| 80992-1 | Date+time of surgery | |
| 97812-2 | Therapeutic goals | |
| 97813-0 | Implant | |
| 74719-6 | Manufacturer name | |
| 74720-4 | Device name | |
| 97814-8 | Anterior access type | |
| 97815-5 | Posterior access | |
| 97816-3 | ASA morbidity state | |
| 71735-5 | Personnel Credentials | |
| 97817-1 | Surgical tech used type | |
| 89875-9 | Proc dur | |
| 9110-8 | Blood loss.total intraop Vol Est | |
| 97818-9 | Bld prod vol/cell saver | |