CPT code 22216: Spinal osteotomy, each additional segment2026 Medicare rate & RVUs in California
Report this add-on for each additional vertebral segment treated with a posterior or posterolateral spinal osteotomy beyond the first segment.
CMS doesn’t publish an office rate for 22216 in California.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 22216 covers
This add-on represents an additional vertebral segment treated during a posterior or posterolateral spinal osteotomy, including the discectomy described for this procedure family. Spine surgeons may perform these osteotomies during surgery to correct spinal deformity, such as kyphosis or scoliosis. The code applies to an additional segment beyond the first; the primary code identifies the spinal region and the initial segment treated.
Report 22216 with the corresponding primary osteotomy code for the first segment, selecting that code by cervical, thoracic, or lumbar region. Documentation should identify the approach, the vertebral segments treated, and the osteotomy performed at each additional segment. The add-on is billed only with a primary procedure and its payment falls within that procedure’s global period.
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 22216 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | Unavailable | $307.52 |
| Chico, CA | Unavailable | $302.81 |
| El Centro, CA | Unavailable | $303.10 |
| Fresno, CA | Unavailable | $302.81 |
| Hanford, CA | Unavailable | $302.81 |
| Los Angeles, CA | Unavailable | $320.76 |
| Madera, CA | Unavailable | $302.81 |
| Marin County, CA | Unavailable | $334.03 |
| Merced, CA | Unavailable | $302.81 |
| Modesto, CA | Unavailable | $302.81 |
| Napa, CA | Unavailable | $324.65 |
| Oxnard, CA | Unavailable | $315.71 |
| Redding, CA | Unavailable | $302.81 |
| Rest of California | Unavailable | $302.81 |
| Riverside, CA | Unavailable | $321.75 |
| Sacramento, CA | Unavailable | $310.90 |
| Salinas, CA | Unavailable | $309.66 |
| San Benito County, CA | Unavailable | $343.61 |
| San Diego, CA | Unavailable | $312.23 |
| San Francisco, CA | Unavailable | $332.02 |
| San Luis Obispo, CA | Unavailable | $305.61 |
| Santa Clara County, CA | Unavailable | $335.39 |
| Santa Cruz, CA | Unavailable | $311.34 |
| Santa Maria, CA | Unavailable | $309.53 |
| Santa Rosa, CA | Unavailable | $313.96 |
| Stockton, CA | Unavailable | $302.81 |
| Vallejo, CA | Unavailable | $321.75 |
| Visalia, CA | Unavailable | $302.81 |
| Yuba City, CA | Unavailable | $302.81 |
How the 22216 rate is calculated
Each of 22216’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 · 22216
RVUs × geographic indexes × conversion factor
Work5.88
5.88 RVUs× 1.000 GPCI
Practice expense1.95
1.95 RVUs× 1.000 GPCI
Malpractice1.77
1.77 RVUs× 1.000 GPCI
Adjusted RVUs
9.6000
Conversion factor
$33.4009
Medicare rate
$320.65
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 22216
The CMS indicators that decide how 22216 is paid alongside other services.
CMS payment indicators · 22216
Spinal osteotomy, each additional segment
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 80 · payment effect
With and without the modifier
22216 without 80 · national facility
$320.65
Spinal osteotomy, each additional segment
22216-80 · Assistant: 16%
$51.30
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
22216 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 22214Spine osteotomyOne lumbar segment
- 22214 reports the first lumbar segment treated. 22216 reports each additional segment and is not a stand-alone substitute for the primary code.
- 22208Spinal osteotomyAdditional three-column segment
- 22208 is the additional-segment code for a three-column spinal osteotomy. Choose the add-on that matches the osteotomy type documented.
- 22224Spinal osteotomyAnterior, single lumbar segment
- 22224 describes a single-segment lumbar osteotomy through an anterior approach. 22216 is for additional segments in the posterior or posterolateral osteotomy series.
22216 billing questions
When is 22216 reported instead of 22214?
22214 reports the first lumbar segment treated with the applicable posterior or posterolateral osteotomy. Use 22216 for each additional segment treated in that procedure.
Which primary code must accompany 22216?
Report it with the primary code for the first segment: 22210 for cervical, 22212 for thoracic, or 22214 for lumbar.
How many units of 22216 should be reported?
Report one unit for each additional vertebral segment treated beyond the first. The operative report should support the number and location of those segments.
Can the included discectomy be billed separately as part of this service?
The osteotomy code family includes discectomy in its described service. Do not separately report the discectomy when it is part of the work represented by the osteotomy.
How does the add-on payment relate to the primary procedure?
22216 is billed only with a primary procedure, and its payment falls within that primary procedure’s global period.
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
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