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Billing code 22844: Spinal fixationMedicare rate & RVUs

Reports posterior segmental spinal fixation spanning 13 or more vertebral segments, commonly used during long constructs for deformity correction or spinal reconstruction.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.6K Medicare services in 2024

Medicare pays $875.10 for 22844 nationally in a facility.

Medicare rate · 22844

Spinal fixation

Swap in your local Medicare rate.

Work RVUs
16.01
Total RVUs
26.20
Global days
ZZZ

National rate · 2026

$875.10

Facility setting, before claim adjustments.

See every locality for 22844 → · 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 22844 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 22844 covers

Code 22844 represents a long posterior fixation construct spanning at least 13 vertebral segments. An orthopedic spine surgeon or neurosurgeon may place rods, screws, or other fixation components during surgery for conditions such as major scoliosis or complex spinal deformity. These procedures are typically performed in a hospital operating room, often alongside spinal fusion or another primary spine procedure.

Select this code based on the number of vertebral segments instrumented, not the number of implants. The operative report should establish the posterior approach, the extent of the construct, and the primary procedure performed. Medicare treats 22844 as an add-on code: report it only with a primary procedure, and its payment falls within that procedure’s global period. It is not reported as a standalone service.

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 22844 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

22844 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$782.30
Alaska*Unavailable$1,080.99
ArizonaUnavailable$846.17
ArkansasUnavailable$771.16
AtlantaUnavailable$912.25
AustinUnavailable$867.94
BakersfieldUnavailable$838.72
Baltimore/Surr. CntysUnavailable$935.18
BeaumontUnavailable$847.56
BrazoriaUnavailable$842.00

22844 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
22844 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 22844 rate is calculated

Each of 22844’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 · 22844

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 16.01Practice expense 5.32Malpractice 4.87

26.2000 adjusted RVUs×$33.4009 conversion factor=$875.10

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

Payment rules and modifiers for 22844

The CMS indicators that decide how 22844 is paid alongside other services.

CMS payment indicators · 22844

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

22844 without 80 · national facility

$875.10

Spinal fixation

22844-80 · Assistant: 16%

$140.02

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

When to use modifier 80

22844 compared with similar codes

Compare codes

22844 vs 22843 vs 22842 vs 22840 vs 22845: national Medicare rates

Swap in your local Medicare rate.

  • 22844
    Spinal fixation · 16.01 wRVU
    —
  • 22843
    Spinal fixation · 13.1 wRVU
    —
  • 22842
    Spinal fixation · 12.25 wRVU
    —
  • 22840
    Spinal fixation · 12.21 wRVU
    —
  • 22845
    Anterior fixation · 11.64 wRVU
    —

How to choose

22843Spinal fixation
Both describe posterior segmental fixation. Use 22844 for 13 or more instrumented vertebral segments; 22843 covers 7 through 12.
22842Spinal fixation
22842 applies to a posterior segmental construct spanning 3 through 6 vertebral segments; 22844 is for 13 or more.
22840Spinal fixation
22840 describes nonsegmental fixation. Use 22844 when the posterior construct is segmental and spans at least 13 vertebral segments.
22845Anterior fixation
22845 describes anterior instrumentation. Code 22844 is for a long posterior segmental construct.

Codes related to 22844

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

Codes related to 22844
CodeHow it relatesNational office range
Primary code
22612Spinal fusionPosterior lumbar arthrodesis may serve as the primary procedure for this instrumentation add-on.No office rate
Same family
22843Spinal fixationPosterior segmental fixation for a shorter construct of 7 through 12 vertebral segments.No office rate
22842Spinal fixationPosterior segmental fixation for a construct of 3 through 6 vertebral segments.No office rate
Used instead
22840Spinal fixationNonsegmental spinal fixation rather than long-segment posterior segmental instrumentation.No office rate
22845Anterior fixationAnterior instrumentation, used for a different approach and construct.No office rate

22844 billing questions

When should 22844 be chosen instead of 22843?

Choose 22844 when the posterior segmental construct spans 13 or more vertebral segments. Code 22843 applies to a shorter construct of 7 through 12 segments.

Can 22844 be reported by itself?

No. It is an add-on code and must be reported with a primary procedure; Medicare payment falls within that procedure’s global period.

Is the code based on the number of screws or rods?

No. Selection depends on the number of vertebral segments instrumented, not the number of screws, rods, or other implants.

What documentation supports reporting 22844?

The operative report should identify the posterior construct and the vertebral segments instrumented, supporting a span of 13 or more segments, as well as the accompanying primary procedure.

How does 22844 differ from 22840?

Code 22844 describes a long posterior segmental construct. Code 22840 is for a nonsegmental fixation method and is not selected by counting 13 or more instrumented segments.

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 22844PPRRVU2026_Oct_nonQPP.csv, line 2,116 (RVU26D)

Open CMS sourceHow we calculate rates

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