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Billing code 22634: Lumbar fusionMedicare rate & RVUs

Reports each additional lumbar interspace fused using combined posterior or posterolateral and posterior interbody techniques during a multilevel fusion.

CMS RVU26DEffective Oct 1, 2026109 payment localities23.3K Medicare services in 2024

Medicare pays $432.54 for 22634 nationally in a facility.

Medicare rate · 22634

Lumbar fusion

Swap in your local Medicare rate.

Work RVUs
7.76
Total RVUs
12.95
Global days
ZZZ

National rate · 2026

$432.54

Facility setting, before claim adjustments.

See every locality for 22634 → · 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 22634 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 22634 covers

This code captures each additional lumbar disc space fused after the first when the surgeon combines a posterior or posterolateral fusion with an interbody fusion performed from the back. The surgeon prepares the disc space and performs interbody fusion while also creating a posterior or posterolateral fusion at that level. Laminectomy or discectomy performed to prepare the interspace is part of the service. Spine surgeons typically report it for multilevel lumbar fusion operations in hospital or ambulatory surgical settings.

Report 22634 for each additional interspace treated with the combined technique beyond the initial level represented by 22633. It is an add-on code and must be billed with that primary procedure; it is paid within the primary procedure's global period. The operative report should identify each fused interspace and document both fusion techniques at each additional level. Count interspaces, not vertebrae or implants.

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 22634 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

22634 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$384.24
Alaska*Unavailable$529.11
ArizonaUnavailable$417.43
ArkansasUnavailable$378.46
AtlantaUnavailable$452.04
AustinUnavailable$428.29
BakersfieldUnavailable$412.14
Baltimore/Surr. CntysUnavailable$463.48
BeaumontUnavailable$418.58
BrazoriaUnavailable$414.87

22634 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
22634 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 22634 rate is calculated

Each of 22634’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 · 22634

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 7.76Practice expense 2.61Malpractice 2.58

12.9500 adjusted RVUs×$33.4009 conversion factor=$432.54

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

Payment rules and modifiers for 22634

The CMS indicators that decide how 22634 is paid alongside other services.

CMS payment indicators · 22634

Lumbar fusion

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
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.

What modifiers do to the payment

Modifier 80 · payment effect

With and without the modifier

22634 without 80 · national facility

$432.54

Lumbar fusion

22634-80 · Assistant: 16%

$69.21

A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.

When to use modifier 80

22634 compared with similar codes

Compare codes

22634 vs 22633 vs 22632 vs 22614 vs 22630: national Medicare rates

Swap in your local Medicare rate.

  • 22634
    Lumbar fusion · 7.76 wRVU
    —
  • 22633
    Lumbar fusion · 26.13 wRVU
    —
  • 22632
    Lumbar fusion · 5.09 wRVU
    —
  • 22614
    Spinal fusion · 6.27 wRVU
    —
  • 22630
    Lumbar fusion · 21.54 wRVU
    —

How to choose

22633Lumbar fusion
22633 represents the initial lumbar interspace treated with the combined technique. Use 22634 for each additional interspace treated that way.
22632Lumbar fusion
22632 applies to each additional level of posterior interbody lumbar fusion alone. 22634 is for an additional level where the posterior or posterolateral fusion technique is combined with interbody fusion.
22614Spinal fusion
22614 is an additional-level code for posterior or posterolateral fusion without the combined interbody technique. Use 22634 when the additional lumbar interspace also receives posterior interbody fusion.
22630Lumbar fusion
22630 represents the initial level of posterior interbody lumbar fusion without the combined posterior or posterolateral technique; 22634 is an add-on for additional levels using the combined technique.

Codes related to 22634

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

Codes related to 22634
CodeHow it relatesNational office range
Primary code
22633Lumbar fusionPrimary code for the initial lumbar interspace treated with the combined fusion technique.No office rate
Used instead
22632Lumbar fusionAdditional-level code for posterior interbody fusion without the combined technique.No office rate
22630Lumbar fusionInitial-level code for posterior interbody lumbar fusion without the combined technique.No office rate
22614Spinal fusionAdditional-level code for posterior or posterolateral fusion without the added interbody technique.No office rate
22612Spinal fusionInitial-level lumbar posterior or posterolateral fusion without posterior interbody fusion.No office rate

22634 billing questions

Which primary code must accompany 22634?

Report 22634 with 22633, which represents the initial lumbar interspace treated with the combined posterior or posterolateral and posterior interbody techniques.

How many units should be reported?

Report one unit for each additional lumbar interspace treated with the combined technique beyond the initial level. Count fused interspaces, not vertebrae.

How does 22634 differ from 22632?

22634 represents an additional interspace treated with combined posterior or posterolateral and posterior interbody fusion. 22632 is the additional-level code for posterior interbody fusion without the combined technique.

What operative documentation supports 22634?

Document the specific additional lumbar interspace and the posterior or posterolateral fusion and posterior interbody fusion performed there.

Is interspace preparation separately described by 22634?

The code includes laminectomy or discectomy performed to prepare the interspace for the interbody fusion. Document the work and its purpose in the operative report.

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 22634PPRRVU2026_Oct_nonQPP.csv, line 2,099 (RVU26D)

Open CMS sourceHow we calculate rates

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