CPT code 22532: Spinal fusion, thoracic lateral extracavitary approach2026 Medicare rate & RVUs in California

CMS doesn’t publish an office rate for 22532 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.

What 22532 covers

This code covers fusion at a thoracic spinal interspace using a lateral extracavitary approach, which reaches the spine from a posterolateral route. The surgeon prepares the interspace for fusion, including limited discectomy when needed, but that preparation is not a separate decompression service. Orthopedic spine surgeons and neurosurgeons typically perform the operation in a hospital operating room for conditions requiring thoracic stabilization and fusion.

Select the code based on the thoracic location and operative approach, not diagnosis alone. The operative report should identify the treated level, the lateral extracavitary technique, and the fusion performed; document additional segments and any separately reportable graft or instrumentation services. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction. Assistant-at-surgery payment and co-surgeon reporting are permitted; team-surgery payment 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 22532 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

How the 22532 rate is calculated

Each of 22532’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.

Payment rules and modifiers for 22532

22532 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

22532 compared with similar codes

How to choose

22533Lumbar fusionLateral extracavitary approach

Both use a lateral extracavitary technique, but 22532 applies to thoracic fusion and 22533 to lumbar fusion.

22534Spinal fusionEach additional segment

22532 reports the primary service at a thoracic segment; 22534 reports each additional segment and is an add-on.

22556Thoracic fusionAnterior interbody technique

22556 describes thoracic interbody fusion through an anterior approach. Choose 22532 when the documented approach is lateral extracavitary.

22558Anterior fusionLumbar, single interspace

22558 is an anterior interbody fusion service for the lumbar region; 22532 is for thoracic fusion using a lateral extracavitary approach.

Codes related to 22532

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

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

Open CMS sourceHow we calculate rates