CPT code 22220: Spinal osteotomy, anterior cervical, one segment2026 Medicare rate & RVUs in California
Report an anterior cervical osteotomy with disc removal when a surgeon releases one vertebral segment to correct a fixed cervical deformity.
CMS doesn’t publish an office rate for 22220 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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On this page 9 sections
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 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 | $1,536.09 |
| Chico, CA | Unavailable | $1,517.39 |
| El Centro, CA | Unavailable | $1,518.56 |
| Fresno, CA | Unavailable | $1,517.39 |
| Hanford, CA | Unavailable | $1,517.39 |
| Los Angeles, CA | Unavailable | $1,615.60 |
| Madera, CA | Unavailable | $1,517.39 |
| Marin County, CA | Unavailable | $1,738.32 |
| Merced, CA | Unavailable | $1,517.39 |
| Modesto, CA | Unavailable | $1,517.39 |
| Napa, CA | Unavailable | $1,672.99 |
| Oxnard, CA | Unavailable | $1,595.64 |
| Redding, CA | Unavailable | $1,517.39 |
| Rest of California | Unavailable | $1,517.39 |
| Riverside, CA | Unavailable | $1,592.88 |
| Sacramento, CA | Unavailable | $1,570.16 |
| Salinas, CA | Unavailable | $1,564.12 |
| San Benito County, CA | Unavailable | $1,786.11 |
| San Diego, CA | Unavailable | $1,586.10 |
| San Francisco, CA | Unavailable | $1,730.30 |
| San Luis Obispo, CA | Unavailable | $1,542.15 |
| Santa Clara County, CA | Unavailable | $1,753.33 |
| Santa Cruz, CA | Unavailable | $1,588.90 |
| Santa Maria, CA | Unavailable | $1,565.91 |
| Santa Rosa, CA | Unavailable | $1,603.11 |
| Stockton, CA | Unavailable | $1,517.39 |
| Vallejo, CA | Unavailable | $1,661.43 |
| Visalia, CA | Unavailable | $1,517.39 |
| Yuba City, CA | Unavailable | $1,517.39 |
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
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| 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. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share 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.
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%).
22220 compared with similar codes
Compare codes · National
5 codes, side by side
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.
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
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