial disc removal, neck, single level | 42 | $1,545.70 |
| 22865 | Artificial disc removal, lower back, single level | 35 | $1,670.87 |
| 22867 | Spine spacer implant with open decompression, one level | 35 | $869.69 |
| 22868 | Spine spacer implant with open decompression, second level | 35 | $197.79 |
| 22869 | Spine spacer implant, no decompression, one level | 35 | $384.12 |
| 22870 | Spine spacer implant, no decompression, second level | 33 | $99.94 |
| 22899 | Unlisted spine procedure | 13 | $822.23 |
| 22999 | Unlisted abdominal wall bone or muscle procedure | 12 | $402.97 |
Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Descriptions are ProviderSignal's own plain-language labels or public-domain CMS text.