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Billing code 22551: ACDFMedicare rate & RVUs

Reports anterior cervical discectomy and fusion at one interspace below C2 when the surgeon also decompresses the spinal cord or nerve roots.

CMS RVU26DEffective Oct 1, 2026109 payment localities51.6K Medicare services in 2024

Medicare pays $1,604.91 for 22551 nationally in a facility.

Medicare rate · 22551

ACDF

Swap in your local Medicare rate.

Work RVUs
24.38
Total RVUs
48.05
Global days
090

National rate · 2026

$1,604.91

Facility setting, before claim adjustments.

See every locality for 22551 → · 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 22551 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 22551 covers

This code describes an anterior cervical discectomy and fusion at a single interspace below C2 that includes removal of disc and bone material to decompress the spinal cord or nerve roots. A spine surgeon, commonly an orthopedic surgeon or neurosurgeon, performs the operation in an operating room. The surgeon prepares the disc space and fuses the adjacent vertebrae, often using graft material and an interbody device. Typical indications include cervical disc disease or osteophytes causing radiculopathy or myelopathy when decompression and fusion are performed at that level.

Report 22551 for one treated interspace when the operative documentation supports both decompression and fusion; the documented level and work distinguish it from fusion without decompression. Additional cervical interspaces may be reported with add-on code 22552. Disc removal, osteophyte removal, and decompression at the coded level are included. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In the same session, the highest-valued procedure is paid in full and other procedures receive the standard multiple-procedure reduction. Modifier 50 is inappropriate for this anatomy. Assistant-at-surgery payment may be made, co-surgeons are permitted, 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 22551 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

22551 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,421.04
Alaska*Unavailable$1,921.99
ArizonaUnavailable$1,549.30
ArkansasUnavailable$1,398.76
AtlantaUnavailable$1,670.92
AustinUnavailable$1,605.06
BakersfieldUnavailable$1,562.25
Baltimore/Surr. CntysUnavailable$1,720.79
BeaumontUnavailable$1,538.99
BrazoriaUnavailable$1,546.24

22551 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
22551 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 22551 rate is calculated

Each of 22551’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 · 22551

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 24.38Practice expense 15.43Malpractice 8.24

48.0500 adjusted RVUs×$33.4009 conversion factor=$1,604.91

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

Payment rules and modifiers for 22551

22551 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 22551

ACDF

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 · 22551

ACDF

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

22551 without 51 · national facility

$1,604.91

ACDF

22551-51 · Second procedure: 50%

$802.46

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

22551 compared with similar codes

Compare codes

22551 vs 22552 vs 22554 vs 22558: national Medicare rates

Swap in your local Medicare rate.

  • 22551
    ACDF · 24.38 wRVU
    —
  • 22552
    Cervical fusion · 6.34 wRVU
    —
  • 22554
    Cervical fusion · 17.25 wRVU
    —
  • 22558
    Anterior fusion · 22.94 wRVU
    —

How to choose

22552Cervical fusion
22552 is the add-on for each additional cervical interspace; 22551 reports the primary interspace.
22554Cervical fusion
22554 is for cervical anterior fusion without decompression. Choose 22551 when the surgeon also decompresses the spinal cord or nerve roots.
22558Anterior fusion
22558 describes anterior interbody fusion in the lumbar region, rather than the cervical interspace below C2 covered by 22551.

Codes related to 22551

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

Codes related to 22551
CodeHow it relatesNational office range
Add-on codes
22552Cervical fusionAdd-on for each additional cervical interspace treated after the primary 22551 service.No office rate
Used instead
22554Cervical fusionCervical anterior fusion without the decompression work included in 22551.No office rate
Often billed with
22853Interbody deviceMay describe placement of an interbody biomechanical device during the fusion.No office rate
20930Sp bone algrft morsel add-onDescribes morselized allograft used in spinal fusion when furnished and supported.No office rate

22551 billing questions

When should 22551 be chosen over 22554?

Use 22551 when the surgeon performs cervical decompression along with the fusion at the interspace. Code 22554 describes cervical anterior fusion without that decompression work.

Can 22552 be reported with 22551?

Yes. Report 22552 as the add-on for each additional cervical interspace treated with the qualifying fusion and decompression service.

Is the discectomy separately reported at the 22551 level?

No. Disc removal, osteophyte removal, and neural decompression at the treated level are included in 22551.

What should the operative report document?

Document the cervical level, the decompression performed, the fusion work, and the number of interspaces treated. The record should support that the work at the 22551 level included decompression as well as fusion.

Can an assistant or co-surgeon be reported?

CMS permits payment for an assistant at surgery and permits co-surgeons for this code. Team-surgery billing is not permitted.

Should modifier 50 be used for two-sided cervical work?

No. Modifier 50 is inappropriate for this code's anatomy; report the treated interspace rather than bilateral units.

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 22551PPRRVU2026_Oct_nonQPP.csv, line 2,083 (RVU26D)

Open CMS sourceHow we calculate rates

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