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CPT code 22558: Anterior fusion, lumbar, single interspace2026 Medicare rate & RVUs

Reports anterior interbody fusion at one lumbar interspace, including the limited disc removal needed to prepare the space for fusion.

CMS RVU26DEffective Oct 1, 2026109 payment localities40.1K Medicare services in 2024

Medicare pays $1,423.88 for 22558 nationally in a facility.

Medicare rate · 22558

Anterior fusion, lumbar, single interspace

Office or facility?

Work RVUs
22.94
Total RVUs
42.63
Global days
090

National rate · 2026

$1,423.88

Facility setting, before claim adjustments.

See every locality for 22558 →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 22558 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 22558 covers

This service fuses a lumbar motion segment through an anterior approach, placing bone graft or another fusion material between the vertebral bodies. The surgeon removes enough disc material to prepare the interspace; that limited preparation is included. Orthopedic spine surgeons and neurosurgeons commonly perform the operation in a hospital operating room for lumbar instability or degenerative disc disease.

Report one unit for the treated interspace. The operative report should support the lumbar level, anterior approach, fusion, and any additional work such as decompression; extensive decompression is distinct from the limited disc preparation included here. A separately reportable interbody device may be coded with the fusion. 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 procedure is paid in full and others at 50%. Bilateral adjustment is inappropriate. Assistant-at-surgery and co-surgeon payment may be allowed; 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 22558 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

22558 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,274.69
AlaskaUnavailable$1,738.32
ArizonaUnavailable$1,379.00
ArkansasUnavailable$1,256.58
Atlanta, GAUnavailable$1,476.80
Austin, TXUnavailable$1,426.27
Bakersfield, CAUnavailable$1,396.01
Baltimore area, MDUnavailable$1,519.70
Beaumont, TXUnavailable$1,368.81
Brazoria, TXUnavailable$1,378.35

22558 rates by state

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

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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
22558 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 22558 rate is calculated

Each of 22558’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 · 22558

RVUs × geographic indexes × conversion factor

Office or facility?

Work22.94

22.94 RVUs× 1.000 GPCI

Practice expense13.20

13.20 RVUs× 1.000 GPCI

Malpractice6.49

6.49 RVUs× 1.000 GPCI

Adjusted RVUs

42.6300

Conversion factor

$33.4009

Medicare rate

$1,423.88

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

Payment rules and modifiers for 22558

22558 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 22558

Anterior fusion, lumbar, single interspace

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)2Permitted.
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 · 22558

Anterior fusion, lumbar, single interspace

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

22558 without 51 · national facility

$1,423.88

Anterior fusion, lumbar, single interspace

22558-51 · Second procedure: 50%

$711.94

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

22558 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 22558

    Anterior fusion, lumbar, single interspace22.94 wRVU

    Not priced

  • 22585

    Anterior fusion, additional interspace5.38 wRVU

    Not priced

  • 22554

    Cervical fusion, anterior, below C2, no decompression17.25 wRVU

    Not priced

  • 22556

    Thoracic fusion, anterior interbody technique24.08 wRVU

    Not priced

  • 22612

    Spinal fusion, posterior lumbar, single level22.94 wRVU

    Not priced

How to choose

22585Anterior fusionAdditional interspace
22558 represents the first lumbar interspace; 22585 is the add-on for each additional interspace in the same fusion session.
22554Cervical fusionAnterior, below C2, no decompression
Both describe anterior interbody fusion, but 22554 is for the cervical spine and 22558 is for the lumbar spine.
22556Thoracic fusionAnterior interbody technique
22556 applies to anterior interbody fusion in the thoracic spine; 22558 applies to the lumbar spine.
22612Spinal fusionPosterior lumbar, single level
22558 is an anterior interbody lumbar fusion. 22612 describes lumbar fusion by a posterior or posterolateral approach.

Codes related to 22558

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

Codes related to 22558
CodeHow it relatesNational office range
Add-on codes
22585Anterior fusion, additional interspaceAdd-on code for each additional interspace fused after the first interspace.No office rate
Same family
22554Cervical fusion, anterior, below C2, no decompressionAnterior interbody fusion at a cervical rather than lumbar level.No office rate
22556Thoracic fusion, anterior interbody techniqueAnterior interbody fusion at a thoracic rather than lumbar level.No office rate
Used instead
22533Lumbar fusion, lateral extracavitary approachLumbar interbody fusion using a lateral extracavitary approach rather than an anterior approach.No office rate
22612Spinal fusion, posterior lumbar, single levelLumbar fusion by a posterior or posterolateral approach rather than an anterior interbody approach.No office rate
Often billed with
22853Interbody device, with interbody arthrodesisMay be reported with the fusion when an interbody biomechanical device is placed.No office rate

22558 billing questions

When should 22558 be reported instead of 22554?

Use 22558 for anterior interbody fusion at a lumbar interspace. Code 22554 describes the corresponding cervical procedure.

Does 22558 include disc removal?

It includes the limited discectomy needed to prepare the interspace for fusion. Do not treat that preparation as a separate decompressive discectomy.

How is an additional lumbar interspace reported?

Report 22558 for the first lumbar interspace and consider add-on code 22585 for each additional interspace fused, when supported by the operative record.

Can an interbody device be reported separately?

A separately reportable interbody biomechanical device may be reported with 22558 using 22853. The operative documentation should identify the device and its placement.

Should modifier 50 be used for this procedure?

No. CMS identifies bilateral adjustment as inappropriate for 22558; report the lumbar interspace treated rather than treating the fusion as a bilateral service.

What payment rules affect the surgical team and follow-up?

The code has a 90-day global period that includes the day-before preoperative visit and related postoperative care. CMS permits assistant-at-surgery and co-surgeon payment, but not team-surgery payment.

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 22558PPRRVU2026_Oct_nonQPP.csv, line 2,087 (RVU26D)

Open CMS sourceHow we calculate rates

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