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CPT code 22214: Spine osteotomy, one lumbar segment2026 Medicare rate & RVUs

Reports a posterior or posterolateral lumbar osteotomy at one vertebral segment to mobilize the spine during correction of deformity.

CMS RVU26DEffective Oct 1, 2026109 payment localities11.6K Medicare services in 2024

Medicare pays $1,444.25 for 22214 nationally in a facility.

Medicare rate · 22214

Spine osteotomy, one lumbar segment

Office or facility?

Work RVUs
20.49
Total RVUs
43.24
Global days
090

National rate · 2026

$1,444.25

Facility setting, before claim adjustments.

See every locality for 22214 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 22214 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 22214 covers

CPT 22214 describes a posterior or posterolateral osteotomy at one lumbar vertebral segment. The surgeon removes or cuts bone, with associated discectomy included in the service, to create mobility for spinal realignment. Orthopedic spine surgeons and neurosurgeons commonly perform it in an operating room during correction of conditions such as scoliosis or kyphosis. The code identifies the lumbar region and one treated segment, not the total number of vertebrae involved in the overall fusion.

Report 22214 for the primary segment and use 22216 for each additional segment when the work meets that add-on code’s requirements. The operative report should identify the approach, lumbar location, segments treated, and osteotomy performed. A 90-day global includes the day-before preoperative visit and related postoperative care during that period. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is not appropriate for this spinal procedure. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 22214 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

22214 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,285.59
AlaskaUnavailable$1,729.91
ArizonaUnavailable$1,397.41
ArkansasUnavailable$1,266.22
Atlanta, GAUnavailable$1,496.59
Austin, TXUnavailable$1,454.25
Bakersfield, CAUnavailable$1,429.84
Baltimore area, MDUnavailable$1,544.47
Beaumont, TXUnavailable$1,379.78
Brazoria, TXUnavailable$1,399.41

22214 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
22214 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 22214 rate is calculated

Each of 22214’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 22214

RVUs × geographic indexes × conversion factor

Office or facility?

Work20.49

20.49 RVUs× 1.000 GPCI

Practice expense16.58

16.58 RVUs× 1.000 GPCI

Malpractice6.17

6.17 RVUs× 1.000 GPCI

Adjusted RVUs

43.2400

Conversion factor

$33.4009

Medicare rate

$1,444.25

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 22214

22214 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 22214

Spine osteotomy, one lumbar segment

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 22214

Spine osteotomy, one lumbar segment

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

22214 without 51 · national facility

$1,444.25

Spine osteotomy, one lumbar segment

22214-51 · Second procedure: 50%

$722.13

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

22214 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 22214

    Spine osteotomy, one lumbar segment20.49 wRVU

    Not priced

  • 22207

    Spinal osteotomy, lumbar, three-column, one segment35.76 wRVU

    Not priced

  • 22216

    Spinal osteotomy, each additional segment5.88 wRVU

    Not priced

  • 22224

    Spinal osteotomy, anterior, single lumbar segment22.51 wRVU

    Not priced

  • 22212

    Spinal osteotomy, single thoracic segment20.47 wRVU

    Not priced

How to choose

22207Spinal osteotomyLumbar, three-column, one segment
22207 identifies a three-column lumbar osteotomy. Use 22214 for the one-segment posterior or posterolateral osteotomy that is not classified as three-column.
22216Spinal osteotomyEach additional segment
22214 reports the primary lumbar segment; 22216 is the add-on for each additional qualifying segment.
22224Spinal osteotomyAnterior, single lumbar segment
22224 is for an anterior lumbar osteotomy. Choose 22214 when the osteotomy is performed through a posterior or posterolateral approach.
22212Spinal osteotomySingle thoracic segment
22212 describes the corresponding one-segment posterior or posterolateral osteotomy in the thoracic region; 22214 is for the lumbar region.

Codes related to 22214

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 22214
CodeHow it relatesNational office range
Add-on codes
22216Spinal osteotomy, each additional segmentAdd-on code for each additional qualifying spinal segment beyond the primary osteotomy.No office rate
Same family
22212Spinal osteotomy, single thoracic segmentPosterior or posterolateral osteotomy at one thoracic segment.No office rate
22210Spinal osteotomy, cervical, one segmentPosterior or posterolateral osteotomy at one cervical segment.No office rate
Used instead
22207Spinal osteotomy, lumbar, three-column, one segmentFor a three-column lumbar osteotomy rather than the one-segment service described by 22214.No office rate
22224Spinal osteotomy, anterior, single lumbar segmentLumbar osteotomy by an anterior approach rather than a posterior or posterolateral approach.No office rate
Often billed with
22612Spinal fusion, posterior lumbar, single levelLumbar posterior or posterolateral fusion may be performed during the same deformity-correction session.No office rate

22214 billing questions

When is 22214 different from 22207?

Use 22214 for a posterior or posterolateral osteotomy at one lumbar segment that is not described as a three-column osteotomy. Code 22207 identifies a three-column lumbar osteotomy.

Can 22216 be reported with 22214?

Yes. Report 22214 for the primary lumbar segment and 22216 for each additional qualifying segment, supported by the operative report.

Is the discectomy separately reported?

Discectomy associated with the osteotomy is included in 22214. A separate discectomy code should not represent that same included work.

Can modifier 50 be used for two sides?

No. Modifier 50 is not appropriate for this midline spinal procedure; the code is selected by lumbar segment rather than side.

What postoperative care is included?

The 90-day global includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.

May an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, while team surgery is not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 22214PPRRVU2026_Oct_nonQPP.csv, line 2,056 (RVU26D)

Open CMS sourceHow we calculate rates

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