CPT code 22841: Spinous-process wiring, spinal fixation2026 Medicare rate & RVUs

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

What 22841 covers

Code 22841 identifies internal fixation using wires placed through the spinal spinous processes. A spine surgeon may use this technique during an operation to stabilize the spine, including a fusion procedure. It describes the fixation method, not the fusion itself, and is distinct from posterior segmental constructs coded according to the number of vertebral segments. The operative report should identify the wiring technique and the spinal procedure performed.

Medicare assigns 22841 physician fee schedule status B. This status means Medicare never pays the code separately; its payment is included in payment for other services. The code identifies spinous-process wiring rather than a segment-counted segmental construct, so the segment ranges for 22842–22844 should not be substituted when this wiring technique is performed. Report the code to represent the documented fixation technique as part of the surgical service.

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 22841 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

22841 rates by state

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

How the 22841 rate is calculated

Each of 22841’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 22841

22841 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

22841 compared with similar codes

How to choose

22840Spinal fixationPosterior, nonsegmental

22841 identifies wiring of the spinous processes. 22840 describes posterior nonsegmental instrumentation, which may include other wire techniques.

22842Spinal fixationPosterior, three to six segments

22842 describes posterior segmental instrumentation spanning 3 to 6 vertebral segments. 22841 identifies spinous-process wiring rather than a segment-counted segmental construct.

22843Spinal fixation7–12 vertebral segments

22843 describes posterior segmental instrumentation spanning 7 to 12 vertebral segments. Use 22841 for the specific spinous-process wiring technique.

22844Spinal fixationPosterior, 13 or more segments

22844 describes posterior segmental instrumentation spanning 13 or more vertebral segments. It differs from 22841, which identifies spinous-process wiring.

Codes related to 22841

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

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