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Billing code 22210: Spinal osteotomyMedicare rate & RVUs

Reports one-segment posterior or posterolateral cervical osteotomy, often for fixed deformity correction, with associated discectomy included in the operative service.

CMS RVU26DEffective Oct 1, 2026109 payment localities713 Medicare services in 2024

Medicare pays $1,713.47 for 22210 nationally in a facility.

Medicare rate · 22210

Spinal osteotomy

Swap in your local Medicare rate.

Work RVUs
24.75
Total RVUs
51.30
Global days
090

National rate · 2026

$1,713.47

Facility setting, before claim adjustments.

See every locality for 22210 → · Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 22210 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 22210 covers

This code represents a posterior or posterolateral osteotomy at one cervical vertebral segment; discectomy performed as part of the corrective work is included. The surgeon removes or reshapes bone to mobilize a rigid deformity, such as fixed cervical kyphosis, and improve alignment. Orthopedic spine surgeons and neurosurgeons typically perform the procedure in an operating room as part of cervical deformity reconstruction.

Choose the code when the operative report supports one treated cervical segment and the posterior or posterolateral approach. Document the level, approach, osteotomy work, and number of segments. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is not appropriate. An assistant at surgery may be paid; co-surgeons require 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 22210 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

22210 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,518.91
Alaska*Unavailable$2,045.21
ArizonaUnavailable$1,655.37
ArkansasUnavailable$1,495.25
AtlantaUnavailable$1,780.25
AustinUnavailable$1,719.96
BakersfieldUnavailable$1,682.39
Baltimore/Surr. CntysUnavailable$1,835.85
BeaumontUnavailable$1,638.80
BrazoriaUnavailable$1,654.94

22210 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.

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View every state and territory as a table
22210 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

How the 22210 rate is calculated

Each of 22210’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 · 22210

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 24.75Practice expense 18.44Malpractice 8.11

51.3000 adjusted RVUs×$33.4009 conversion factor=$1,713.47

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 22210

22210 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 22210

Spinal osteotomy

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 22210

Spinal osteotomy

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

22210 without 51 · national facility

$1,713.47

Spinal osteotomy

22210-51 · Second procedure: 50%

$856.74

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%).

When to use modifier 51

22210 compared with similar codes

Compare codes

22210 vs 22212 vs 22214 vs 22216 vs 22220: national Medicare rates

Swap in your local Medicare rate.

  • 22210
    Spinal osteotomy · 24.75 wRVU
    —
  • 22212
    Spinal osteotomy · 20.47 wRVU
    —
  • 22214
    Spine osteotomy · 20.49 wRVU
    —
  • 22216
    Spinal osteotomy · 5.88 wRVU
    —
  • 22220
    Spinal osteotomy · 22.37 wRVU
    —

How to choose

22212Spinal osteotomy
Use 22212 when the one-segment osteotomy is thoracic; 22210 is for a cervical segment.
22214Spine osteotomy
Use 22214 when the one-segment osteotomy is lumbar; 22210 is for a cervical segment.
22216Spinal osteotomy
22216 reports additional segments and is not the primary code for the first segment. Use 22210 for the cervical primary segment.
22220Spinal osteotomy
Both describe cervical osteotomy work at one segment, but 22220 uses an anterior approach; 22210 uses a posterior or posterolateral approach.

Codes related to 22210

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

Codes related to 22210
CodeHow it relatesNational office range
Same family
22212Spinal osteotomyOne-segment posterior or posterolateral osteotomy in the thoracic region.No office rate
22214Spine osteotomyOne-segment posterior or posterolateral osteotomy in the lumbar region.No office rate
Add-on codes
22216Spinal osteotomyAdd-on code for each additional vertebral segment treated with a qualifying primary osteotomy.No office rate
Used instead
22220Spinal osteotomyCervical one-segment osteotomy using an anterior rather than posterior or posterolateral approach.No office rate

22210 billing questions

How is this code distinguished from 22212 or 22214?

Use 22210 for one cervical segment. Code 22212 is for a thoracic segment, while 22214 is for a lumbar segment.

Can 22216 be reported with this code?

When the surgeon performs osteotomy work at additional vertebral segments, 22216 is the add-on code for those additional segments. The operative report should support the number and location of the treated segments.

Is the associated discectomy separately reported?

Discectomy performed as part of the osteotomy is included in this service. Document the osteotomy and any separately performed procedures distinctly.

Should modifier 50 be appended for bilateral work?

No. The descriptor and anatomy make modifier 50 inappropriate for this code.

What assistant or co-surgeon rules apply?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

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 22210PPRRVU2026_Oct_nonQPP.csv, line 2,054 (RVU26D)

Open CMS sourceHow we calculate rates

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