CPT code 22630: Lumbar fusion, single lumbar interspace2026 Medicare rate & RVUs in Puerto Rico

In Puerto Rico, Medicare pays $1,512.58 for 22630 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 22630 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 22630 covers

A spine surgeon performs a posterior approach to fuse one lumbar interspace by preparing the disc space and placing bone graft between adjacent vertebral bodies. The work includes the laminectomy and/or discectomy needed to prepare the interspace for fusion, but not when performed solely as a separate decompression. This procedure is typically performed in a hospital operating room for conditions such as lumbar instability or degenerative disc disease.

Report 22630 for one interspace treated with the posterior interbody technique. Use 22632 for each additional interspace fused using that technique; a posterolateral fusion alone or a combined posterolateral and interbody fusion follows a different code path. The operative report should identify the lumbar level, fusion technique, and interspace preparation. The day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures at 50%. Assistant-at-surgery payment and co-surgeon billing are permitted; team-surgery billing 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 Puerto Rico compares for 22630

Across 109 of 109 payment localities, the facility rate for 22630 runs from $1,306.35 in Nebraska to $1,934.80 in Miami, FL. Puerto Rico pays $1,512.58. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

22630 rates by state

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

See 22630 in every payment locality

How the 22630 rate is calculated

Each of 22630’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 22630

22630 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

Codes related to 22630

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

How 22630 has changed in Puerto Rico

Price 22630 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

• Aceitunas
• Adjuntas
• Aguada
• Aguadilla
• Aguas Buenas
• Aguas Claras
• Aguilita
• Aibonito

Browse all communities in Puerto Rico

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