FeeBase
Log inGet started
Menu

Billing code 22532: Spinal fusionMedicare rate & RVUs

Reports thoracic spinal fusion through a lateral extracavitary approach, including limited disc-space preparation when performed as part of the fusion.

CMS RVU26DEffective Oct 1, 2026109 payment localities539 Medicare services in 2024

Medicare pays $1,732.17 for 22532 nationally in a facility.

Medicare rate · 22532

Spinal fusion

Swap in your local Medicare rate.

Work RVUs
25.34
Total RVUs
51.86
Global days
090

National rate · 2026

$1,732.17

Facility setting, before claim adjustments.

See every locality for 22532 → · 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 22532 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 22532 covers

This code covers fusion at a thoracic spinal interspace using a lateral extracavitary approach, which reaches the spine from a posterolateral route. The surgeon prepares the interspace for fusion, including limited discectomy when needed, but that preparation is not a separate decompression service. Orthopedic spine surgeons and neurosurgeons typically perform the operation in a hospital operating room for conditions requiring thoracic stabilization and fusion.

Select the code based on the thoracic location and operative approach, not diagnosis alone. The operative report should identify the treated level, the lateral extracavitary technique, and the fusion performed; document additional segments and any separately reportable graft or instrumentation services. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction. Assistant-at-surgery payment and co-surgeon reporting are permitted; team-surgery payment 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 22532 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

22532 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,531.14
Alaska*Unavailable$2,062.72
ArizonaUnavailable$1,671.69
ArkansasUnavailable$1,506.74
AtlantaUnavailable$1,802.95
AustinUnavailable$1,734.97
BakersfieldUnavailable$1,690.96
Baltimore/Surr. CntysUnavailable$1,858.31
BeaumontUnavailable$1,658.00
BrazoriaUnavailable$1,669.30

22532 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
22532 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 22532 rate is calculated

Each of 22532’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 · 22532

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 25.34Practice expense 17.77Malpractice 8.75

51.8600 adjusted RVUs×$33.4009 conversion factor=$1,732.17

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

Payment rules and modifiers for 22532

22532 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 22532

Spinal fusion

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)2Permitted.
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 · 22532

Spinal fusion

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

22532 without 51 · national facility

$1,732.17

Spinal fusion

22532-51 · Second procedure: 50%

$866.09

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

22532 compared with similar codes

Compare codes

22532 vs 22533 vs 22534 vs 22556 vs 22558: national Medicare rates

Swap in your local Medicare rate.

  • 22532
    Spinal fusion · 25.34 wRVU
    —
  • 22533
    Lumbar fusion · 24.17 wRVU
    —
  • 22534
    Spinal fusion · 5.84 wRVU
    —
  • 22556
    Thoracic fusion · 24.08 wRVU
    —
  • 22558
    Anterior fusion · 22.94 wRVU
    —

How to choose

22533Lumbar fusion
Both use a lateral extracavitary technique, but 22532 applies to thoracic fusion and 22533 to lumbar fusion.
22534Spinal fusion
22532 reports the primary service at a thoracic segment; 22534 reports each additional segment and is an add-on.
22556Thoracic fusion
22556 describes thoracic interbody fusion through an anterior approach. Choose 22532 when the documented approach is lateral extracavitary.
22558Anterior fusion
22558 is an anterior interbody fusion service for the lumbar region; 22532 is for thoracic fusion using a lateral extracavitary approach.

Codes related to 22532

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

Codes related to 22532
CodeHow it relatesNational office range
Same family
22533Lumbar fusionUses the lateral extracavitary technique for lumbar rather than thoracic fusion.No office rate
Add-on codes
22534Spinal fusionAdd-on for each additional thoracic or lumbar segment treated with this technique.No office rate
Used instead
22556Thoracic fusionThoracic interbody fusion by an anterior approach rather than a lateral extracavitary approach.No office rate
Often billed with
20930Sp bone algrft morsel add-onMorselized allograft may be separately reported when used in spine surgery.No office rate
22842Spinal fixationSegmental spinal instrumentation may be reported when placed and supported by the operative record.No office rate

22532 billing questions

How does 22532 differ from 22533?

22532 is for a thoracic fusion using the lateral extracavitary approach. The corresponding lumbar service is 22533.

When is 22534 reported with 22532?

22534 is an add-on for each additional thoracic or lumbar vertebral segment treated with the lateral extracavitary technique. The operative report should identify the additional segment.

Does 22532 include disc-space preparation?

It includes limited discectomy performed to prepare the interspace for fusion. Document a distinct decompression service separately when performed and supported.

Can graft or instrumentation be reported separately?

Graft and instrumentation services may have separate codes when performed and reportable. Document the material used and the instrumentation placed.

What global and multiple-procedure rules affect 22532?

The 90-day global includes the day-before preoperative visit and related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and the others are subject to a 50% reduction.

May an assistant or co-surgeon be reported?

CMS permits assistant-at-surgery payment and co-surgeon reporting for this service. Team-surgery payment 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 22532PPRRVU2026_Oct_nonQPP.csv, line 2,079 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 22532 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 22532 and the rest of your codes on one sheet

Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.

Build my fee sheetOr price your code list free →