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CPT code 22614: Spinal fusion, each additional level2026 Medicare rate & RVUs

Reports each additional vertebral level fused using a posterior or posterolateral approach, alongside the applicable primary fusion code.

CMS RVU26DEffective Oct 1, 2026109 payment localities228.2K Medicare services in 2024

Medicare pays $349.37 for 22614 nationally in a facility.

Medicare rate · 22614

Spinal fusion, each additional level

Office or facility?

Work RVUs
6.27
Total RVUs
10.46
Global days
ZZZ

National rate · 2026

$349.37

Facility setting, before claim adjustments.

See every locality for 22614 →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 22614 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 22614 covers

This add-on describes an additional spinal level fused through a posterior or posterolateral approach. Spine surgeons, including orthopedic spine surgeons and neurosurgeons, may perform multilevel fusion in an operating room for conditions such as spinal instability or degenerative disease. The surgeon’s operative report should identify the vertebral levels treated and the fusion technique used.

Report 22614 for each additional level after the primary posterior or posterolateral fusion code, such as 22600 for cervical, 22610 for thoracic, or 22612 for lumbar fusion. It cannot be reported by itself. Documentation should distinguish each fused level from instrumentation or other work performed at the same levels. CMS treats 22614 as an add-on code: it is billed only with a primary procedure and paid within that procedure’s global period.

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 22614 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

22614 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$310.41
AlaskaUnavailable$427.47
ArizonaUnavailable$337.18
ArkansasUnavailable$305.74
Atlanta, GAUnavailable$365.09
Austin, TXUnavailable$345.96
Bakersfield, CAUnavailable$332.95
Baltimore area, MDUnavailable$374.33
Beaumont, TXUnavailable$338.10
Brazoria, TXUnavailable$335.13

22614 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
22614 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 22614 rate is calculated

Each of 22614’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 · 22614

RVUs × geographic indexes × conversion factor

Office or facility?

Work6.27

6.27 RVUs× 1.000 GPCI

Practice expense2.11

2.11 RVUs× 1.000 GPCI

Malpractice2.08

2.08 RVUs× 1.000 GPCI

Adjusted RVUs

10.4600

Conversion factor

$33.4009

Medicare rate

$349.37

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

Payment rules and modifiers for 22614

The CMS indicators that decide how 22614 is paid alongside other services.

CMS payment indicators · 22614

Spinal fusion, each additional level

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
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.

What modifiers do to the payment

Modifier 80 · payment effect

With and without the modifier

22614 without 80 · national facility

$349.37

Spinal fusion, each additional level

22614-80 · Assistant: 16%

$55.90

A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.

When to use modifier 80

22614 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 22614

    Spinal fusion, each additional level6.27 wRVU

    Not priced

  • 22612

    Spinal fusion, posterior lumbar, single level22.94 wRVU

    Not priced

  • 22632

    Lumbar fusion, each additional interspace5.09 wRVU

    Not priced

  • 22634

    Lumbar fusion, each additional interspace7.76 wRVU

    Not priced

How to choose

22612Spinal fusionPosterior lumbar, single level
22612 is the primary code for a lumbar posterior or posterolateral fusion level; 22614 reports each additional level.
22632Lumbar fusionEach additional interspace
22632 is for an additional lumbar level fused through a posterior interbody approach, rather than the posterior or posterolateral technique represented by 22614.
22634Lumbar fusionEach additional interspace
22634 describes an additional lumbar level treated with both posterior or posterolateral and interbody fusion techniques; 22614 represents the posterior or posterolateral fusion level.

Codes related to 22614

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

Codes related to 22614
CodeHow it relatesNational office range
Primary code
22600Cervical fusion, posterior, one interspacePrimary posterior or posterolateral fusion code for the cervical region.No office rate
22610Spinal fusion, posterior thoracic, single levelPrimary posterior or posterolateral fusion code for the thoracic region.No office rate
22612Spinal fusion, posterior lumbar, single levelPrimary posterior or posterolateral fusion code for the lumbar region.No office rate
Used instead
22632Lumbar fusion, each additional interspaceReports an additional lumbar level using a posterior interbody fusion technique.No office rate
22634Lumbar fusion, each additional interspaceReports an additional lumbar level using combined posterior or posterolateral and interbody fusion.No office rate

22614 billing questions

Can 22614 be reported by itself?

No. It is an add-on for an additional fusion level and must be billed with the applicable primary posterior or posterolateral fusion code.

How many units should be reported?

Report one unit for each additional vertebral level treated after the primary level. The operative report should identify the levels fused.

How is 22614 different from 22612?

22612 describes the primary lumbar posterior or posterolateral fusion level. Use 22614 for each additional level in that fusion.

How is 22614 different from 22632?

22614 represents an additional level of posterior or posterolateral fusion. 22632 represents an additional level of lumbar posterior interbody fusion.

Does instrumentation determine the number of 22614 units?

No. Units follow the additional vertebral fusion levels documented, not the number of implants or fixation points.

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 22614PPRRVU2026_Oct_nonQPP.csv, line 2,095 (RVU26D)

Open CMS sourceHow we calculate rates

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