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Ragans will undergo surgery on his left elbow Wednesday, Anne Rogers of MLB.com reports.
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The Royals recalled Cerantola from Triple-A Omaha on Saturday.
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The Royals optioned Spence to Triple-A Omaha on Saturday.
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Spence (0-2) took the loss against the White Sox on Friday, allowing 10 runs on eight hits and three walks with two strikeouts over 1.1 innings.
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Witt (knee) is batting second as the designated hitter Friday against the White Sox.
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The Royals recalled Spence from Triple-A Omaha on Friday.
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Cruz is listed as the Royals' opener for Friday's game against the White Sox.
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Bubic (elbow) threw a perfect inning while striking out one in Wednesday's rehab start with Triple-A Omaha.
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Lugo (3-5) took the loss Thursday against the Rays, allowing seven runs on seven hits and two walks over five innings. He struck out three.
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Royals manager Matt Quatraro indicated Thursday that Witt (knee) is on track to return to the lineup Friday versus the White Sox, Joel Goldberg of Bally Sports Kansas City reports.
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Kolek won't be available to make his scheduled start Friday against the White Sox and is expected to be placed on the paternity list prior to the contest, Joel Goldberg of Bally Sports Kansas City reports.
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Massey is absent from the lineup for Thursday's game against the Rays.
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Witt (knee) remains out of the lineup for Thursday's contest versus the Rays.
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Cameron (4-5) took the loss Wednesday against the Rays, allowing five runs on eight hits and three walks over five innings. He struck out five.
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Thomas is out of the lineup for Wednesday's game against the Rays.
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Witt (knee) is out of the lineup for Wednesday's game against the Rays.
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Estevez (shoulder) threw a bullpen Sunday and is scheduled to throw another Wednesday, MLB.com reports.
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Mears (shoulder) received an injection and began playing catch again Monday, MLB.com reports.
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Bubic (elbow) is slated to make a rehab start Wednesday with Double-A Northwest Arkansas.
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Loftin went 4-for-5 with a home run, two RBI and four runs scored in Tuesday's 12-5 win over the Rays.
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Caglianone went 3-for-5 with two home runs, three RBI and an additional run scored in Tuesday's 12-5 win over the Rays.
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Avila (3-3) earned the win against the Rays on Tuesday, allowing one run on three hits and four walks with six strikeouts over five innings.
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Manager Matt Quatraro said Tuesday that Ragans will likely need some type of elbow surgery, but the specific procedure and potential recovery timeline remain unclear, as the left-hander is scheduled to visit another doctor soon, Brian Murphy of MLB.com reports.
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Collins is not in the lineup for Tuesday's game against the Rays.
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Witt (knee) remains out of the lineup for Tuesday's game against the Rays.
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