July 14, 2022
I placed posterior percutaneous screws and rods without an arthrodesis. I know I have to use an unlisted code, 22899. How should I price it?
Good question. Let’s assume you’re doing +22842 (posterior instrumentation, 3-6 segments) which is an add-on code. Add-on codes are valued for only the intra-operative portion of the service and do not include any value for pre-op (e.g., H&P, discussion with patient), certain intra-operative work (e.g., incision, closure) or post-op work.
Recall that Medicare reduces the payment for secondary stand-alone procedure codes by 50% to account for overlapping pre- and post-op work.
Therefore, we recommend you double your fee for +22842 to achieve your fee for the unlisted code. For example, if your fee for +22842 is $100 then your fee for the unlisted code would be $200.
*This response is based on the best information available as of 07/14/22.