CPT code 22846: Spinal fixation, anterior, four to seven segments2026 Medicare rate & RVUs in Montana

Reports anterior spinal fixation spanning four to seven vertebral segments, typically added to a qualifying fusion or other primary spinal procedure.

CMS RVU26DEffective Oct 1, 2026One payment locality13.3K Medicare services in 2024

In Montana, Medicare pays $673.09 for 22846 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$673.09Hospital or facility

Check a contract rate as a % of Medicare · 22846 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 22846 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Montana
  2. What 22846 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 22846 covers

This code represents an anteriorly placed fixation construct spanning four to seven vertebral segments. A spine surgeon may use a plate-and-screw construct to stabilize the spine during an anterior fusion, such as multilevel cervical fusion, or another qualifying spinal operation. The construct’s approach and span distinguish this service from posterior fixation and from a device placed within an interspace.

Select the code by counting the vertebral segments instrumented, not the number of screws or the number of disc spaces treated. The operative report should identify the anterior approach and the segments spanned by the fixation construct. This is an add-on code: report it only with a qualifying primary procedure, not by itself. CMS payment is tied to 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 22846

Across 109 of 109 payment localities, the facility rate for 22846 runs from $574.98 in Wisconsin to $883.71 in Miami, FL. Montana pays $673.09. The RVUs are the same everywhere; the geographic indexes change the dollars.

22846 in Montana vs other payment areas
  1. Montana · this page$673.09
  2. Los Angeles, CA · California$669.73−$3.36
  3. Washington, DC area · District of Columbia$734.44+$61.35
  4. Miami, FL · Florida$883.71+$210.62
  5. Chicago, IL · Illinois$850.32+$177.23
  6. Manhattan, NY · New York$799.66+$126.57
  7. Alaska · Alaska$823.95+$150.86

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

Every other payment area

22846 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$598.28
ArkansasArkansas—$589.28
ArizonaArizona—$649.87
Bakersfield, CACalifornia—$641.68
Chico, CACalifornia—$631.10
El Centro, CACalifornia—$631.77
Fresno, CACalifornia—$631.10
Hanford, CACalifornia—$631.10

22846 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

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22846 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 22846 in every payment locality

How the 22846 rate is calculated

Each of 22846’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 · 22846

RVUs × geographic indexes × conversion factor

Office or facility?

Work12.09

12.09 RVUs× 1.000 GPCI

Practice expense4.06

4.06 RVUs× 1.000 GPCI

Malpractice4.01

4.01 RVUs× 1.000 GPCI

Adjusted RVUs

20.1600

Conversion factor

$33.4009

Medicare rate

$673.36

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

2,118

Code
22846
Physician work
12.09
Practice expense
4.06
Malpractice
4.01

GPCI2026.csv

71

Locality
Montana
Physician work
1.000
Practice expense
1.000
Malpractice
0.998
Facility calculation for 22846 in Montana
ComponentRVULocality factorAdjusted
Physician work12.09× 1.00012.0900
Practice expense4.06× 1.0004.0600
Malpractice4.01× 0.9984.0020
Total RVUs20.1520
Conversion factor× 33.4009

Facility rate, Montana$673.09

Facility: (12.09 × 1 + 4.06 × 1 + 4.01 × 0.998) × $33.4009 = $673.09

Open 22846 in the RVU calculator

Payment rules and modifiers for 22846

The CMS indicators that decide how 22846 is paid alongside other services.

CMS payment indicators · 22846

Spinal fixation, anterior, four to seven 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

22846 without 80 · national facility

$673.36

Spinal fixation, anterior, four to seven segments

22846-80 · Assistant: 16%

$107.74

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

When to use modifier 80

How 22846 has changed in Montana

22846 · 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$673.09RVU26D
2026-07-01Not available in this setting$673.09RVU26C
2026-04-01Not available in this setting$673.09RVU26B
2026-01-01Not available in this setting$673.09RVU26A
2025-10-01Not available in this setting$731.72RVU25D
2025-07-01Not available in this setting$731.72RVU25C
2025-04-01Not available in this setting$731.72RVU25B
2025-01-01Not available in this setting$731.72RVU25A
2024-10-01Not available in this setting$749.65RVU24D
2024-07-01Not available in this setting$749.65RVU24C
2024-04-01Not available in this setting$749.65RVU24B
2024-03-09Not available in this setting$749.65RVU24AR
2024-01-01Not available in this setting$737.41RVU24A
2023-10-01Not available in this setting$760.19RVU23D
2023-07-01Not available in this setting$760.19RVU23C
2023-04-01Not available in this setting$760.19RVU23B
2023-01-01Not available in this setting$760.19RVU23A
2022-10-01Not available in this setting$769.01RVU22D
2022-07-01Not available in this setting$769.01RVU22C
2022-04-01Not available in this setting$769.01RVU22B
2022-01-01Not available in this setting$769.01RVU22A
2021-10-01Not available in this setting$773.03RVU21D
2021-07-01Not available in this setting$773.03RVU21C
2021-04-01Not available in this setting$773.03RVU21B
2021-01-01Not available in this setting$773.03RVU21A
2020-10-01Not available in this setting$835.04RVU20D
2020-07-01Not available in this setting$835.04RVU20C
2020-04-01Not available in this setting$835.04RVU20B
2020-01-01Not available in this setting$835.04RVU20A
2019-10-01Not available in this setting$886.27RVU19D
2019-07-01Not available in this setting$886.27RVU19C
2019-04-01Not available in this setting$886.27RVU19B
2019-01-01Not available in this setting$886.27RVU19A
2018-10-01Not available in this setting$884.98RVU18D
2018-07-01Not available in this setting$884.98RVU18C
2018-04-01Not available in this setting$884.98RVU18B
2018-01-01Not available in this setting$884.98RVU18AR1
2017-10-01Not available in this setting$858.06RVU17D
2017-07-01Not available in this setting$858.06RVU17C
2017-04-01Not available in this setting$858.06RVU17B
2017-01-01Not available in this setting$858.06RVU17A
2016-10-01Not available in this setting$830.04RVU16D
2016-07-01Not available in this setting$830.04RVU16C
2016-04-01Not available in this setting$830.04RVU16B
2016-01-01Not available in this setting$830.04RVU16A
2015-10-01Not available in this setting$837.00RVU15D
2015-07-01Not available in this setting$837.00RVU15C
2015-04-01Not available in this setting$832.84RVU15B
2015-01-01Not available in this setting$832.84RVU15A
2014-10-01Not available in this setting$808.72RVU14D
2014-07-01Not available in this setting$808.72RVU14C
2014-04-01Not available in this setting$808.72RVU14B
2014-01-01Not available in this setting$808.72RVU14A
2013-10-01Not available in this setting$780.77RVU13D
2013-07-01Not available in this setting$780.77RVU13C
2013-04-01Not available in this setting$780.77RVU13B
2013-01-01Not available in this setting$780.77RVU13AR

Price 22846 for an earlier date of service

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

Browse all communities in Montana

22846 billing questions

How is 22846 distinguished from 22845 and 22847?

Choose by the number of vertebral segments spanned by the anterior construct: 22846 covers four to seven. Codes 22845 and 22847 cover smaller and larger spans, respectively.

Do I count treated disc spaces or fixation hardware?

Base selection on the vertebral segments instrumented. The number of screws and the number of disc spaces treated do not set the code level.

Can 22846 be billed by itself?

No. It is an add-on code and must be reported with a qualifying primary procedure.

What should the operative report document?

Document the anterior approach and the vertebral segments spanned by the fixation construct. This supports both the instrumentation type and the four-to-seven-segment selection.

Is an interbody device the same service as 22846?

No. 22846 represents anterior fixation spanning vertebral segments; an interbody device is placed within a disc space. The operative report should support each service reported.

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 22846PPRRVU2026_Oct_nonQPP.csv, line 2,118 (RVU26D)
Geographic factors for MontanaGPCI2026.csv, line 71 (RVU26D)

Open CMS sourceHow we calculate rates

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