CPT code 22842: Spinal fixation, posterior, three to six segments2026 Medicare rate & RVUs in Montana
Reports posterior segmental spinal fixation spanning three to six vertebral segments, commonly added to a fusion procedure requiring multilevel stabilization.
In Montana, Medicare pays $679.77 for 22842 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 22842 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
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.
How Montana compares for 22842
Across 109 of 109 payment localities, the facility rate for 22842 runs from $581.61 in Wisconsin to $890.45 in Miami, FL. Montana pays $679.77. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Montana · this page$679.77
- Los Angeles, CA · California$676.88−$2.89
- Washington, DC area · District of Columbia$741.65+$61.88
- Miami, FL · Florida$890.45+$210.68
- Chicago, IL · Illinois$857.04+$177.27
- Manhattan, NY · New York$806.90+$127.13
- Alaska · Alaska$833.39+$153.62
Other areas in Montana first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $604.80 |
| ArkansasArkansas | — | $595.77 |
| ArizonaArizona | — | $656.51 |
| Bakersfield, CACalifornia | — | $648.59 |
| Chico, CACalifornia | — | $638.00 |
| El Centro, CACalifornia | — | $638.67 |
| Fresno, CACalifornia | — | $638.00 |
| Hanford, CACalifornia | — | $638.00 |
| Madera, CACalifornia | — | $638.00 |
| Merced, CACalifornia | — | $638.00 |
| Modesto, CACalifornia | — | $638.00 |
| Napa, CACalifornia | — | $683.47 |
| Oxnard, CACalifornia | — | $665.93 |
| Redding, CACalifornia | — | $638.00 |
| Rest of CaliforniaCalifornia | — | $638.00 |
| Riverside, CACalifornia | — | $680.86 |
| Sacramento, CACalifornia | — | $654.95 |
| Salinas, CACalifornia | — | $652.35 |
| San Diego, CACalifornia | — | $657.81 |
| Marin County, CACalifornia | — | $702.60 |
| San Francisco, CACalifornia | — | $698.05 |
| San Benito County, CACalifornia | — | $723.43 |
| Santa Clara County, CACalifornia | — | $704.81 |
| San Luis Obispo, CACalifornia | — | $643.89 |
| Santa Cruz, CACalifornia | — | $655.93 |
| Santa Maria, CACalifornia | — | $652.08 |
| Santa Rosa, CACalifornia | — | $661.39 |
| Stockton, CACalifornia | — | $638.00 |
| Vallejo, CACalifornia | — | $676.91 |
| Visalia, CACalifornia | — | $638.00 |
| Yuba City, CACalifornia | — | $638.00 |
| ColoradoColorado | — | $664.38 |
| ConnecticutConnecticut | — | $726.90 |
| DelawareDelaware | — | $666.92 |
| Fort Lauderdale, FLFlorida | — | $790.04 |
| Rest of FloridaFlorida | — | $741.39 |
| Atlanta, GAGeorgia | — | $710.38 |
| Rest of GeorgiaGeorgia | — | $690.97 |
| Hawaii, Guam, HIHawaii | — | $642.42 |
| IowaIowa | — | $587.64 |
| IdahoIdaho | — | $598.50 |
| East St. Louis, ILIllinois | — | $804.90 |
| Rest of IllinoisIllinois | — | $743.54 |
| Suburban Chicago, ILIllinois | — | $790.00 |
| IndianaIndiana | — | $601.20 |
| KansasKansas | — | $600.46 |
| KentuckyKentucky | — | $653.46 |
| New Orleans, LALouisiana | — | $690.18 |
| Rest of LouisianaLouisiana | — | $658.67 |
| Metropolitan Boston, MAMassachusetts | — | $708.65 |
| Rest of MassachusettsMassachusetts | — | $666.66 |
| Baltimore area, MDMaryland | — | $728.33 |
| Rest of MarylandMaryland | — | $674.79 |
| Rest of MaineMaine | — | $618.46 |
| Southern Maine, MEMaine | — | $629.39 |
| Detroit, MIMichigan | — | $767.13 |
| Rest of MichiganMichigan | — | $685.41 |
| MinnesotaMinnesota | — | $589.72 |
| Metropolitan Kansas City, MOMissouri | — | $668.61 |
| Metropolitan St. Louis, MOMissouri | — | $673.74 |
| Rest of MissouriMissouri | — | $657.66 |
| MississippiMississippi | — | $626.05 |
| North CarolinaNorth Carolina | — | $622.52 |
| North DakotaNorth Dakota | — | $600.48 |
| NebraskaNebraska | — | $586.19 |
| New HampshireNew Hampshire | — | $668.91 |
| Northern New JerseyNew Jersey | — | $736.84 |
| Rest of New JerseyNew Jersey | — | $722.00 |
| New MexicoNew Mexico | — | $695.60 |
| NevadaNevada | — | $657.81 |
| NYC suburbs and Long Island, NYNew York | — | $846.90 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $739.59 |
| Queens, NYNew York | — | $790.35 |
| Rest of New YorkNew York | — | $633.42 |
| OhioOhio | — | $669.20 |
| OklahomaOklahoma | — | $635.52 |
| Portland, OROregon | — | $667.50 |
| Rest of OregonOregon | — | $639.72 |
| Metropolitan Philadelphia, PAPennsylvania | — | $718.87 |
| Rest of PennsylvaniaPennsylvania | — | $661.45 |
| Puerto RicoPuerto Rico | — | $679.54 |
| Rhode IslandRhode Island | — | $677.87 |
| South CarolinaSouth Carolina | — | $649.54 |
| South DakotaSouth Dakota | — | $591.11 |
| TennesseeTennessee | — | $605.57 |
| Austin, TXTexas | — | $673.53 |
| Beaumont, TXTexas | — | $658.21 |
| Brazoria, TXTexas | — | $652.62 |
| Dallas, TXTexas | — | $664.16 |
| Fort Worth, TXTexas | — | $664.53 |
| Galveston, TXTexas | — | $659.32 |
| Houston, TXTexas | — | $732.72 |
| Rest of TexasTexas | — | $660.07 |
| UtahUtah | — | $658.16 |
| VirginiaVirginia | — | $638.34 |
| Virgin Islands, VIUnited States Virgin Islands | — | $679.54 |
| VermontVermont | — | $612.51 |
| Rest of WashingtonWashington | — | $660.61 |
| King County, WAWashington | — | $707.08 |
| WisconsinWisconsin | — | $581.61 |
| West VirginiaWest Virginia | — | $719.83 |
| WyomingWyoming | — | $645.22 |
22842 rates by state
Office rate range in each state. Select a state to see its payment localities.
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
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.
The exact Montana inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
2,114
- Code
- 22842
- Physician work
- 12.25
- Practice expense
- 4.10
- Malpractice
- 4.01
GPCI2026.csv
71
- Locality
- Montana
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.998
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 12.25 | × 1.000 | 12.2500 |
| Practice expense | 4.10 | × 1.000 | 4.1000 |
| Malpractice | 4.01 | × 0.998 | 4.0020 |
| Total RVUs | 20.3520 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Montana$679.77
Facility: (12.25 × 1 + 4.1 × 1 + 4.01 × 0.998) × $33.4009 = $679.77
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.
How 22842 has changed in Montana
22842 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $679.77 | RVU26D |
| 2026-07-01 | Not available in this setting | $679.77 | RVU26C |
| 2026-04-01 | Not available in this setting | $679.77 | RVU26B |
| 2026-01-01 | Not available in this setting | $679.77 | RVU26A |
| 2025-10-01 | Not available in this setting | $738.55 | RVU25D |
| 2025-07-01 | Not available in this setting | $738.55 | RVU25C |
| 2025-04-01 | Not available in this setting | $738.55 | RVU25B |
| 2025-01-01 | Not available in this setting | $738.55 | RVU25A |
| 2024-10-01 | Not available in this setting | $756.35 | RVU24D |
| 2024-07-01 | Not available in this setting | $756.35 | RVU24C |
| 2024-04-01 | Not available in this setting | $756.35 | RVU24B |
| 2024-03-09 | Not available in this setting | $756.35 | RVU24AR |
| 2024-01-01 | Not available in this setting | $744.01 | RVU24A |
| 2023-10-01 | Not available in this setting | $767.01 | RVU23D |
| 2023-07-01 | Not available in this setting | $767.01 | RVU23C |
| 2023-04-01 | Not available in this setting | $767.01 | RVU23B |
| 2023-01-01 | Not available in this setting | $767.01 | RVU23A |
| 2022-10-01 | Not available in this setting | $775.64 | RVU22D |
| 2022-07-01 | Not available in this setting | $775.64 | RVU22C |
| 2022-04-01 | Not available in this setting | $775.64 | RVU22B |
| 2022-01-01 | Not available in this setting | $775.64 | RVU22A |
| 2021-10-01 | Not available in this setting | $779.04 | RVU21D |
| 2021-07-01 | Not available in this setting | $779.04 | RVU21C |
| 2021-04-01 | Not available in this setting | $779.04 | RVU21B |
| 2021-01-01 | Not available in this setting | $779.04 | RVU21A |
| 2020-10-01 | Not available in this setting | $839.96 | RVU20D |
| 2020-07-01 | Not available in this setting | $839.96 | RVU20C |
| 2020-04-01 | Not available in this setting | $839.96 | RVU20B |
| 2020-01-01 | Not available in this setting | $839.96 | RVU20A |
| 2019-10-01 | Not available in this setting | $889.90 | RVU19D |
| 2019-07-01 | Not available in this setting | $889.90 | RVU19C |
| 2019-04-01 | Not available in this setting | $889.90 | RVU19B |
| 2019-01-01 | Not available in this setting | $889.90 | RVU19A |
| 2018-10-01 | Not available in this setting | $887.20 | RVU18D |
| 2018-07-01 | Not available in this setting | $887.20 | RVU18C |
| 2018-04-01 | Not available in this setting | $887.20 | RVU18B |
| 2018-01-01 | Not available in this setting | $887.20 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $859.23 | RVU17D |
| 2017-07-01 | Not available in this setting | $859.23 | RVU17C |
| 2017-04-01 | Not available in this setting | $859.23 | RVU17B |
| 2017-01-01 | Not available in this setting | $859.23 | RVU17A |
| 2016-10-01 | Not available in this setting | $830.69 | RVU16D |
| 2016-07-01 | Not available in this setting | $830.69 | RVU16C |
| 2016-04-01 | Not available in this setting | $830.69 | RVU16B |
| 2016-01-01 | Not available in this setting | $830.69 | RVU16A |
| 2015-10-01 | Not available in this setting | $836.77 | RVU15D |
| 2015-07-01 | Not available in this setting | $836.77 | RVU15C |
| 2015-04-01 | Not available in this setting | $832.60 | RVU15B |
| 2015-01-01 | Not available in this setting | $832.60 | RVU15A |
| 2014-10-01 | Not available in this setting | $806.12 | RVU14D |
| 2014-07-01 | Not available in this setting | $806.12 | RVU14C |
| 2014-04-01 | Not available in this setting | $806.12 | RVU14B |
| 2014-01-01 | Not available in this setting | $806.12 | RVU14A |
| 2013-10-01 | Not available in this setting | $778.59 | RVU13D |
| 2013-07-01 | Not available in this setting | $778.59 | RVU13C |
| 2013-04-01 | Not available in this setting | $778.59 | RVU13B |
| 2013-01-01 | Not available in this setting | $778.59 | RVU13AR |
Where the Montana rate applies
Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.
- Absarokee
- Acton
- Alberton
- Alder
- Alzada
- Amsterdam
- Anaconda-Deer Lodge County
- Antelope
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.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
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