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Billing code 22830: Fusion explorationMedicare rate & RVUs

An operative inspection of a previously fused spinal segment, reported when the surgeon assesses whether the fusion is solid or has failed.

CMS RVU26DEffective Oct 1, 2026109 payment localities8.6K Medicare services in 2024

Medicare pays $791.60 for 22830 nationally in a facility.

Medicare rate · 22830

Fusion exploration

Swap in your local Medicare rate.

Work RVUs
10.94
Total RVUs
23.70
Global days
090

National rate · 2026

$791.60

Facility setting, before claim adjustments.

See every locality for 22830 → · 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 22830 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 22830 covers

A spine surgeon—typically an orthopedic surgeon or neurosurgeon—operatively exposes and assesses a prior fusion to determine whether the bone has united or whether a nonunion or other failure is present. This is an intraoperative assessment, often encountered during surgery planned for persistent symptoms or revision of a prior spinal procedure; it is not an imaging study or a routine office examination. The operative report should identify the fusion site explored and describe the findings that support the assessment.

Report 22830 for the exploration itself, distinguishing it in the record from any revision fusion, fixation-device work, or other procedure performed during the same operation. It has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and others at 50%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this code.

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 22830 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

22830 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$703.86
Alaska*Unavailable$944.67
ArizonaUnavailable$765.78
ArkansasUnavailable$693.13
AtlantaUnavailable$820.16
AustinUnavailable$797.86
BakersfieldUnavailable$785.13
Baltimore/Surr. CntysUnavailable$846.86
BeaumontUnavailable$755.36
BrazoriaUnavailable$767.15

22830 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
22830 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 22830 rate is calculated

Each of 22830’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 · 22830

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 10.94Practice expense 9.42Malpractice 3.34

23.7000 adjusted RVUs×$33.4009 conversion factor=$791.60

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

Payment rules and modifiers for 22830

22830 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 22830

Fusion exploration

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 · 22830

Fusion exploration

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

22830 without 51 · national facility

$791.60

Fusion exploration

22830-51 · Second procedure: 50%

$395.80

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

22830 compared with similar codes

Compare codes

22830 vs 22612 vs 22852 vs 22849: national Medicare rates

Swap in your local Medicare rate.

  • 22830
    Fusion exploration · 10.94 wRVU
    —
  • 22612
    Spinal fusion · 22.94 wRVU
    —
  • 22852
    Spinal hardware removal · 9.14 wRVU
    —
  • 22849
    Spinal fixation · 18.69 wRVU
    —

How to choose

22612Spinal fusion
22612 reports posterior or posterolateral lumbar fusion work. Code 22830 reports assessment of an existing fusion, not creation of a new fusion.
22852Spinal hardware removal
22852 describes removal of segmental spinal instrumentation. Use 22830 for exploration of the fusion itself, not simply for taking out hardware.
22849Spinal fixation
22849 describes reinsertion of a spinal fixation device. It concerns fixation hardware, whereas 22830 concerns assessment of the prior bone fusion.

Codes related to 22830

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

Codes related to 22830
CodeHow it relatesNational office range
Often billed with
22612Spinal fusionA posterior or posterolateral lumbar fusion may be performed during the same operation when revision is needed.No office rate
22852Spinal hardware removalSegmental spinal instrumentation may be removed during an operation that includes fusion exploration.No office rate
22849Spinal fixationSpinal fixation-device reinsertion may accompany revision work following exploration.No office rate
22850Spinal hardware removalRemoval of nonsegmental spinal fixation may occur during the same revision operation.No office rate

22830 billing questions

How is exploration different from revision fusion?

Exploration assesses whether the prior fusion has united; revision fusion treats or extends the fusion. The operative note should distinguish the assessment from any repair performed.

Does 22830 include removal of spinal hardware?

No. Exploration concerns the prior fusion, while hardware removal is a separate service, such as removal of segmental instrumentation reported with 22852. Document each service performed and follow applicable coding edits.

Can 22830 be reported with a fusion procedure?

It may occur during an operation that also revises or extends a fusion. Documentation should show the distinct exploration and its findings; whether both services are separately reportable depends on applicable coding edits.

Should modifier 50 be used when the surgeon explores both sides?

No. CMS identifies bilateral adjustment as inappropriate for 22830; modifier 50 should not be used for this code.

What documentation supports 22830?

Record the previously fused site that was explored and the surgeon's intraoperative findings about fusion integrity, including evidence supporting a solid union or suspected failure.

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 22830PPRRVU2026_Oct_nonQPP.csv, line 2,108 (RVU26D)

Open CMS sourceHow we calculate rates

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