CPT code 22844: Spinal fixation, posterior, 13 or more segments2026 Medicare rate & RVUs in Oregon
Reports posterior segmental spinal fixation spanning 13 or more vertebral segments, commonly used during long constructs for deformity correction or spinal reconstruction.
CMS doesn’t publish an office rate for 22844 in Oregon.
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 22844 covers
Code 22844 represents a long posterior fixation construct spanning at least 13 vertebral segments. An orthopedic spine surgeon or neurosurgeon may place rods, screws, or other fixation components during surgery for conditions such as major scoliosis or complex spinal deformity. These procedures are typically performed in a hospital operating room, often alongside spinal fusion or another primary spine procedure.
Select this code based on the number of vertebral segments instrumented, not the number of implants. The operative report should establish the posterior approach, the extent of the construct, and the primary procedure performed. Medicare treats 22844 as an add-on code: report it only with a primary procedure, and its payment falls within that procedure’s global period. It is not reported as a standalone 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 22844 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland, OR | Unavailable | $861.74 |
| Rest of Oregon | Unavailable | $826.08 |
How the 22844 rate is calculated
Each of 22844’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 · 22844
RVUs × geographic indexes × conversion factor
Work16.01
16.01 RVUs× 1.000 GPCI
Practice expense5.32
5.32 RVUs× 1.000 GPCI
Malpractice4.87
4.87 RVUs× 1.000 GPCI
Adjusted RVUs
26.2000
Conversion factor
$33.4009
Medicare rate
$875.10
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 22844
The CMS indicators that decide how 22844 is paid alongside other services.
CMS payment indicators · 22844
Spinal fixation, posterior, 13 or more 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
22844 without 80 · national facility
$875.10
Spinal fixation, posterior, 13 or more segments
22844-80 · Assistant: 16%
$140.02
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
22844 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 22843Spinal fixation7–12 vertebral segments
- Both describe posterior segmental fixation. Use 22844 for 13 or more instrumented vertebral segments; 22843 covers 7 through 12.
- 22842Spinal fixationPosterior, three to six segments
- 22842 applies to a posterior segmental construct spanning 3 through 6 vertebral segments; 22844 is for 13 or more.
- 22840Spinal fixationPosterior, nonsegmental
- 22840 describes nonsegmental fixation. Use 22844 when the posterior construct is segmental and spans at least 13 vertebral segments.
- 22845Anterior fixationTwo to three vertebral segments
- 22845 describes anterior instrumentation. Code 22844 is for a long posterior segmental construct.
22844 billing questions
When should 22844 be chosen instead of 22843?
Choose 22844 when the posterior segmental construct spans 13 or more vertebral segments. Code 22843 applies to a shorter construct of 7 through 12 segments.
Can 22844 be reported by itself?
No. It is an add-on code and must be reported with a primary procedure; Medicare payment falls within that procedure’s global period.
Is the code based on the number of screws or rods?
No. Selection depends on the number of vertebral segments instrumented, not the number of screws, rods, or other implants.
What documentation supports reporting 22844?
The operative report should identify the posterior construct and the vertebral segments instrumented, supporting a span of 13 or more segments, as well as the accompanying primary procedure.
How does 22844 differ from 22840?
Code 22844 describes a long posterior segmental construct. Code 22840 is for a nonsegmental fixation method and is not selected by counting 13 or more instrumented 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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