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Billing code 22554: Cervical fusionMedicare rate & RVUs

Reports anterior interbody fusion at a cervical level below C2 when disc removal is limited to preparing the space and is not for decompression.

CMS RVU26DEffective Oct 1, 2026109 payment localities4.7K Medicare services in 2024

Medicare pays $1,215.79 for 22554 nationally in a facility.

Medicare rate · 22554

Cervical fusion

Swap in your local Medicare rate.

Work RVUs
17.25
Total RVUs
36.40
Global days
090

National rate · 2026

$1,215.79

Facility setting, before claim adjustments.

See every locality for 22554 → · 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 22554 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 22554 covers

A spine surgeon approaches the cervical spine from the front and joins adjacent vertebrae with an interbody fusion. The code includes limited disc removal to prepare the space for fusion, but that removal is not performed to decompress neural structures. Neurosurgeons and orthopedic spine surgeons commonly perform this operation in a hospital or other surgical facility for cervical disc or alignment problems requiring fusion.

Select 22554 when the operative report supports anterior interbody fusion below C2 and distinguishes preparatory disc removal from decompression. The 90-day global period includes 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 payment may be made, and co-surgeons are permitted; team surgery is not. Modifier 50 is inappropriate for this code. The code represents the fusion service, not a bilateral procedure.

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 22554 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

22554 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,075.98
Alaska*Unavailable$1,445.88
ArizonaUnavailable$1,174.07
ArkansasUnavailable$1,058.96
AtlantaUnavailable$1,263.59
AustinUnavailable$1,220.72
BakersfieldUnavailable$1,193.80
Baltimore/Surr. CntysUnavailable$1,303.48
BeaumontUnavailable$1,161.91
BrazoriaUnavailable$1,173.77

22554 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
22554 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 22554 rate is calculated

Each of 22554’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 · 22554

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 17.25Practice expense 13.35Malpractice 5.80

36.4000 adjusted RVUs×$33.4009 conversion factor=$1,215.79

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

Payment rules and modifiers for 22554

22554 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 22554

Cervical 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 · 22554

Cervical 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

22554 without 51 · national facility

$1,215.79

Cervical fusion

22554-51 · Second procedure: 50%

$607.90

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

22554 compared with similar codes

Compare codes

22554 vs 22551 vs 22558 vs 22585: national Medicare rates

Swap in your local Medicare rate.

  • 22554
    Cervical fusion · 17.25 wRVU
    —
  • 22551
    ACDF · 24.38 wRVU
    —
  • 22558
    Anterior fusion · 22.94 wRVU
    —
  • 22585
    Anterior fusion · 5.38 wRVU
    —

How to choose

22551ACDF
22554 covers cervical fusion with limited disc removal to prepare the space; 22551 applies when the cervical disc work includes decompression.
22558Anterior fusion
22558 describes the comparable anterior interbody fusion service in the lumbar region, rather than the cervical region below C2.
22585Anterior fusion
22585 is the add-on for each additional interspace; 22554 reports the primary cervical interspace service.

Codes related to 22554

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

Codes related to 22554
CodeHow it relatesNational office range
Add-on codes
22585Anterior fusionAdd-on for each additional interspace fused with the anterior interbody technique.No office rate
Used instead
22551ACDFUse for anterior cervical fusion when the disc work includes decompression.No office rate
Same family
22556Thoracic fusionAnterior interbody fusion code for the thoracic region.No office rate
22558Anterior fusionAnterior interbody fusion code for the lumbar region.No office rate
Often billed with
22845Anterior fixationAnterior instrumentation may be reported with the fusion when performed and supported by documentation.No office rate
20931Spinal bone graftStructural allograft may be separately reported when used and documented.No office rate

22554 billing questions

How is 22554 distinguished from 22551?

Use 22554 when the anterior cervical fusion includes only the limited disc removal needed to prepare the interspace. When the disc work includes decompression, 22551 is the relevant cervical fusion code.

Is the preparatory disc removal separately reported?

No. The limited disc removal to prepare the interspace is included in 22554. Document whether disc removal was only preparatory or was also performed for decompression.

Can an additional cervical interspace be reported?

For an additional interspace fused using this non-decompression approach, 22585 is the add-on code. The operative report should identify each treated interspace.

Should modifier 50 be appended?

No. Modifier 50 is inappropriate for 22554; the code is not adjusted as a bilateral service.

How does the global period affect postoperative visits?

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

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made, and co-surgeons are permitted. Team surgery is not permitted for this code.

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 22554PPRRVU2026_Oct_nonQPP.csv, line 2,085 (RVU26D)

Open CMS sourceHow we calculate rates

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