CPT code 22845: Anterior fixation, two to three vertebral segments2026 Medicare rate & RVUs in Kentucky

Reports anterior spinal fixation spanning two or three vertebral segments during a qualifying spine operation, such as fusion with an anterior plate.

CMS RVU26DEffective Oct 1, 2026One payment locality42.5K Medicare services in 2024

In Kentucky, Medicare pays $622.25 for 22845 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$622.25Hospital or facility

Check a contract rate as a % of Medicare · 22845 nationwide

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

We’ll open 22845 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Kentucky
  2. What 22845 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 22845 covers

22845 reports placement of anterior spinal fixation across two or three vertebral segments as part of a spine operation. A common example is an anterior cervical plate secured with screws across the operative vertebrae during cervical fusion; anterior fixation may also be used with thoracic or lumbar procedures. The work is typically performed by an orthopedic spine surgeon or neurosurgeon in an operating room. This code represents supplemental stabilization, not an interbody cage or the fusion itself.

Select the code based on the vertebral segments actually instrumented, not simply the number of disc spaces treated. The operative report should identify the anterior approach, device placement, segments spanned, and associated primary procedure. 22845 is an add-on code: report it only with an eligible primary procedure, and Medicare payment is handled within that procedure’s global period. It is not a standalone service. For fixation spanning more segments, use the applicable higher segment-count code when supported by the operative details.

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 Kentucky compares for 22845

Across 109 of 109 payment localities, the facility rate for 22845 runs from $553.19 in Wisconsin to $849.60 in Miami, FL. Kentucky pays $622.25. The RVUs are the same everywhere; the geographic indexes change the dollars.

22845 in Kentucky vs other payment areas
  1. Kentucky · this page$622.25
  2. Los Angeles, CA · California$644.21+$21.96
  3. Washington, DC area · District of Columbia$706.36+$84.11
  4. Miami, FL · Florida$849.60+$227.35
  5. Chicago, IL · Illinois$817.54+$195.29
  6. Manhattan, NY · New York$768.98+$146.73
  7. Alaska · Alaska$792.77+$170.52

Other areas in Kentucky first, then benchmark localities. Bars start at $0.

Every other payment area

22845 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$575.55
ArkansasArkansas—$566.91
ArizonaArizona—$625.09
Bakersfield, CACalifornia—$617.26
Chico, CACalifornia—$607.09
El Centro, CACalifornia—$607.73
Fresno, CACalifornia—$607.09
Hanford, CACalifornia—$607.09

22845 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
22845 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 22845 in every payment locality

How the 22845 rate is calculated

Each of 22845’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 · 22845

RVUs × geographic indexes × conversion factor

Office or facility?

Work11.64

11.64 RVUs× 1.000 GPCI

Practice expense3.90

3.90 RVUs× 1.000 GPCI

Malpractice3.85

3.85 RVUs× 1.000 GPCI

Adjusted RVUs

19.3900

Conversion factor

$33.4009

Medicare rate

$647.64

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Kentucky inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

2,117

Code
22845
Physician work
11.64
Practice expense
3.90
Malpractice
3.85

GPCI2026.csv

55

Locality
Kentucky
Physician work
1.000
Practice expense
0.889
Malpractice
0.915
Facility calculation for 22845 in Kentucky
ComponentRVULocality factorAdjusted
Physician work11.64× 1.00011.6400
Practice expense3.90× 0.8893.4671
Malpractice3.85× 0.9153.5228
Total RVUs18.6299
Conversion factor× 33.4009

Facility rate, Kentucky$622.25

Facility: (11.64 × 1 + 3.9 × 0.889 + 3.85 × 0.915) × $33.4009 = $622.25

Open 22845 in the RVU calculator

Payment rules and modifiers for 22845

The CMS indicators that decide how 22845 is paid alongside other services.

CMS payment indicators · 22845

Anterior fixation, two to three vertebral segments

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)2Permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 80 · payment effect

With and without the modifier

22845 without 80 · national facility

$647.64

Anterior fixation, two to three vertebral segments

22845-80 · Assistant: 16%

$103.62

A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.

When to use modifier 80

How 22845 has changed in Kentucky

22845 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

Base rate by release · bars start at $0 · select a bar to compare

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
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$622.25RVU26D
2026-07-01Not available in this setting$622.25RVU26C
2026-04-01Not available in this setting$622.25RVU26B
2026-01-01Not available in this setting$622.25RVU26A
2025-10-01Not available in this setting$670.38RVU25D
2025-07-01Not available in this setting$670.38RVU25C
2025-04-01Not available in this setting$670.38RVU25B
2025-01-01Not available in this setting$670.38RVU25A
2024-10-01Not available in this setting$687.61RVU24D
2024-07-01Not available in this setting$687.61RVU24C
2024-04-01Not available in this setting$687.61RVU24B
2024-03-09Not available in this setting$687.61RVU24AR
2024-01-01Not available in this setting$676.39RVU24A
2023-10-01Not available in this setting$691.19RVU23D
2023-07-01Not available in this setting$691.19RVU23C
2023-04-01Not available in this setting$691.19RVU23B
2023-01-01Not available in this setting$691.19RVU23A
2022-10-01Not available in this setting$694.13RVU22D
2022-07-01Not available in this setting$694.13RVU22C
2022-04-01Not available in this setting$694.13RVU22B
2022-01-01Not available in this setting$694.13RVU22A
2021-10-01Not available in this setting$698.22RVU21D
2021-07-01Not available in this setting$698.22RVU21C
2021-04-01Not available in this setting$698.22RVU21B
2021-01-01Not available in this setting$698.22RVU21A
2020-10-01Not available in this setting$715.49RVU20D
2020-07-01Not available in this setting$715.49RVU20C
2020-04-01Not available in this setting$715.49RVU20B
2020-01-01Not available in this setting$715.49RVU20A
2019-10-01Not available in this setting$719.88RVU19D
2019-07-01Not available in this setting$719.88RVU19C
2019-04-01Not available in this setting$719.88RVU19B
2019-01-01Not available in this setting$719.88RVU19A
2018-10-01Not available in this setting$719.77RVU18D
2018-07-01Not available in this setting$719.77RVU18C
2018-04-01Not available in this setting$719.77RVU18B
2018-01-01Not available in this setting$719.77RVU18AR1
2017-10-01Not available in this setting$717.24RVU17D
2017-07-01Not available in this setting$717.24RVU17C
2017-04-01Not available in this setting$717.24RVU17B
2017-01-01Not available in this setting$717.24RVU17A
2016-10-01Not available in this setting$714.23RVU16D
2016-07-01Not available in this setting$714.23RVU16C
2016-04-01Not available in this setting$714.23RVU16B
2016-01-01Not available in this setting$714.23RVU16A
2015-10-01Not available in this setting$719.66RVU15D
2015-07-01Not available in this setting$719.66RVU15C
2015-04-01Not available in this setting$716.08RVU15B
2015-01-01Not available in this setting$716.08RVU15A
2014-10-01Not available in this setting$704.07RVU14D
2014-07-01Not available in this setting$704.07RVU14C
2014-04-01Not available in this setting$704.07RVU14B
2014-01-01Not available in this setting$704.07RVU14A
2013-10-01Not available in this setting$682.13RVU13D
2013-07-01Not available in this setting$682.13RVU13C
2013-04-01Not available in this setting$682.13RVU13B
2013-01-01Not available in this setting$682.13RVU13AR

Price 22845 for an earlier date of service

Where the Kentucky rate applies

Kentucky is a Medicare payment area, not a city. Our Census mapping connects it to 553 cities and communities in Kentucky. Some span more than one payment area; confirm with the service ZIP.

  • Adairville
  • Ages
  • Albany
  • Alexandria
  • Allen
  • Allensville
  • Anchorage
  • Annville

Browse all communities in Kentucky

22845 billing questions

How is 22845 distinguished from 22846?

22845 is for anterior fixation spanning two or three vertebral segments. 22846 applies when the anterior fixation spans four to seven segments.

Can 22845 be billed by itself?

No. It is an add-on code and must be reported with an eligible primary procedure; Medicare payment is handled within that procedure’s global period.

What documentation supports the segment count?

The operative report should describe the anterior fixation device and identify the vertebral segments it spans. Count the instrumented segments rather than assuming the count from the number of treated disc spaces.

Is an interbody cage reported with 22845?

The codes describe different work: 22845 represents anterior fixation, while 22853 describes placement of an interbody biomechanical device. They may be reported for distinct work in the same fusion operation when documented.

Does 22845 describe the fusion itself?

No. It describes supplemental anterior stabilization. Report the applicable primary fusion or other procedure separately.

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
RVUs for 22845PPRRVU2026_Oct_nonQPP.csv, line 2,117 (RVU26D)
Geographic factors for KentuckyGPCI2026.csv, line 55 (RVU26D)

Open CMS sourceHow we calculate rates

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