CPT 22554 · Fusion — Anterior
Arthrodesis, Anterior Interbody (Minimal Discectomy) — Cervical
Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); cervical below C2. Do not report with 22551 at same level.
Free with practitioner sign-in — magic-link email auth, no credit card.
Rubrica tracks payor coverage for CPT 22554 (Arthrodesis, Anterior Interbody (Minimal Discectomy) — Cervical) across 18 payors — every Medicare MAC, the major commercial plans, the BCBS family, all 50-state Medicaid programs, and selected workers' comp and auto/PIP carriers. Aggregate coverage patterns are shown below; full payor-specific criteria, source citations, and last-reviewed dates are available to signed-in practitioners.
Top payors covering CPT 22554
Sample of 12 payors with coverage for this code. Sign in for the complete payor list, verbatim criteria, denial-risk score, and source citations for each.
| Payor | Coverage | Prior auth |
|---|---|---|
| Aetna | Covered | Prior auth |
| Aetna Medicare Advantage | Covered | Prior auth |
| Anthem BCBS | Covered | Prior auth |
| Cigna | Covered | Prior auth |
| Cigna Medicare / HealthSpring | Covered | Prior auth |
| Humana Commercial | Covered | Prior auth |
| Humana Medicare Advantage | Covered | Prior auth |
| Medicare (CGS MAC) | Covered | Prior auth |
| Medicare (FCSO MAC) | Covered | Prior auth |
| Medicare (NGS MAC) | Covered | Prior auth |
| Medicare (Noridian JF MAC) | Covered | Prior auth |
| Medicare (Novitas MAC) | Covered | Prior auth |
Coverage themes for CPT 22554
Common patterns across the 18 payors we track. Specific criteria per payor are available after sign-in.
Most payors require ≥12 weeks of conservative care before approving 22554.
15 of 18 payors require imaging concordance documentation.
Of the 18 payors with coverage records for CPT 22554, 15 require prior authorization, 3 cover without prior authorization, and 0 flag the procedure as investigational or experimental under current criteria.
See the policy for every payor.
Sign in to see verbatim coverage criteria, conservative-care duration requirements, imaging concordance rules, and the documentation each payor wants in the submission.
Sign in — free for practitioners →