CPT code 22633: Lumbar fusion, combined techniques, one level2026 Medicare rate & RVUs in Florida
Reports lumbar fusion at one interspace when the surgeon combines a posterior interbody technique with posterolateral fusion during the same operation.
CMS doesn’t publish an office rate for 22633 in Florida.
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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On this page 9 sections
What 22633 covers
This code represents fusion at one lumbar interspace using both an interbody approach from the back and posterolateral fusion. The surgeon prepares the disc space and places material intended to promote fusion between the vertebrae, while also fusing the posterior-lateral elements. It is generally performed by a spine surgeon in a hospital or other operative facility for conditions such as degenerative disease or instability requiring fusion.
Report it only when both fusion techniques are performed at the same lumbar interspace; a single technique calls for a different code. The operative report should identify the treated level and document the interbody and posterolateral work. For another interspace treated with both techniques, 22634 is the add-on code. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued is paid in full and others at 50%. 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 22633 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale, FL | Unavailable | $1,935.51 |
| Miami, FL | Unavailable | $2,154.49 |
| Rest of Florida | Unavailable | $1,818.27 |
How the 22633 rate is calculated
Each of 22633’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 · 22633
RVUs × geographic indexes × conversion factor
Work26.13
26.13 RVUs× 1.000 GPCI
Practice expense16.31
16.31 RVUs× 1.000 GPCI
Malpractice8.46
8.46 RVUs× 1.000 GPCI
Adjusted RVUs
50.9000
Conversion factor
$33.4009
Medicare rate
$1,700.11
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 22633
22633 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 22633
Lumbar fusion, combined techniques, one level
| 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 · 22633
Lumbar fusion, combined techniques, one level
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
22633 without 51 · national facility
$1,700.11
Lumbar fusion, combined techniques, one level
22633-51 · Second procedure: 50%
$850.06
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%).
22633 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 22612Spinal fusionPosterior lumbar, single level
- 22612 represents posterolateral lumbar fusion alone. Choose 22633 when the surgeon also performs posterior interbody fusion at that same interspace.
- 22630Lumbar fusionSingle lumbar interspace
- 22630 represents posterior interbody lumbar fusion alone. Choose 22633 when posterolateral fusion is also performed at the same interspace.
- 22634Lumbar fusionEach additional interspace
- 22634 is an add-on for an additional interspace treated with both techniques; 22633 represents the primary interspace.
- 22632Lumbar fusionEach additional interspace
- 22632 adds another interspace to a posterior interbody-only fusion reported with 22630. It does not represent an additional level fused with both techniques.
22633 billing questions
When should 22633 be chosen over 22612 or 22630?
Use 22633 when the surgeon performs both posterolateral fusion and posterior interbody fusion at the same lumbar interspace. A single fusion technique is reported with the code for that technique instead.
How is another level treated with both techniques reported?
Report 22634 for each additional interspace fused using the combined techniques. The documentation should distinguish the additional treated level from the primary interspace.
Can 22633 be reported with spinal instrumentation or bone graft codes?
Instrumentation and qualifying bone graft services may be separately reportable when performed and documented. The operative record should support the specific hardware or graft service billed.
Does modifier 50 apply to 22633?
No. The code's anatomy and descriptor make bilateral adjustment inappropriate; do not append modifier 50.
What postoperative care is included in the Medicare global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. Medicare also permits assistant-at-surgery payment and co-surgeons for this procedure.
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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