Medtronic Plc. · NYSE:MDT
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33 slides from Medtronic's investor presentation, January 2026
Slide 1: 2026 Billing and Coding Guide: Spinal procedures
Overview Overview New for 2026 New for 2026 2026 Billing and Coding Guide Spinal procedures Coding & Reimbursement Coding & Reimbursement Resources Resources Disclaimer
Slide 2: Overview
Overview This guide is intended to aid providers in appropriate procedure code selection for spinal related procedures. The document reflects applicable and commonly billed procedure codes as well as the unadjusted national Overview Medicare average rates assigned to the CPT®1 code. Overview New for
Slide 3: New for 2026
New for 2026 Overview Overview Medicare Site of Service Policy New CPT® Codes New for 2026 Effective January 1, 2026, Medicare has removed over 75 As of January 1, 2026, several new CPT® codes for New for 2026 spine and cranial procedures from the Inpatient Only (IPO) List decompression procedures a
Slide 4: Coding & reimbursement
Coding & reimbursement TOC Overview Overview This section provides Medicare unadjusted national average allowable rates for physician, hospital outpatient, ambulatory surgery, and hospital inpatient settings. The coding information in this section does not replace seeking coding advice from New for
Slide 5: Medicare payment systems
Coding & reimbursement Medicare payment systems Overview Overview Payment system Place of service Basis of payment Types of services included Inpatient Prospective • Inpatient admissions that require hospital stays Payment System6 Hospital Inpatient MS-DRGs6 • Procedures excluded from coverage in th
Slide 6: HCPCS Level II codes
Coding & reimbursement C-code Finder HCPCS4 Level II codes Level II HCPCS4 codes are primarily used to report supplies, drugs and implants that are not reported by a CPT®1 code. HCPCS codes are reported by the physician, Overview hospital or DME provider that purchased the item, device, or supply. D
Slide 7: Common spinal procedures: Posterior fusion
Coding & reimbursement Common spinal procedures Physician*5 Hospital Outpatient2 Ambulatory Surgery Center3 Overview CPT®1 Description Work RVU Facility Status APC Rate Payment Rate Overview code rate indicator indicator Posterior fusion 22595 Arthrodesis, posterior technique, atlas-axis (C1-C2) 20.
Slide 8: Common spinal procedures: Anterior fusion
Coding & reimbursement Common spinal procedures Physician*5 Hospital Outpatient2 Ambulatory Surgery Overview Center3 CPT®1 Facility Status Payment Overview Description Work RVU APC Rate Rate code rate indicator indicator Anterior fusion Arthrodesis, anterior interbody, including disc space preparati
Slide 9: Common spinal procedures: Combined fusion
Coding & reimbursement Common spinal procedures Ambulatory Surgery Physician*5 Hospital Outpatient2 Center3 Overview CPT®1 Description Work RVU Facility Status APC Rate Payment Rate Overview code rate indicator indicator Combined fusion Arthrodesis, combined posterior or posterolateral technique wit
Slide 10: Common spinal procedures: Biomechanical devices
Coding & reimbursement Common spinal procedures Physician*5 Hospital Outpatient2 Ambulatory Surgery Center3 Overview CPT®1 Description Work RVU Facility Status APC Rate Payment Rate Overview code rate indicator indicator Biomechanical devices Insertion of interbody biomechanical device(s) (e.g., syn
Slide 11: Common spinal procedures: Anterior instrumentation, bone graft
Coding & reimbursement Common spinal procedures Physician*5 Hospital Outpatient2 Ambulatory Surgery Center3 Overview CPT®1 Description Work RVU Facility Status APC Rate Payment Rate Overview code rate indicator indicator Anterior instrumentation Anterior instrumentation; two to three vertebral segme
Slide 12: Common spinal procedures: Navigation, decompression
Coding & reimbursement Common spinal procedures Ambulatory Surgery Physician*5 Hospital Outpatient2 Center3 Overview CPT®1 Description Work RVU Facility Status APC Rate Payment Rate Overview code rate indicator indicator Navigation Stereotactic computer-assisted (navigational) procedure; spinal (Lis
Slide 13: Common spinal procedures: Decompression procedures
Coding & reimbursement Common spinal procedures Physician*5 Hospital Outpatient2 Ambulatory Surgery Overview Center3 CPT®1 Facility Status Payment Overview Description Work RVU APC Rate Rate code rate indicator indicator Decompression procedures Laminectomy with exploration and/or decompression of s
Slide 14: Common spinal procedures: Decompression procedures
Coding & reimbursement Common spinal procedures Ambulatory Surgery Physician*5 Hospital Outpatient2 Center3 CPT®1 Facility Status Payment code Description Work RVU rate indicator APC Rate indicator Rate Overview Decompression procedures Laminotomy (hemilaminectomy), with decompression of nerve root(
Slide 15: Common spinal procedures: Decompression procedures
Coding & reimbursement Common spinal procedures Ambulatory Surgery Physician*5 Hospital Outpatient2 Center3 Overview CPT®1 code Description Work RVU Facility rate Status indicator APC Rate Payment indicator Rate Overview Decompression procedures Laminoplasty, cervical, with decompression of the spin
Slide 16: Common spinal procedures: Decompression procedures
Coding & reimbursement Common spinal procedures Physician*5 Hospital Outpatient2 Ambulatory Surgery Overview Center3 CPT®1 Facility Status Payment Overview Description Work RVU APC Rate Rate code rate indicator indicator Decompression procedures Costovertebral approach with decompression of spinal c
Slide 17: Common spinal procedures: Decompression procedures
Coding & reimbursement Common spinal procedures Ambulatory Surgery Overview Physician*5 Hospital Outpatient2 Center3 Overview CPT®1 Facility Status Payment Description Work RVU APC Rate Rate code rate indicator indicator Decompression procedures 63087 Vertebral corpectomy (vertebral body resection),
Slide 18: Modifiers
Coding & reimbursement Modifiers Overview Modifiers are used to supplement the information or adjust the care description to provide extra details concerning a procedure or service. Modifiers help further describe a procedure code without changing its definition. Overview Modifiers are appended to C
Slide 19: Status/payment indicators
Coding & reimbursement Status/payment indicators Each HCPCS code in the Outpatient Prospective Payment System and Ambulatory Surgery Center System Overview is assigned a status or payment indicator to signify whether a discount (payment reduction) applies to the Overview respective payment. Indicato
Slide 20: Medicare Severity-Diagnosis Related Groups
Coding & reimbursement Medicare Severity-Diagnosis Related Groups Overview Overview Medicare reimburses inpatient hospital services under the Inpatient Prospective Payment System (IPPS) which bases payment on Medicare Severity Diagnosis-Related Groups (MS-DRGs). The MS-DRG payment system groups simi
Slide 21: Complication and comorbidity designation
Coding & reimbursement Complication and comorbidity designation Secondary Diagnosis MS-DRG groups are further differentiated by assigning a CC, MCC, or without CC/MCC. For more information on these designations, see the MS-DRG Manual. MCC Major Complications and Comorbidities CC Complications and Co
Slide 22: Inpatient national unadjusted reimbursement rates
Coding & reimbursement Inpatient6 national unadjusted reimbursement rates Under Medicare’s MS-DRG6 methodology for hospital inpatient payment, each inpatient stay is assigned to one of about 750 diagnosis-related groups, Overview based on the ICD-10 codes assigned to the diagnoses and procedures. Ea
Slide 23: Inpatient national unadjusted reimbursement rates
Coding & reimbursement Inpatient6 national unadjusted reimbursement rates Overview MS-DRG Description 2026 Rate Overview Other Spinal Procedures (MDC 8) Laminectomy, laminotomy, discectomy; (peripheral nervous system procedures) ex. nerve decompression 515 Other musculoskeletal system and connective
Slide 24: Inpatient national unadjusted reimbursement rates
Coding & reimbursement Inpatient6 national unadjusted reimbursement rates Overview MS-DRG Description 2026 Rates Overview Lumbar or Thoracic Fusion (MDC 8) Standard lumbar or thoracic fusions due to degeneration; ex. ALIF, DLIF, OLIF, PLIF, TLIF, SI Fusion 447 Multiple level spinal fusion except cer
Slide 25: ICD-10-PCS
Coding & reimbursement ICD-10-PCS7 ICD-10-PCS7 procedure codes are used by hospitals to report surgeries and procedures performed in the inpatient setting. Below are Overview commonly used ICD-10-PCS procedure codes, however codes listed below are not exhaustive as other codes may apply. Overview IC
Slide 26: Site of service
Coding & reimbursement Site of service The table below reflects common spinal procedures by site of service. Overview Overview 2026 Anterior Cervical Anterior Cervical Lumbar PLF/PLIF PLIF/TLIF Posterolateral SI Lumbar Disc Discectomy and Interbody Fusion Lumbar Lumbar Lumbar Fusion Discectomy Repla
Slide 27: Frequently asked questions
Frequently asked questions Where can the Medicare physician fee schedule be found? The physician fee schedule can be found at CMS.gov. Overview What is the appropriate code for Cornerstone, Tangent, Precision and other tricortical allografts? Per the February 2005 edition of CPT Assistant9, all stru
Slide 28: Frequently asked questions
Frequently asked questions How is a lumbar discectomy procedure coded when it’s performed with the METRX system? Overview CPT code 63030 may be appropriate for an open procedure when there is continuous direct visualization through the surgical opening. Code 63035 would be assigned in addition to th
Slide 29: Appendix
Appendix Term Footnote Definition An Add-on Code (AOC) is a Healthcare Common Procedure Coding System (HCPCS) / Current Procedural Terminology (CPT) code that describes a service that is Overview Add-on CPT®1 codes + performed in conjunction with the primary service by the same practitioner. An AOC
Slide 30: Medtronic SpineLine
Medtronic SpineLineTM Medtronic SpineLineTM offers resources, education, and training to help physicians, hospitals, and coding professionals navigate reimbursement and coding for our spine and biologics products and therapies. Medtronic.com/SpineLine Billing and coding guides CPT/HCPCS codes Reimbu
Slide 31: Reimbursement Support Center
Resources Coding, coverage & payment Reimbursement Support Center Customer education & training rs.CSTUSReimbursementSupport@medtronic.com Resources & assistance © 2026 Medtronic. All rights reserved. Medtronic, Medtronic logo and Engineering the extraordinary are trademarks of Medtronic. Third part
Slide 32: References
References 1. CPT Copyright © 2025 American Medical Association. All rights reserved. CPT® is a registered trademark of the American Medical Association. Applicable FARS/DFARS restrictions Overview apply to government use. Fee schedules, relative value units, conversion factors and/or related compon
Slide 33: Disclaimer
Disclaimer Overview Medtronic provides this information for your convenience only. It does not constitute legal or reimbursement advice or a recommendation regarding clinical practice. Information provided is gathered from third-party sources and is subject to change without notice due to frequently