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Billing code 22212: Spinal osteotomyMedicare rate & RVUs

Reports a posterior or posterolateral osteotomy at one thoracic vertebral segment as part of surgical correction of spinal deformity.

CMS RVU26DEffective Oct 1, 2026109 payment localities2.6K Medicare services in 2024

Medicare pays $1,455.95 for 22212 nationally in a facility.

Medicare rate · 22212

Spinal osteotomy

Swap in your local Medicare rate.

Work RVUs
20.47
Total RVUs
43.59
Global days
090

National rate · 2026

$1,455.95

Facility setting, before claim adjustments.

See every locality for 22212 → · 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 22212 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 22212 covers

This code describes a surgeon’s posterior or posterolateral osteotomy at one thoracic vertebral segment to help correct a spinal deformity, such as thoracic kyphosis or scoliosis. The work is performed in an operating room, typically by an orthopedic spine surgeon or neurosurgeon as part of a corrective spine operation. The selected code reflects the spinal region, approach, and number of vertebral segments treated; this code is for one thoracic segment, rather than a three-column osteotomy or an anterior approach.

The operative report should identify the thoracic level, approach, osteotomy performed, and segment count. Medicare assigns 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.

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 22212 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

22212 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,293.98
Alaska*Unavailable$1,739.15
ArizonaUnavailable$1,408.08
ArkansasUnavailable$1,274.21
AtlantaUnavailable$1,509.53
AustinUnavailable$1,465.68
BakersfieldUnavailable$1,439.94
Baltimore/Surr. CntysUnavailable$1,557.99
BeaumontUnavailable$1,390.47
BrazoriaUnavailable$1,409.78

22212 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.

View every state and territory as a table
22212 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 22212 rate is calculated

Each of 22212’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 · 22212

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 20.47Practice expense 16.78Malpractice 6.34

43.5900 adjusted RVUs×$33.4009 conversion factor=$1,455.95

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

Payment rules and modifiers for 22212

22212 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 22212

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 · 22212

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

22212 without 51 · national facility

$1,455.95

Spinal osteotomy

22212-51 · Second procedure: 50%

$727.98

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

22212 compared with similar codes

Compare codes

22212 vs 22206 vs 22216 vs 22214 vs 22222: national Medicare rates

Swap in your local Medicare rate.

  • 22212
    Spinal osteotomy · 20.47 wRVU
    —
  • 22206
    Spinal osteotomy · 36.25 wRVU
    —
  • 22216
    Spinal osteotomy · 5.88 wRVU
    —
  • 22214
    Spine osteotomy · 20.49 wRVU
    —
  • 22222
    Spinal osteotomy · 22.51 wRVU
    —

How to choose

22206Spinal osteotomy
Use 22212 for a posterior or posterolateral osteotomy at one thoracic segment. Use 22206 when the thoracic osteotomy is a three-column procedure.
22216Spinal osteotomy
22212 represents the primary single-segment service. 22216 reports each additional vertebral segment in the applicable osteotomy family.
22214Spine osteotomy
Both codes describe posterior or posterolateral osteotomy at one segment; 22212 is thoracic, while 22214 is lumbar.
22222Spinal osteotomy
Both concern a single thoracic segment, but 22212 uses a posterior or posterolateral approach and 22222 uses an anterior approach.

Codes related to 22212

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

Codes related to 22212
CodeHow it relatesNational office range
Add-on codes
22216Spinal osteotomyAdd-on code for each additional vertebral segment in this osteotomy family.No office rate
Same family
22210Spinal osteotomyPosterior or posterolateral single-segment osteotomy for the cervical region.No office rate
22214Spine osteotomyPosterior or posterolateral single-segment osteotomy for the lumbar region.No office rate
Used instead
22206Spinal osteotomyFor a three-column osteotomy at one thoracic vertebral segment.No office rate
22222Spinal osteotomyThoracic single-segment osteotomy performed through an anterior approach.No office rate

22212 billing questions

How is this code different from a three-column thoracic osteotomy?

This code represents a posterior or posterolateral osteotomy at one thoracic vertebral segment. Code 22206 is for a three-column osteotomy at one thoracic segment.

Can an additional vertebral segment be reported?

Code 22216 is the add-on code for each additional vertebral segment in this osteotomy family. Document the additional segment treated and report it with the applicable primary osteotomy code.

What documentation supports reporting one segment?

The operative report should identify the thoracic level and describe the osteotomy and posterior or posterolateral approach. It should make clear that the work involved one vertebral segment.

Is the related postoperative care separately reported?

The code has a 90-day global period. Related postoperative care during that period, along with the day-before preoperative visit, is included.

How are multiple procedures in the same session paid?

Medicare pays the highest-valued procedure in full and applies the standard 50% multiple-procedure reduction to the other procedures in that session.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

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 22212PPRRVU2026_Oct_nonQPP.csv, line 2,055 (RVU26D)

Open CMS sourceHow we calculate rates

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