Billing code 22207: Spinal osteotomyMedicare rate & RVUs

Medicare pays $2,214.48 for 22207 nationally in a facility.

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

What 22207 covers

This code represents a major corrective bone-cutting procedure through the lumbar spine that changes alignment by releasing or removing bone across all three spinal columns at one vertebral segment. A lumbar pedicle subtraction osteotomy is a familiar example, often performed for rigid sagittal imbalance or another fixed deformity that cannot be adequately corrected with a less extensive release. A spine surgeon performs it in the operating room, often as part of a reconstruction that may also include instrumentation or fusion.

Select the code when the operative report identifies a lumbar level and documents work spanning three columns; a posterior osteotomy that does not span all three columns belongs in a different code. Document the approach, vertebral level, extent of bone removal, and corrective objective. CMS assigns a 90-day global period, including the day-before preoperative visit and related care through 90 days after surgery. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. CMS permits assistant-at-surgery payment; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

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 22207 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

22207 rates by state

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

How the 22207 rate is calculated

Each of 22207’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.

Payment rules and modifiers for 22207

22207 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

22207 compared with similar codes

How to choose

22206Spinal osteotomy

22206 is the thoracic counterpart; 22207 is for a lumbar vertebral segment.

22208Spinal osteotomy

22208 reports each additional segment after the first three-column osteotomy, rather than the initial lumbar segment.

22214Spine osteotomy

22214 is for a lumbar posterior or posterolateral osteotomy without the three-column extent specified for 22207.

22224Spinal osteotomy

22224 describes a lumbar osteotomy through an anterior approach, rather than the posterior or posterolateral approach for 22207.

Codes related to 22207

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates