
$44100
Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; each additional inter...
7620 N University St, Suite 104
Peoria, IL 61614
309-691-7774
rkube@prairiespine.com
CPT-22633, CPT-22634
spine, surgery, minimally invasive, outpatient, lumbar, back, fusion, anterior-posterior, pain, neurosurgery, orthopedic surgery, tlif, fusion

$39780
Arthrodesis, sacroiliac joint, percutaneous or minimally invasive (indirect visualization), with image guidance, includes obtaining bone graft when performed, and placement of transfixing device
7620 N University St, Suite 104
Peoria, IL 61614
309-691-7774
rkube@prairiespine.com
CPT-27279
minimally invasive, outpatient, sacroiliac joint, si joint, pain management, interventional pain, pain procedure, si joint fusion, sacroiliac

Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar
7620 N University St, Suite 104
Peoria, IL 61614
309-691-7774
rkube@prairiespine.com
CPT-63030
minimally invasive, outpatient, spine, cervical, neck, laminectomy, laminotomy, microdiscectomy, microdisc, pain management, surgery, neurosurgery, orthopedics

Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; each additional interspace, cervical or lumbar (List separately in addition to code for pri...
7620 N University St, Suite 104
Peoria, IL 61614
309-691-7774
rkube@prairiespine.com
CPT-63030, CPT-63035
minimally invasive, outpatient, spine, cervical, neck, laminectomy, laminotomy, microdiscectomy, pain management, surgery, neurosurgery, orthopedics

$18750
Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; single level
7620 N University St, Suite 104
Peoria, IL 61614
309-691-7774
rkube@prairiespine.com
CPT-22867
minimally invasive, outpatient, spine, lumbar, back, pain, fusion alternative, lumbar stabilization, lumbar motion preservation, dynamic stabilization, pain management, neurosurgery, orthopedic surgery

$25550
Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; second level (List separately in addition to code for primary procedure
7620 N University St, Suite 104
Peoria, IL 61614
309-691-7774
rkube@prairiespine.com
CPT-22867, CPT-22868
minimally invasive, outpatient, spine, lumbar, back, pain, fusion alternative, lumbar stabilization, lumbar motion preservation, dynamic stabilization, pain management, neurosurgery, orthopedic surgery

$1550
Injection procedure for discography, each level; lumbar
7620 N University St, Suite 104
Peoria, IL 61614
309-691-7774
rkube@prairiespine.com
CPT-62290
spine, surgery, minimally invasive, outpatient, lumbar, back, fusion, anterior-posterior, pain, neurosurgery, orthopedic surgery, tlif, fusion, discogram

$1950
Injection procedure for discography, each level; lumbar
7620 N University St, Suite 104
Peoria, IL 61614
309-691-7774
rkube@prairiespine.com
CPT-62290
spine, surgery, minimally invasive, outpatient, lumbar, back, fusion, anterior-posterior, pain, neurosurgery, orthopedic surgery, tlif, fusion, discogram

$2350
Injection procedure for discography, each level; lumbar
7620 N University St, Suite 104
Peoria, IL 61614
309-691-7774
rkube@prairiespine.com
CPT-62290
spine, surgery, minimally invasive, outpatient, lumbar, back, fusion, anterior-posterior, pain, neurosurgery, orthopedic surgery, tlif, fusion, discogram

$2450
Injection procedure for discography, each level; lumbar
7620 N University St, Suite 104
Peoria, IL 61614
309-691-7774
rkube@prairiespine.com
CPT-62290
spine, surgery, minimally invasive, outpatient, lumbar, back, fusion, anterior-posterior, pain, neurosurgery, orthopedic surgery, tlif, fusion, discogram

$9100
Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guida...
7620 N University St, Suite 104
Peoria, IL 61614
309-691-7774
rkube@prairiespine.com
CPT-22513
vertebroplasty, minimally invasive, outpatient, fracture, compression fracture, osteoporosis, lumbar, back, pain, thoracic pain, neurosurgery, spine surgery

$12100
Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guida...
7620 N University St, Suite 104
Peoria, IL 61614
309-691-7774
rkube@prairiespine.com
CPT-22513, CPT-22515
vertebroplasty, minimally invasive, outpatient, fracture, compression fracture, osteoporosis, lumbar, back, pain, thoracic pain, neurosurgery, spine surgery

$15100
Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guida...
7620 N University St, Suite 104
Peoria, IL 61614
309-691-7774
rkube@prairiespine.com
CPT-22513, CPT-22515
vertebroplasty, minimally invasive, outpatient, fracture, compression fracture, osteoporosis, lumbar, back, pain, thoracic pain, neurosurgery, spine surgery

Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or th...
7620 N University St, Suite 104
Peoria, IL 61614
309-691-7774
rkube@prairiespine.com
CPT-62321
minimally invasive, outpatient, cervical, neck pain, pain management, interventional pain, spine injections, steroid injection, pain injection, cesi, cervical epidural steroid injection, interlaminar

Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); lumbar or sacral, single level
7620 N University St, Suite 104
Peoria, IL 61614
309-691-7774
rkube@prairiespine.com
CPT-64483
minimally invasive, outpatient, spine, lumbar, back, interventional pain, pain management, spine injection, pain injections, pain, steroid injection

Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional level (List separately in addition to code for primary procedure)
7620 N University St, Suite 104
Peoria, IL 61614
309-691-7774
rkube@prairiespine.com
CPT-64483, CPT-64484
minimally invasive, outpatient, spine, lumbar, back, interventional pain, pain management, spine injection, pain injections, pain, steroid injection

Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or CT), lumbar or sacral; single level
7620 N University St, Suite 104
Peoria, IL 61614
309-691-7774
rkube@prairiespine.com
CPT-64493
minimally invasive, outpatient, spine, lumbar, back, interventional pain, pain management, spine injection, pain injections, rfa, radiofrequency ablation

Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional level (List separately in addition to code for primary procedure)
7620 N University St, Suite 104
Peoria, IL 61614
309-691-7774
rkube@prairiespine.com
CPT-64493, CPT-64494
minimally invasive, outpatient, spine, lumbar, back, interventional pain, pain management, spine injection, pain injections, rfa, radiofrequency ablation

Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional level (List separately in addition to code for primary procedure)
7620 N University St, Suite 104
Peoria, IL 61614
309-691-7774
rkube@prairiespine.com
CPT-64493, CPT-64494
minimally invasive, outpatient, spine, lumbar, back, interventional pain, pain management, spine injection, pain injections, rfa, radiofrequency ablation

Injection procedure for sacroiliac joint, anesthetic/steroid, with image guidance (fluoroscopy or CT) including arthrography when performed
7620 N University St, Suite 104
Peoria, IL 61614
309-691-7774
rkube@prairiespine.com
CPT-27096
minimally invasive, outpatient, sacroiliac joint, si joint, pain management, interventional pain, pain procedure, si joint fusion, spine injection, pain injection, steroid injection, lidocaine, contrast