CPT code 22532: Spinal fusion, thoracic lateral extracavitary approach2026 Medicare rate & RVUs in Washington, DC area
Reports thoracic spinal fusion through a lateral extracavitary approach, including limited disc-space preparation when performed as part of the fusion.
In Washington, DC area, Medicare pays $1,916.55 for 22532 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 22532 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
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.
How Washington, DC area compares for 22532
Across 109 of 109 payment localities, the facility rate for 22532 runs from $1,504.68 in Nebraska to $2,203.37 in Miami, FL. Washington, DC area pays $1,916.55. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Washington, DC area · this page$1,916.55
- Los Angeles, CA · California$1,777.29−$139.26
- Miami, FL · Florida$2,203.37+$286.82
- Chicago, IL · Illinois$2,119.54+$202.99
- Manhattan, NY · New York$2,053.75+$137.20
- Alaska · Alaska$2,062.72+$146.17
- Alabama · Alabama$1,531.14−$385.41
Other areas in District of Columbia first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| ArkansasArkansas | — | $1,506.74 |
| ArizonaArizona | — | $1,671.69 |
| Bakersfield, CACalifornia | — | $1,690.96 |
| Chico, CACalifornia | — | $1,667.93 |
| El Centro, CACalifornia | — | $1,669.39 |
| Fresno, CACalifornia | — | $1,667.93 |
| Hanford, CACalifornia | — | $1,667.93 |
| Madera, CACalifornia | — | $1,667.93 |
| Merced, CACalifornia | — | $1,667.93 |
| Modesto, CACalifornia | — | $1,667.93 |
| Napa, CACalifornia | — | $1,830.45 |
| Oxnard, CACalifornia | — | $1,753.71 |
| Redding, CACalifornia | — | $1,667.93 |
| Rest of CaliforniaCalifornia | — | $1,667.93 |
| Riverside, CACalifornia | — | $1,761.42 |
| Sacramento, CACalifornia | — | $1,723.78 |
| Salinas, CACalifornia | — | $1,717.17 |
| San Diego, CACalifornia | — | $1,740.04 |
| Marin County, CACalifornia | — | $1,897.81 |
| San Francisco, CACalifornia | — | $1,887.88 |
| San Benito County, CACalifornia | — | $1,952.01 |
| Santa Clara County, CACalifornia | — | $1,911.38 |
| San Luis Obispo, CACalifornia | — | $1,693.45 |
| Santa Cruz, CACalifornia | — | $1,741.95 |
| Santa Maria, CACalifornia | — | $1,718.79 |
| Santa Rosa, CACalifornia | — | $1,757.28 |
| Stockton, CACalifornia | — | $1,667.93 |
| Vallejo, CACalifornia | — | $1,816.12 |
| Visalia, CACalifornia | — | $1,667.93 |
| Yuba City, CACalifornia | — | $1,667.93 |
| ColoradoColorado | — | $1,716.31 |
| ConnecticutConnecticut | — | $1,856.17 |
| DelawareDelaware | — | $1,699.76 |
| Fort Lauderdale, FLFlorida | — | $1,976.03 |
| Rest of FloridaFlorida | — | $1,853.06 |
| Atlanta, GAGeorgia | — | $1,802.95 |
| Rest of GeorgiaGeorgia | — | $1,724.18 |
| Hawaii, Guam, HIHawaii | — | $1,690.44 |
| IowaIowa | — | $1,505.49 |
| IdahoIdaho | — | $1,530.67 |
| East St. Louis, ILIllinois | — | $1,981.04 |
| Rest of IllinoisIllinois | — | $1,845.07 |
| Suburban Chicago, ILIllinois | — | $1,979.74 |
| IndianaIndiana | — | $1,538.62 |
| KansasKansas | — | $1,530.23 |
| KentuckyKentucky | — | $1,641.45 |
| New Orleans, LALouisiana | — | $1,736.90 |
| Rest of LouisianaLouisiana | — | $1,651.64 |
| Metropolitan Boston, MAMassachusetts | — | $1,849.87 |
| Rest of MassachusettsMassachusetts | — | $1,717.84 |
| Baltimore area, MDMaryland | — | $1,858.31 |
| Rest of MarylandMaryland | — | $1,723.79 |
| Rest of MaineMaine | — | $1,574.21 |
| Southern Maine, MEMaine | — | $1,618.99 |
| Detroit, MIMichigan | — | $1,911.89 |
| Rest of MichiganMichigan | — | $1,718.23 |
| MinnesotaMinnesota | — | $1,543.63 |
| Metropolitan Kansas City, MOMissouri | — | $1,689.24 |
| Metropolitan St. Louis, MOMissouri | — | $1,704.27 |
| Rest of MissouriMissouri | — | $1,642.66 |
| MississippiMississippi | — | $1,573.39 |
| MontanaMontana | — | $1,731.59 |
| North CarolinaNorth Carolina | — | $1,586.90 |
| North DakotaNorth Dakota | — | $1,558.57 |
| NebraskaNebraska | — | $1,504.68 |
| New HampshireNew Hampshire | — | $1,719.97 |
| Northern New JerseyNew Jersey | — | $1,900.33 |
| Rest of New JerseyNew Jersey | — | $1,848.98 |
| New MexicoNew Mexico | — | $1,741.65 |
| NevadaNevada | — | $1,683.96 |
| NYC suburbs and Long Island, NYNew York | — | $2,148.98 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $1,888.02 |
| Queens, NYNew York | — | $2,023.54 |
| Rest of New YorkNew York | — | $1,615.69 |
| OhioOhio | — | $1,682.87 |
| OklahomaOklahoma | — | $1,603.49 |
| Portland, OROregon | — | $1,736.78 |
| Rest of OregonOregon | — | $1,643.00 |
| Metropolitan Philadelphia, PAPennsylvania | — | $1,828.15 |
| Rest of PennsylvaniaPennsylvania | — | $1,667.43 |
| Puerto RicoPuerto Rico | — | $1,734.32 |
| Rhode IslandRhode Island | — | $1,736.27 |
| South CarolinaSouth Carolina | — | $1,643.22 |
| South DakotaSouth Dakota | — | $1,538.11 |
| TennesseeTennessee | — | $1,542.84 |
| Austin, TXTexas | — | $1,734.97 |
| Beaumont, TXTexas | — | $1,658.00 |
| Brazoria, TXTexas | — | $1,669.30 |
| Dallas, TXTexas | — | $1,695.91 |
| Fort Worth, TXTexas | — | $1,693.78 |
| Galveston, TXTexas | — | $1,684.52 |
| Houston, TXTexas | — | $1,844.68 |
| Rest of TexasTexas | — | $1,673.55 |
| UtahUtah | — | $1,666.75 |
| VirginiaVirginia | — | $1,636.16 |
| Virgin Islands, VIUnited States Virgin Islands | — | $1,734.32 |
| VermontVermont | — | $1,581.86 |
| Rest of WashingtonWashington | — | $1,704.78 |
| King County, WAWashington | — | $1,855.74 |
| WisconsinWisconsin | — | $1,505.00 |
| West VirginiaWest Virginia | — | $1,780.38 |
| WyomingWyoming | — | $1,656.18 |
22532 rates by state
Office rate range in each state. Select a state to see its payment localities.
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
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.
How the rate is built · 22532
RVUs × geographic indexes × conversion factor
Work25.34
25.34 RVUs× 1.000 GPCI
Practice expense17.77
17.77 RVUs× 1.000 GPCI
Malpractice8.75
8.75 RVUs× 1.000 GPCI
Adjusted RVUs
51.8600
Conversion factor
$33.4009
Medicare rate
$1,732.17
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Washington, DC area inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
2,079
- Code
- 22532
- Physician work
- 25.34
- Practice expense
- 17.77
- Malpractice
- 8.75
GPCI2026.csv
39
- Locality
- Washington, DC area
- Physician work
- 1.054
- Practice expense
- 1.178
- Malpractice
- 1.113
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 25.34 | × 1.054 | 26.7084 |
| Practice expense | 17.77 | × 1.178 | 20.9331 |
| Malpractice | 8.75 | × 1.113 | 9.7387 |
| Total RVUs | 57.3802 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Washington, DC area$1916.55
Facility: (25.34 × 1.054 + 17.77 × 1.178 + 8.75 × 1.113) × $33.4009 = $1916.55
Payment rules and modifiers for 22532
22532 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 22532
Spinal fusion, thoracic lateral extracavitary approach
| 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) | 2 | Permitted. |
| 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 · 22532
Spinal fusion, thoracic lateral extracavitary approach
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
22532 without 51 · national facility
$1,732.17
Spinal fusion, thoracic lateral extracavitary approach
22532-51 · Second procedure: 50%
$866.09
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%).
How 22532 has changed in Washington, DC area
22532 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $1,916.55 | RVU26D |
| 2026-07-01 | Not available in this setting | $1,916.55 | RVU26C |
| 2026-04-01 | Not available in this setting | $1,916.55 | RVU26B |
| 2026-01-01 | Not available in this setting | $1,916.55 | RVU26A |
| 2025-10-01 | Not available in this setting | $1,983.06 | RVU25D |
| 2025-07-01 | Not available in this setting | $1,983.06 | RVU25C |
| 2025-04-01 | Not available in this setting | $1,983.06 | RVU25B |
| 2025-01-01 | Not available in this setting | $1,983.06 | RVU25A |
| 2024-10-01 | Not available in this setting | $2,032.17 | RVU24D |
| 2024-07-01 | Not available in this setting | $2,032.17 | RVU24C |
| 2024-04-01 | Not available in this setting | $2,032.17 | RVU24B |
| 2024-03-09 | Not available in this setting | $2,032.17 | RVU24AR |
| 2024-01-01 | Not available in this setting | $1,999.00 | RVU24A |
| 2023-10-01 | Not available in this setting | $2,087.12 | RVU23D |
| 2023-07-01 | Not available in this setting | $2,087.12 | RVU23C |
| 2023-04-01 | Not available in this setting | $2,087.12 | RVU23B |
| 2023-01-01 | Not available in this setting | $2,087.12 | RVU23A |
| 2022-10-01 | Not available in this setting | $2,141.48 | RVU22D |
| 2022-07-01 | Not available in this setting | $2,141.48 | RVU22C |
| 2022-04-01 | Not available in this setting | $2,141.48 | RVU22B |
| 2022-01-01 | Not available in this setting | $2,141.48 | RVU22A |
| 2021-10-01 | Not available in this setting | $2,137.44 | RVU21D |
| 2021-07-01 | Not available in this setting | $2,137.44 | RVU21C |
| 2021-04-01 | Not available in this setting | $2,137.44 | RVU21B |
| 2021-01-01 | Not available in this setting | $2,137.44 | RVU21A |
| 2020-10-01 | Not available in this setting | $2,150.82 | RVU20D |
| 2020-07-01 | Not available in this setting | $2,150.82 | RVU20C |
| 2020-04-01 | Not available in this setting | $2,150.82 | RVU20B |
| 2020-01-01 | Not available in this setting | $2,150.82 | RVU20A |
| 2019-10-01 | Not available in this setting | $2,142.59 | RVU19D |
| 2019-07-01 | Not available in this setting | $2,142.59 | RVU19C |
| 2019-04-01 | Not available in this setting | $2,142.59 | RVU19B |
| 2019-01-01 | Not available in this setting | $2,142.59 | RVU19A |
| 2018-10-01 | Not available in this setting | $2,126.11 | RVU18D |
| 2018-07-01 | Not available in this setting | $2,126.11 | RVU18C |
| 2018-04-01 | Not available in this setting | $2,126.11 | RVU18B |
| 2018-01-01 | Not available in this setting | $2,126.11 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $2,103.53 | RVU17D |
| 2017-07-01 | Not available in this setting | $2,103.53 | RVU17C |
| 2017-04-01 | Not available in this setting | $2,103.53 | RVU17B |
| 2017-01-01 | Not available in this setting | $2,103.53 | RVU17A |
| 2016-10-01 | Not available in this setting | $2,112.62 | RVU16D |
| 2016-07-01 | Not available in this setting | $2,112.62 | RVU16C |
| 2016-04-01 | Not available in this setting | $2,112.62 | RVU16B |
| 2016-01-01 | Not available in this setting | $2,112.62 | RVU16A |
| 2015-10-01 | Not available in this setting | $2,123.92 | RVU15D |
| 2015-07-01 | Not available in this setting | $2,123.92 | RVU15C |
| 2015-04-01 | Not available in this setting | $2,113.35 | RVU15B |
| 2015-01-01 | Not available in this setting | $2,113.35 | RVU15A |
| 2014-10-01 | Not available in this setting | $2,065.60 | RVU14D |
| 2014-07-01 | Not available in this setting | $2,065.60 | RVU14C |
| 2014-04-01 | Not available in this setting | $2,065.60 | RVU14B |
| 2014-01-01 | Not available in this setting | $2,065.60 | RVU14A |
| 2013-10-01 | Not available in this setting | $2,009.36 | RVU13D |
| 2013-07-01 | Not available in this setting | $2,009.36 | RVU13C |
| 2013-04-01 | Not available in this setting | $2,009.36 | RVU13B |
| 2013-01-01 | Not available in this setting | $2,009.36 | RVU13AR |
Where the Washington, DC area rate applies
Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.
- Washington
22532 billing questions
How does 22532 differ from 22533?
22532 is for a thoracic fusion using the lateral extracavitary approach. The corresponding lumbar service is 22533.
When is 22534 reported with 22532?
22534 is an add-on for each additional thoracic or lumbar vertebral segment treated with the lateral extracavitary technique. The operative report should identify the additional segment.
Does 22532 include disc-space preparation?
It includes limited discectomy performed to prepare the interspace for fusion. Document a distinct decompression service separately when performed and supported.
Can graft or instrumentation be reported separately?
Graft and instrumentation services may have separate codes when performed and reportable. Document the material used and the instrumentation placed.
What global and multiple-procedure rules affect 22532?
The 90-day global includes the day-before preoperative visit and related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and the others are subject to a 50% reduction.
May an assistant or co-surgeon be reported?
CMS permits assistant-at-surgery payment and co-surgeon reporting for this service. Team-surgery payment 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
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