CPT code 22533: Lumbar fusion, lateral extracavitary approach2026 Medicare rate & RVUs in Missouri
Reports lumbar vertebral fusion using a lateral extracavitary approach, including limited disc-space preparation when it is performed as part of the fusion.
CMS doesn’t publish an office rate for 22533 in Missouri.
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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What 22533 covers
This code describes fusion of a lumbar vertebral segment through a lateral extracavitary exposure. The surgeon reaches the spine through a lateral, posterior-side corridor and may remove a limited amount of disc tissue to prepare the space for fusion. That preparation is part of the service; the code is not for a discectomy performed to decompress neural structures. Spine surgeons typically perform the operation in a hospital operating room for a lumbar segment requiring stabilization and fusion.
Report 22533 for the lumbar level and use 22534 for each additional vertebral segment when applicable. The operative report should identify the lumbar level, approach, fusion work, and any additional segments. 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 other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment and co-surgeons are permitted; team surgery is not. Modifier 50 is inappropriate for this code.
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 22533 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $1,511.08 |
| Metropolitan St. Louis, MO | Unavailable | $1,523.38 |
| Rest of Missouri | Unavailable | $1,470.52 |
How the 22533 rate is calculated
Each of 22533’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 · 22533
RVUs × geographic indexes × conversion factor
Work24.17
24.17 RVUs× 1.000 GPCI
Practice expense15.51
15.51 RVUs× 1.000 GPCI
Malpractice6.66
6.66 RVUs× 1.000 GPCI
Adjusted RVUs
46.3400
Conversion factor
$33.4009
Medicare rate
$1,547.80
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 22533
22533 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 22533
Lumbar fusion, 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 · 22533
Lumbar fusion, 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
22533 without 51 · national facility
$1,547.80
Lumbar fusion, lateral extracavitary approach
22533-51 · Second procedure: 50%
$773.90
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%).
22533 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 22532Spinal fusionThoracic lateral extracavitary approach
- 22532 is the thoracic counterpart in the lateral extracavitary fusion family. Use 22533 for the lumbar region.
- 22534Spinal fusionEach additional segment
- 22534 reports each additional vertebral segment; 22533 reports the initial lumbar segment.
- 22558Anterior fusionLumbar, single interspace
- 22558 describes lumbar interbody fusion through an anterior approach. 22533 is selected for the lateral extracavitary approach.
- 22612Spinal fusionPosterior lumbar, single level
- 22612 describes lumbar fusion using a posterior or posterolateral approach. 22533 is for the lateral extracavitary approach.
22533 billing questions
When is 22534 reported with 22533?
22534 is the add-on code for each additional vertebral segment treated after the initial lumbar segment reported with 22533. Document each level treated.
How does 22533 differ from 22558?
22533 describes lumbar fusion through a lateral extracavitary approach. 22558 describes lumbar interbody fusion through an anterior approach.
Is limited discectomy included?
Limited disc removal to prepare the interspace for fusion is included. The code describes preparation other than discectomy performed for decompression.
Can modifier 50 be used for bilateral work?
No. The descriptor and anatomy make modifier 50 inappropriate for 22533.
What payment rules affect multiple procedures and surgical assistance?
When procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment and co-surgeons are permitted; team surgery is not.
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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