CPT code 22842: Spinal fixation, posterior, three to six segments2026 Medicare rate & RVUs in California
Reports posterior segmental spinal fixation spanning three to six vertebral segments, commonly added to a fusion procedure requiring multilevel stabilization.
CMS doesn’t publish an office rate for 22842 in California.
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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What 22842 covers
This code describes posterior segmental fixation spanning three to six vertebral segments, using connected hardware such as rods with pedicle screws, hooks, or wires. Spine surgeons commonly place this instrumentation during surgery for spinal fusion when multilevel stabilization is needed, including for deformity or instability. The code identifies the fixation construct, not the spinal fusion itself or an interbody device.
Select the code by the number of vertebral segments spanned by the posterior segmental construct, not by the number of screws or other individual implants. The operative report should establish the posterior approach, segmental fixation method, and levels instrumented. This is an add-on code: report it with an eligible primary procedure, not by itself. CMS pays it within the primary 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 22842 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | Unavailable | $648.59 |
| Chico, CA | Unavailable | $638.00 |
| El Centro, CA | Unavailable | $638.67 |
| Fresno, CA | Unavailable | $638.00 |
| Hanford, CA | Unavailable | $638.00 |
| Los Angeles, CA | Unavailable | $676.88 |
| Madera, CA | Unavailable | $638.00 |
| Marin County, CA | Unavailable | $702.60 |
| Merced, CA | Unavailable | $638.00 |
| Modesto, CA | Unavailable | $638.00 |
| Napa, CA | Unavailable | $683.47 |
| Oxnard, CA | Unavailable | $665.93 |
| Redding, CA | Unavailable | $638.00 |
| Rest of California | Unavailable | $638.00 |
| Riverside, CA | Unavailable | $680.86 |
| Sacramento, CA | Unavailable | $654.95 |
| Salinas, CA | Unavailable | $652.35 |
| San Benito County, CA | Unavailable | $723.43 |
| San Diego, CA | Unavailable | $657.81 |
| San Francisco, CA | Unavailable | $698.05 |
| San Luis Obispo, CA | Unavailable | $643.89 |
| Santa Clara County, CA | Unavailable | $704.81 |
| Santa Cruz, CA | Unavailable | $655.93 |
| Santa Maria, CA | Unavailable | $652.08 |
| Santa Rosa, CA | Unavailable | $661.39 |
| Stockton, CA | Unavailable | $638.00 |
| Vallejo, CA | Unavailable | $676.91 |
| Visalia, CA | Unavailable | $638.00 |
| Yuba City, CA | Unavailable | $638.00 |
How the 22842 rate is calculated
Each of 22842’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 · 22842
RVUs × geographic indexes × conversion factor
Work12.25
12.25 RVUs× 1.000 GPCI
Practice expense4.10
4.10 RVUs× 1.000 GPCI
Malpractice4.01
4.01 RVUs× 1.000 GPCI
Adjusted RVUs
20.3600
Conversion factor
$33.4009
Medicare rate
$680.04
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 22842
The CMS indicators that decide how 22842 is paid alongside other services.
CMS payment indicators · 22842
Spinal fixation, posterior, three to six segments
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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. |
What modifiers do to the payment
Modifier 80 · payment effect
With and without the modifier
22842 without 80 · national facility
$680.04
Spinal fixation, posterior, three to six segments
22842-80 · Assistant: 16%
$108.81
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
22842 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 22840Spinal fixationPosterior, nonsegmental
- Use 22840 for posterior nonsegmental fixation, such as fixation across one motion segment. Use 22842 when posterior segmental instrumentation spans three to six vertebral segments.
- 22843Spinal fixation7–12 vertebral segments
- Both describe posterior segmental instrumentation; 22843 is for a construct spanning more vertebral segments than 22842.
- 22845Anterior fixationTwo to three vertebral segments
- 22845 describes anterior instrumentation across a limited span. Choose based on the approach and construct, rather than treating anterior and posterior fixation as interchangeable.
- 22853Interbody deviceWith interbody arthrodesis
- 22853 concerns insertion of an interbody biomechanical device. It does not describe the posterior segmental fixation reported with 22842.
22842 billing questions
How do I distinguish this code from 22840?
This code is for posterior segmental fixation spanning three to six vertebral segments. Code 22840 describes posterior nonsegmental fixation, typically spanning one motion segment or using a nonsegmental technique.
How are the segments counted?
Count the vertebral segments spanned by the fixation construct, rather than the number of screws, hooks, or rods. The operative report should identify the instrumented levels and the construct.
Can 22842 be reported by itself?
No. It is an add-on code and must be reported with an eligible primary procedure. For example, posterior lumbar fusion code 22612 may be a primary procedure when performed with the instrumentation.
Is an interbody device included in this service?
This code describes posterior fixation, not insertion of an interbody biomechanical device. When an interbody device is placed, determine separately whether the applicable device code is supported.
What documentation supports reporting 22842?
Document the posterior approach, fixation method, and vertebral levels spanned. The record should support a segmental construct across three to six vertebral segments.
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.
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