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CPT code 22224: Spinal osteotomy, anterior, single lumbar segment2026 Medicare rate & RVUs

Reports an anterior osteotomy with disc removal at one lumbar vertebral segment to mobilize the spine, commonly during correction of a fixed deformity.

CMS RVU26DEffective Oct 1, 2026109 payment localities703 Medicare services in 2024

Medicare pays $1,480.33 for 22224 nationally in a facility.

Medicare rate · 22224

Spinal osteotomy, anterior, single lumbar segment

Office or facility?

Work RVUs
22.51
Total RVUs
44.32
Global days
090

National rate · 2026

$1,480.33

Facility setting, before claim adjustments.

See every locality for 22224 →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 22224 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 22224 covers

A spine surgeon uses an anterior approach to remove disc and adjacent bone at one lumbar vertebral segment, creating mobility for correction of a fixed spinal deformity or alignment problem. This work may be part of a larger reconstruction that includes lumbar fusion. The code includes the discectomy integral to the osteotomy at that segment; it is not simply a code for routine disc removal or an interbody fusion.

Report one unit for the treated lumbar segment and document the operative level, anterior approach, bone and disc work, and its role in the correction. When osteotomy is performed at another segment, 22226 is the add-on code for each additional segment. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; 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 22224 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

22224 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,330.03
AlaskaUnavailable$1,805.06
ArizonaUnavailable$1,436.08
ArkansasUnavailable$1,311.66
Atlanta, GAUnavailable$1,529.71
Austin, TXUnavailable$1,491.11
Bakersfield, CAUnavailable$1,471.18
Baltimore area, MDUnavailable$1,576.98
Beaumont, TXUnavailable$1,418.41
Brazoria, TXUnavailable$1,439.33

22224 rates by state

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

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Explore a state

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
22224 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 22224 rate is calculated

Each of 22224’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 · 22224

RVUs × geographic indexes × conversion factor

Office or facility?

Work22.51

22.51 RVUs× 1.000 GPCI

Practice expense16.07

16.07 RVUs× 1.000 GPCI

Malpractice5.74

5.74 RVUs× 1.000 GPCI

Adjusted RVUs

44.3200

Conversion factor

$33.4009

Medicare rate

$1,480.33

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

Payment rules and modifiers for 22224

22224 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 22224

Spinal osteotomy, anterior, single 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 · 22224

Spinal osteotomy, anterior, single 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

22224 without 51 · national facility

$1,480.33

Spinal osteotomy, anterior, single lumbar segment

22224-51 · Second procedure: 50%

$740.17

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

22224 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 22224

    Spinal osteotomy, anterior, single lumbar segment22.51 wRVU

    Not priced

  • 22214

    Spine osteotomy, one lumbar segment20.49 wRVU

    Not priced

  • 22207

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

How to choose

22214Spine osteotomyOne lumbar segment
Use 22224 for the anterior lumbar osteotomy; 22214 describes a single-segment lumbar osteotomy performed through a posterior or posterolateral approach.
22207Spinal osteotomyLumbar, three-column, one segment
22207 is for a posterior lumbar osteotomy involving three columns. 22224 describes the anterior approach at one lumbar segment.
22222Spinal osteotomyAnterior thoracic, one segment
22222 describes the corresponding anterior single-segment osteotomy in the thoracic spine; 22224 is for the lumbar spine.
22226Spinal osteotomyEach additional anterior segment
22224 reports the primary lumbar segment. 22226 is an add-on for each additional qualifying segment, not a substitute for the primary code.

Codes related to 22224

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

Codes related to 22224
CodeHow it relatesNational office range
Add-on codes
22226Spinal osteotomy, each additional anterior segmentAdd-on code for each additional segment treated with the qualifying anterior osteotomy.No office rate
Same family
22220Spinal osteotomy, anterior cervical, one segmentAnterior osteotomy at a single cervical rather than lumbar segment.No office rate
22222Spinal osteotomy, anterior thoracic, one segmentAnterior osteotomy at a single thoracic rather than lumbar segment.No office rate
Used instead
22214Spine osteotomy, one lumbar segmentSingle-segment lumbar osteotomy using a posterior or posterolateral approach.No office rate
22207Spinal osteotomy, lumbar, three-column, one segmentLumbar osteotomy involving three columns through a posterior approach.No office rate

22224 billing questions

How is 22224 different from 22214?

22224 describes an anterior lumbar osteotomy. 22214 describes a posterior or posterolateral osteotomy at one lumbar segment.

When is 22226 reported with 22224?

Report 22226 for each additional vertebral segment treated with the qualifying anterior osteotomy. Document the separate additional level; do not use it for another service at the same segment.

Can the discectomy at the osteotomy level be billed separately?

Disc removal integral to the osteotomy at that segment is included in 22224. A separate discectomy code should not describe that same work.

Can 22224 be billed with a lumbar fusion code?

An osteotomy may be performed as part of a lumbar reconstruction that also includes fusion. Report the fusion service only when performed and separately supported by the operative record.

Should modifier 50 be used for a bilateral approach?

No. The code represents work at a lumbar vertebral segment, not a paired structure, so modifier 50 is inappropriate.

What supports assistant or co-surgeon reporting?

CMS allows assistant-at-surgery payment for this code. Co-surgeon payment requires supporting documentation; 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 22224PPRRVU2026_Oct_nonQPP.csv, line 2,060 (RVU26D)

Open CMS sourceHow we calculate rates

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