CPT code 22855: Hardware removal, anterior spinal instrumentation2026 Medicare rate & RVUs in Puerto Rico
Removal of anterior spinal fixation hardware, reported when a surgeon removes a previously placed construct during revision or other spine surgery.
In Puerto Rico, Medicare pays $1,052.42 for 22855 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 22855 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 22855 covers
This service covers surgical removal of fixation hardware placed along the front of the spine, such as an anterior plate, screws, or related instrumentation. It is typically performed by an orthopedic spine surgeon or neurosurgeon during revision surgery, including cases involving hardware failure, infection, pain, or a change in the treatment plan. The work may occur during a larger spinal operation or as a separate procedure in a facility setting.
Report the code when the operative documentation identifies anterior spinal instrumentation and describes its removal. Distinguish it from removal of posterior hardware based on the approach and location of the construct. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate.
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 Puerto Rico compares for 22855
Across 109 of 109 payment localities, the facility rate for 22855 runs from $919.14 in Arkansas to $1,316.24 in Miami, FL. Puerto Rico pays $1,052.42. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Puerto Rico · this page$1,052.42
- Los Angeles, CA · California$1,084.82+$32.40
- Washington, DC area · District of Columbia$1,163.16+$110.74
- Miami, FL · Florida$1,316.24+$263.82
- Chicago, IL · Illinois$1,268.21+$215.79
- Manhattan, NY · New York$1,239.81+$187.39
- Alaska · Alaska$1,259.59+$207.17
Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $933.42 |
| ArkansasArkansas | — | $919.14 |
| ArizonaArizona | — | $1,015.73 |
| Bakersfield, CACalifornia | — | $1,032.20 |
| Chico, CACalifornia | — | $1,019.22 |
| El Centro, CACalifornia | — | $1,020.04 |
| Fresno, CACalifornia | — | $1,019.22 |
| Hanford, CACalifornia | — | $1,019.22 |
| Madera, CACalifornia | — | $1,019.22 |
| Merced, CACalifornia | — | $1,019.22 |
| Modesto, CACalifornia | — | $1,019.22 |
| Napa, CACalifornia | — | $1,120.70 |
| Oxnard, CACalifornia | — | $1,071.03 |
| Redding, CACalifornia | — | $1,019.22 |
| Rest of CaliforniaCalifornia | — | $1,019.22 |
| Riverside, CACalifornia | — | $1,071.62 |
| Sacramento, CACalifornia | — | $1,053.87 |
| Salinas, CACalifornia | — | $1,049.81 |
| San Diego, CACalifornia | — | $1,063.99 |
| Marin County, CACalifornia | — | $1,163.31 |
| San Francisco, CACalifornia | — | $1,157.75 |
| San Benito County, CACalifornia | — | $1,195.53 |
| Santa Clara County, CACalifornia | — | $1,172.78 |
| San Luis Obispo, CACalifornia | — | $1,035.16 |
| Santa Cruz, CACalifornia | — | $1,065.41 |
| Santa Maria, CACalifornia | — | $1,050.86 |
| Santa Rosa, CACalifornia | — | $1,074.87 |
| Stockton, CACalifornia | — | $1,019.22 |
| Vallejo, CACalifornia | — | $1,112.68 |
| Visalia, CACalifornia | — | $1,019.22 |
| Yuba City, CACalifornia | — | $1,019.22 |
| ColoradoColorado | — | $1,044.87 |
| ConnecticutConnecticut | — | $1,124.04 |
| DelawareDelaware | — | $1,032.40 |
| Fort Lauderdale, FLFlorida | — | $1,187.85 |
| Rest of FloridaFlorida | — | $1,116.80 |
| Atlanta, GAGeorgia | — | $1,091.17 |
| Rest of GeorgiaGeorgia | — | $1,042.17 |
| Hawaii, Guam, HIHawaii | — | $1,032.68 |
| IowaIowa | — | $920.59 |
| IdahoIdaho | — | $934.88 |
| East St. Louis, ILIllinois | — | $1,187.09 |
| Rest of IllinoisIllinois | — | $1,110.68 |
| Suburban Chicago, ILIllinois | — | $1,190.77 |
| IndianaIndiana | — | $939.60 |
| KansasKansas | — | $934.02 |
| KentuckyKentucky | — | $995.73 |
| New Orleans, LALouisiana | — | $1,051.18 |
| Rest of LouisianaLouisiana | — | $1,001.28 |
| Metropolitan Boston, MAMassachusetts | — | $1,125.89 |
| Rest of MassachusettsMassachusetts | — | $1,045.48 |
| Baltimore area, MDMaryland | — | $1,124.91 |
| Rest of MarylandMaryland | — | $1,046.98 |
| Rest of MaineMaine | — | $959.27 |
| Southern Maine, MEMaine | — | $987.06 |
| Detroit, MIMichigan | — | $1,150.09 |
| Rest of MichiganMichigan | — | $1,039.65 |
| MinnesotaMinnesota | — | $946.32 |
| Metropolitan Kansas City, MOMissouri | — | $1,024.41 |
| Metropolitan St. Louis, MOMissouri | — | $1,033.32 |
| Rest of MissouriMissouri | — | $995.37 |
| MississippiMississippi | — | $956.54 |
| MontanaMontana | — | $1,050.46 |
| North CarolinaNorth Carolina | — | $966.87 |
| North DakotaNorth Dakota | — | $953.58 |
| NebraskaNebraska | — | $920.45 |
| New HampshireNew Hampshire | — | $1,045.54 |
| Northern New JerseyNew Jersey | — | $1,153.77 |
| Rest of New JerseyNew Jersey | — | $1,121.43 |
| New MexicoNew Mexico | — | $1,052.92 |
| NevadaNevada | — | $1,023.83 |
| NYC suburbs and Long Island, NYNew York | — | $1,294.17 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $1,143.62 |
| Queens, NYNew York | — | $1,223.66 |
| Rest of New YorkNew York | — | $983.65 |
| OhioOhio | — | $1,019.85 |
| OklahomaOklahoma | — | $974.62 |
| Portland, OROregon | — | $1,058.31 |
| Rest of OregonOregon | — | $1,000.70 |
| Metropolitan Philadelphia, PAPennsylvania | — | $1,106.88 |
| Rest of PennsylvaniaPennsylvania | — | $1,011.39 |
| Rhode IslandRhode Island | — | $1,055.16 |
| South CarolinaSouth Carolina | — | $998.07 |
| South DakotaSouth Dakota | — | $942.12 |
| TennesseeTennessee | — | $941.28 |
| Austin, TXTexas | — | $1,054.67 |
| Beaumont, TXTexas | — | $1,005.80 |
| Brazoria, TXTexas | — | $1,015.58 |
| Dallas, TXTexas | — | $1,030.72 |
| Fort Worth, TXTexas | — | $1,029.14 |
| Galveston, TXTexas | — | $1,024.18 |
| Houston, TXTexas | — | $1,113.87 |
| Rest of TexasTexas | — | $1,016.01 |
| UtahUtah | — | $1,011.85 |
| VirginiaVirginia | — | $996.37 |
| Virgin Islands, VIUnited States Virgin Islands | — | $1,052.42 |
| VermontVermont | — | $966.23 |
| Rest of WashingtonWashington | — | $1,038.04 |
| King County, WAWashington | — | $1,130.82 |
| WisconsinWisconsin | — | $921.97 |
| West VirginiaWest Virginia | — | $1,072.76 |
| WyomingWyoming | — | $1,008.24 |
22855 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 22855 rate is calculated
Each of 22855’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 · 22855
RVUs × geographic indexes × conversion factor
Work15.46
15.46 RVUs× 1.000 GPCI
Practice expense11.10
11.10 RVUs× 1.000 GPCI
Malpractice4.90
4.90 RVUs× 1.000 GPCI
Adjusted RVUs
31.4600
Conversion factor
$33.4009
Medicare rate
$1,050.79
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Puerto Rico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
2,126
- Code
- 22855
- Physician work
- 15.46
- Practice expense
- 11.10
- Malpractice
- 4.90
GPCI2026.csv
91
- Locality
- Puerto Rico
- Physician work
- 1.000
- Practice expense
- 1.011
- Malpractice
- 0.985
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 15.46 | × 1.000 | 15.4600 |
| Practice expense | 11.10 | × 1.011 | 11.2221 |
| Malpractice | 4.90 | × 0.985 | 4.8265 |
| Total RVUs | 31.5086 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Puerto Rico$1052.42
Facility: (15.46 × 1 + 11.1 × 1.011 + 4.9 × 0.985) × $33.4009 = $1052.42
Payment rules and modifiers for 22855
22855 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 22855
Hardware removal, anterior spinal instrumentation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 22855
Hardware removal, anterior spinal instrumentation
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
22855 without 51 · national facility
$1,050.79
Hardware removal, anterior spinal instrumentation
22855-51 · Second procedure: 50%
$525.40
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
How 22855 has changed in Puerto Rico
22855 · 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 | $1,052.42 | RVU26D |
| 2026-07-01 | Not available in this setting | $1,052.42 | RVU26C |
| 2026-04-01 | Not available in this setting | $1,052.42 | RVU26B |
| 2026-01-01 | Not available in this setting | $1,052.42 | RVU26A |
| 2025-10-01 | Not available in this setting | $1,093.06 | RVU25D |
| 2025-07-01 | Not available in this setting | $1,093.06 | RVU25C |
| 2025-04-01 | Not available in this setting | $1,093.06 | RVU25B |
| 2025-01-01 | Not available in this setting | $1,093.06 | RVU25A |
| 2024-10-01 | Not available in this setting | $1,119.14 | RVU24D |
| 2024-07-01 | Not available in this setting | $1,119.14 | RVU24C |
| 2024-04-01 | Not available in this setting | $1,119.14 | RVU24B |
| 2024-03-09 | Not available in this setting | $1,119.14 | RVU24AR |
| 2024-01-01 | Not available in this setting | $1,100.87 | RVU24A |
| 2023-10-01 | Not available in this setting | $1,131.30 | RVU23D |
| 2023-07-01 | Not available in this setting | $1,130.48 | RVU23C |
| 2023-04-01 | Not available in this setting | $1,130.48 | RVU23B |
| 2023-01-01 | Not available in this setting | $1,130.48 | RVU23A |
| 2022-10-01 | Not available in this setting | $1,140.05 | RVU22D |
| 2022-07-01 | Not available in this setting | $1,140.05 | RVU22C |
| 2022-04-01 | Not available in this setting | $1,140.05 | RVU22B |
| 2022-01-01 | Not available in this setting | $1,140.05 | RVU22A |
| 2021-10-01 | Not available in this setting | $1,144.29 | RVU21D |
| 2021-07-01 | Not available in this setting | $1,144.29 | RVU21C |
| 2021-04-01 | Not available in this setting | $1,144.29 | RVU21B |
| 2021-01-01 | Not available in this setting | $1,144.29 | RVU21A |
| 2020-10-01 | Not available in this setting | $1,160.56 | RVU20D |
| 2020-07-01 | Not available in this setting | $1,160.56 | RVU20C |
| 2020-04-01 | Not available in this setting | $1,160.56 | RVU20B |
| 2020-01-01 | Not available in this setting | $1,160.56 | RVU20A |
| 2019-10-01 | Not available in this setting | $1,161.28 | RVU19D |
| 2019-07-01 | Not available in this setting | $1,161.28 | RVU19C |
| 2019-04-01 | Not available in this setting | $1,161.28 | RVU19B |
| 2019-01-01 | Not available in this setting | $1,161.28 | RVU19A |
| 2018-10-01 | Not available in this setting | $1,158.94 | RVU18D |
| 2018-07-01 | Not available in this setting | $1,158.94 | RVU18C |
| 2018-04-01 | Not available in this setting | $1,158.94 | RVU18B |
| 2018-01-01 | Not available in this setting | $1,158.94 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $1,034.15 | RVU17D |
| 2017-07-01 | Not available in this setting | $1,034.15 | RVU17C |
| 2017-04-01 | Not available in this setting | $1,034.15 | RVU17B |
| 2017-01-01 | Not available in this setting | $1,034.15 | RVU17A |
| 2016-10-01 | Not available in this setting | $910.28 | RVU16D |
| 2016-07-01 | Not available in this setting | $910.28 | RVU16C |
| 2016-04-01 | Not available in this setting | $910.28 | RVU16B |
| 2016-01-01 | Not available in this setting | $910.28 | RVU16A |
| 2015-10-01 | Not available in this setting | $914.62 | RVU15D |
| 2015-07-01 | Not available in this setting | $914.62 | RVU15C |
| 2015-04-01 | Not available in this setting | $910.07 | RVU15B |
| 2015-01-01 | Not available in this setting | $910.07 | RVU15A |
| 2014-10-01 | Not available in this setting | $900.28 | RVU14D |
| 2014-07-01 | Not available in this setting | $900.28 | RVU14C |
| 2014-04-01 | Not available in this setting | $900.28 | RVU14B |
| 2014-01-01 | Not available in this setting | $900.28 | RVU14A |
| 2013-10-01 | Not available in this setting | $873.03 | RVU13D |
| 2013-07-01 | Not available in this setting | $873.03 | RVU13C |
| 2013-04-01 | Not available in this setting | $873.03 | RVU13B |
| 2013-01-01 | Not available in this setting | $873.03 | RVU13AR |
Where the Puerto Rico rate applies
Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.
- Aceitunas
- Adjuntas
- Aguada
- Aguadilla
- Aguas Buenas
- Aguas Claras
- Aguilita
- Aibonito
22855 billing questions
How is this distinguished from posterior instrumentation removal?
Use this code for removal of anterior spinal instrumentation. Codes 22850 and 22852 describe removal of posterior instrumentation, with the applicable code depending on the posterior construct.
Can this be reported with new anterior fixation placement?
It may be reported with a new anterior instrumentation code when the surgeon removes the prior construct and places new fixation during the same operation. The record should describe both the removal and the new placement.
Should modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this service, and modifier 50 is not appropriate.
What documentation supports reporting this code?
Document the anterior location and type of instrumentation, the removal performed, and the clinical reason for removing it. The operative report should make clear that the work was removal of the spinal construct, not simply exposure or revision of another structure.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. Other same-session procedures may also trigger the standard multiple-procedure reduction.
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
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