CPT® Code 22857

Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression); single interspace, lumbar

Total disc arthroplasty is a surgical procedure aimed at the complete replacement of a severely damaged or diseased intervertebral disc with an artificial disc. This procedure is specifically indicated for the lumbar region of the spine and is performed through an anterior approach, which involves making an incision in the abdomen to access the lumbar vertebrae. The process begins with the careful retraction of the intervertebral muscles to expose the target disc, which is then confirmed using radiological guidance. The damaged disc material is meticulously removed using a rongeur, preparing the interspace for the insertion of the artificial implant. The artificial disc typically consists of two metal endplates and a polyethylene insert that bears weight. The endplates are inserted into the prepared disc space in a collapsed state and are then expanded to fit securely into the vertebrae above and below. The polyethylene insert is subsequently placed and secured within the endplates using a snap-lock mechanism. After the successful assembly of the artificial disc, the surgical wounds are closed, and a drain may be left in place to prevent fluid accumulation. This procedure is reported using CPT® code 22857 for a single lumbar interspace, while code 22860 is used for a second lumbar interspace if applicable.