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Billing code 22843: Spinal fixationMedicare rate & RVUs

Reports posterior segmental fixation spanning 7–12 vertebral segments, commonly placed with spinal fusion or reconstruction to stabilize a long spinal construct.

CMS RVU26DEffective Oct 1, 2026109 payment localities14.8K Medicare services in 2024

Medicare pays $728.47 for 22843 nationally in a facility.

Medicare rate · 22843

Spinal fixation

Work RVUs
13.1
Total RVUs
21.81
Global days
ZZZ

National rate · 2026

$728.47

Facility setting, before claim adjustments.

See every locality for 22843 →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 22843 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 22843 covers

Code 22843 represents posterior segmental fixation spanning 7 through 12 vertebral segments. Typical constructs use pedicle screws and rods or other segmental anchors, such as multiple hooks or sublaminar wires, to stabilize a long portion of the spine. Orthopedic spine surgeons and neurosurgeons commonly place this instrumentation during facility-based operations for spinal fusion, deformity correction, or extensive instability.

Choose the code by counting the vertebral segments instrumented, not the disc spaces fused. The operative report should identify the spinal levels and describe the fixation construct so the 7–12 segment span is supported. This is an add-on code: report it only with an appropriate primary procedure. CMS pays it within that primary procedure’s global period, rather than assigning it a separate global period.

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 22843 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

22843 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$647.63
Alaska*Unavailable$892.17
ArizonaUnavailable$703.19
ArkansasUnavailable$637.93
AtlantaUnavailable$761.07
AustinUnavailable$721.46
BakersfieldUnavailable$694.61
Baltimore/Surr. CntysUnavailable$780.32
BeaumontUnavailable$705.03
BrazoriaUnavailable$698.98

22843 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
22843 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 22843 rate is calculated

Each of 22843’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 · 22843

RVUs × geographic indexes × conversion factor

Work13.10

13.10 RVUs× 1.000 GPCI

Practice expense4.40

4.40 RVUs× 1.000 GPCI

Malpractice4.31

4.31 RVUs× 1.000 GPCI

Adjusted RVUs

21.8100

Conversion factor

$33.4009

Medicare rate

$728.47

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 22843

The CMS indicators that decide how 22843 is paid alongside other services.

CMS payment indicators · 22843

Spinal fixation

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

22843 without 80 · national facility

$728.47

Spinal fixation

22843-80 · Assistant: 16%

$116.56

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

When to use modifier 80

22843 compared with similar codes

Compare codes · National

5 codes, side by side

  • 22843

    Spinal fixation13.1 wRVU

    Not priced

  • 22842

    Spinal fixation12.25 wRVU

    Not priced

  • 22844

    Spinal fixation16.01 wRVU

    Not priced

  • 22840

    Spinal fixation12.21 wRVU

    Not priced

  • 22853

    Interbody device4.14 wRVU

    Not priced

How to choose

22842Spinal fixation
Use 22842 when posterior segmental fixation covers 3–6 vertebral segments. Use 22843 when the construct includes 7–12.
22844Spinal fixation
Use 22844 for posterior segmental fixation spanning 13 or more vertebral segments; 22843 is limited to 7–12.
22840Spinal fixation
22840 describes posterior nonsegmental fixation. Choose 22843 when the construct uses segmental fixation across 7–12 vertebral segments.
22853Interbody device
22853 describes placement of an interbody biomechanical device, not the long posterior fixation construct reported with 22843.

Codes related to 22843

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

Codes related to 22843
CodeHow it relatesNational office range
Same family
22842Spinal fixationPosterior segmental fixation for a shorter span of 3–6 vertebral segments.No office rate
22844Spinal fixationPosterior segmental fixation for a longer span of 13 or more vertebral segments.No office rate
Used instead
22840Spinal fixationPosterior fixation for nonsegmental constructs rather than a 7–12 segment segmental construct.No office rate
Primary code
22612Spinal fusionPosterior lumbar fusion that may serve as the primary procedure for this instrumentation add-on.No office rate
Often billed with
22853Interbody deviceInterbody device placement may be reported separately when performed during the same fusion operation.No office rate

22843 billing questions

How is 22843 distinguished from 22842 or 22844?

Count the vertebral segments included in the posterior segmental construct. Code 22843 is for 7–12 segments; 22842 covers a shorter span, and 22844 covers a longer one.

Does 22843 require a primary procedure?

Yes. It is an add-on code and must be reported with an eligible primary procedure, such as a spinal fusion when the operative work supports both services.

Are instrumented segments the same as fusion levels?

No. Select the code from the vertebral segments included in the fixation construct, not simply the number of disc spaces fused. The operative report should make the instrumented span clear.

Can 22843 be reported with an interbody device code?

It may be reported with a separate interbody-device service, such as 22853, when that device is placed and the documentation supports both services. The fixation construct and interbody device represent different work.

Does 22843 have its own global period?

No separate global period is assigned in the CMS facts for this add-on code. Payment is within the global period of the primary procedure.

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 22843PPRRVU2026_Oct_nonQPP.csv, line 2,115 (RVU26D)

Open CMS sourceHow we calculate rates

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