CPT Codes
CPT Codes Eligible for Bundled Pricing.
Evaluation & Management
CPT Codes
- 99213 - 3 Level Office Visit
- 99214 - 4 Level Office Visit
- 99243 - 4 Level Office Consult
- 99244 - 4 Level Office Consult
- 99245 - 5 Level Office Consult
Pain Management
CPT Codes
- 00600-00670 - Anesthesia
- J1030 - Injection, 40 mg
- J1040 - Injection, 80 mg
- 64491 - Facet Joint Injection 2nd Level
- 64492 - Facet Joint Injection 3+ Level
- 64494 - Facet Joint Injection 2nd Level
- 64495 - Facet Joint Injection 3+ Level
- 62321 - Cervical Epidural Injection
- 62323 - Lumbar Epidural Injection
- 64483 - Transforaminal Epidural Injection
- 64484 - Transforaminal Epidural Injection - Addtional Levels
Radiology
CPT Codes
- CT - 72126 - 72133
- MRI - 72142 - 72158
- Xray - 72020 - 72120
- Discography - 62290, 72295
- Myelography - 62270, 62272
Physical Therapy
CPT Codes
- 97001 - Evaluation
- 97002 - Re-evaluation
- 97110 - Thearpy Exercises
- 97140 - Manual Therapy
Lumbar Laminectomy
for decompression - 1 Level
CPT Codes
- 63047 - Laminectomy
- 69990 - Operating microscope
Lumbar Laminectomy
for decompression - 2 Level
CPT Codes
- 63047 - Laminectomy
- 63048 - Laminectomy, facetectomy, or foraminotomy of additional segment
- 69990 - Operating microscope
Lumbar Discectomy
for herniated disc - 1 Level
CPT Codes
- 63030 - Discectomy
- 69990 - Operating microscope
Lumbar Discectomy
for herniated disc - 2 Level
CPT Codes
- 63030 - Discectomy
- 63035 - Discectomy of additional segment
- 69990 - Operating microscope
Posterior Lumbar Decompression
with fusion (PLDF) - 1 Level
CPT Codes
- 22612 - Posterolateral fusion
- 63047 - Laminectomy
- 22840 - Non-segmental instrumentation
- 20930 - Allograft
- 20936 - Autograft
- 61783 - Stereotactic computer-assisted procedure
Posterior Lumbar Decompression
with fusion (PLDF) - 2 Level
CPT Codes
- 22612 - Posterolateral fusion
- 22614 - Additional PLDF
- 63047 - Laminectomy
- 63048 - Laminectomy, facetectomy, or foraminotomy of additional segment
- 22842 - Segmental instrumentation
- 20930 - Allograft
- 20936 - Autograft
- 61783 - Stereotactic computer-assisted procedure
Posterolateral Interbody Lumbar Fusion
(PLIF) - 1 Level
CPT Codes
- 22633 - posterior or posterolateral interbody fusion
- 22840 - Non-segmental instrumentation
- 22853 - Insertion of device
- 20930 - Allograft
- 20936 - Autograft
- 61783 - Stereotactic computer-assisted procedure
Posterolateral Interbody Lumbar Fusion
(PLIF) - 2 Level
CPT Codes
- 22633 - posterior or posterolateral interbody fusion
- 22634 - Additional PLIF
- 22842 - Segmental Instrumentation
- 22853 x 2 - Insertion of devices
- 20930 - Allograft
- 20936 - Autograft
- 61783 - Stereotactic computer-assisted procedure
Anterior Lumbar Interbody Fusion
with fusion (ALIF) - 1
Level
CPT Codes
- 22558 -Anterior lumbar interbody fusion
- 22845 - Anterior instrumentation
- 22853 - Insertion of device
- 20936 - Autograft
- 20930 - Allograft, morselized, or placement of osteopromotive material
Anterior Lumbar Interbody Fusion
with fusion (ALIF) - 2
Level
CPT Codes
- 22558 -Anterior lumbar interbody fusion
- 22585 -Additional ALIF
- 22845 - Anterior instrumentation
- 22853 x 2 - Insertion of devices
- 20936 - Autograft
- 20930 - Allograft, morselized, or placement of osteopromotive material
Anterior Cervical Discectomy
with fusion (ACDF) - 2 Level
CPT Codes
- 22551 - Anterior interbody fusion
- 22552 - Additional ACDF
- 22845 - Anterior instrumentation
- 22853 x 2 - Insertion of devices
- 20930 - Allograft, morselized, or placement of osteopromotive material
Anterior Cervical Discectomy
with fusion (ACDF) - 3 Level
CPT Codes
- 22551 - Anterior interbody fusion
- 22552 - Additional ACDF
- 22845 - Anterior instrumentation
- 22853 x 3 - Insertion of devices
- 20930 - Allograft, morselized, or placement of osteopromotive material
Lumbar Rhizotomy
CPT Codes
- 64635 - Destruction by neurolytic agent of facet joint
- 64636 - Destruction by neurolytic agent of additional facet joint
Cervical Decompression
with fusion - 1 Level
CPT Codes
- 63045 - Laminectomy, facetectomy, or foraminotomy of single segment
- 22600 - Posterior Cervical below C2
- 22840 - Posterior non-segmental instrumentation
- 20936 - Autograft
- 20930 - Allograft
Cervical Decompression
with fusion - 2 Level
CPT Codes
- 63045 - Laminectomy, facetectomy, or foraminotomy of single segment
- 63048 - Laminectomy, facetectomy, or foraminotomy of additional segment
- 22600 - Posterior Cervical below C2
- 22614 - Additional Lumbar fusion
- 22842 - Posterior segmental instrumentation
- 20936 - Autograft
- 20930 - Allograft
Cervical Rhizotomy
CPT Codes
- 64633 - Destruction by neurolytic agent of facet joint
- 64634 - Destruction by neurolytic agent of additional facet joint
Carpal Tunnel Release
CPT Codes
- 64721 - Neuroplasty and/or transposition; median nerve at carpal tunnel
Ulnar Nerve Release
CPT Codes
- 64718 - Neuroplasty at elbow
- 64719 - Neuroplasty at wrist
- 24301 - Muscle or Tendon transfer
- 24357 - Percutaneous tenotomy
- 24358 - Debridement
- 24359 - Debridement with repair
