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CPT code 22220: Spinal osteotomy, anterior cervical, one segment2026 Medicare rate & RVUs

Report an anterior cervical osteotomy with disc removal when a surgeon releases one vertebral segment to correct a fixed cervical deformity.

CMS RVU26DEffective Oct 1, 2026109 payment localities503 Medicare services in 2024

Medicare pays $1,558.82 for 22220 nationally in a facility.

Medicare rate · 22220

Spinal osteotomy, anterior cervical, one segment

Office or facility?

Work RVUs
22.37
Total RVUs
46.67
Global days
090

National rate · 2026

$1,558.82

Facility setting, before claim adjustments.

See every locality for 22220 →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 22220 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 22220 covers

This service involves an anteriorly approached osteotomy at one cervical vertebral segment, with removal of the intervening disc as part of the release. A spine surgeon may perform it to mobilize a fixed deformity, such as cervical kyphosis, when correction requires an osteotomy rather than routine disc decompression. It is performed in the operating room and may be part of a larger reconstruction or fusion procedure.

Report one unit for the cervical segment actually osteotomized. The operative report should identify the treated level, anterior approach, bony release, associated disc removal, and correction performed. Routine cervical discectomy and fusion without an osteotomy is not this service; 22226 describes each additional segment. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. An assistant at surgery may be paid; co-surgeons require 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 22220 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

22220 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,384.50
AlaskaUnavailable$1,863.96
ArizonaUnavailable$1,507.01
ArkansasUnavailable$1,363.26
Atlanta, GAUnavailable$1,617.67
Austin, TXUnavailable$1,566.83
Bakersfield, CAUnavailable$1,536.09
Baltimore area, MDUnavailable$1,668.70
Beaumont, TXUnavailable$1,490.25
Brazoria, TXUnavailable$1,507.74

22220 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
22220 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 22220 rate is calculated

Each of 22220’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 · 22220

RVUs × geographic indexes × conversion factor

Office or facility?

Work22.37

22.37 RVUs× 1.000 GPCI

Practice expense17.24

17.24 RVUs× 1.000 GPCI

Malpractice7.06

7.06 RVUs× 1.000 GPCI

Adjusted RVUs

46.6700

Conversion factor

$33.4009

Medicare rate

$1,558.82

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

Payment rules and modifiers for 22220

22220 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 22220

Spinal osteotomy, anterior cervical, one 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 · 22220

Spinal osteotomy, anterior cervical, one 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

22220 without 51 · national facility

$1,558.82

Spinal osteotomy, anterior cervical, one segment

22220-51 · Second procedure: 50%

$779.41

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

22220 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 22220

    Spinal osteotomy, anterior cervical, one segment22.37 wRVU

    Not priced

  • 22210

    Spinal osteotomy, cervical, one segment24.75 wRVU

    Not priced

  • 22222

    Spinal osteotomy, anterior thoracic, one segment22.51 wRVU

    Not priced

  • 22226

    Spinal osteotomy, each additional anterior segment5.88 wRVU

    Not priced

  • 22551

    ACDF, one cervical interspace with decompression24.38 wRVU

    Not priced

How to choose

22210Spinal osteotomyCervical, one segment
Both describe a cervical osteotomy with disc removal, but 22210 is the posterior-approach service; 22220 is anterior.
22222Spinal osteotomyAnterior thoracic, one segment
This is the corresponding anterior osteotomy for a thoracic segment. Use 22220 for a cervical segment.
22226Spinal osteotomyEach additional anterior segment
22220 describes the first cervical segment; 22226 describes each additional anterior osteotomy segment.
22551ACDFOne cervical interspace with decompression
22551 describes anterior cervical discectomy and fusion, not an osteotomy for deformity release. Report 22220 only when the operative work includes the osteotomy.

Codes related to 22220

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

Codes related to 22220
CodeHow it relatesNational office range
Add-on codes
22226Spinal osteotomy, each additional anterior segmentAdditional anterior osteotomy segments may be reported with this single-segment service.No office rate
Same family
22222Spinal osteotomy, anterior thoracic, one segmentAnterior osteotomy for one thoracic vertebral segment rather than a cervical segment.No office rate
22224Spinal osteotomy, anterior, single lumbar segmentAnterior osteotomy for one lumbar vertebral segment rather than a cervical segment.No office rate
Used instead
22210Spinal osteotomy, cervical, one segmentCervical osteotomy through a posterior approach rather than the anterior approach.No office rate

22220 billing questions

How is 22220 different from routine anterior cervical discectomy and fusion?

22220 requires an osteotomy to release a cervical vertebral segment for deformity correction. Routine disc removal and fusion without that osteotomy is not enough to report it.

Does 22220 include removal of the disc?

Yes. Disc removal at the treated segment is part of the osteotomy service; do not separately report that same disc removal as a separate service.

When is 22226 used with 22220?

Use 22220 for the first anterior cervical segment osteotomized and 22226 for each additional segment when documented.

What operative documentation supports 22220?

Document the cervical level, anterior approach, vertebral osteotomy and associated disc removal, and the deformity release or correction performed.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeons are paid only with supporting documentation; team surgery is not permitted.

How does the global period affect postoperative billing?

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

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 22220PPRRVU2026_Oct_nonQPP.csv, line 2,058 (RVU26D)

Open CMS sourceHow we calculate rates

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