FeeBase
Log inGet started
Menu

Billing code 22845: Anterior fixationMedicare rate & RVUs

Reports anterior spinal fixation spanning two or three vertebral segments during a qualifying spine operation, such as fusion with an anterior plate.

CMS RVU26DEffective Oct 1, 2026109 payment localities42.5K Medicare services in 2024

Medicare pays $647.64 for 22845 nationally in a facility.

Medicare rate · 22845

Anterior fixation

Swap in your local Medicare rate.

Work RVUs
11.64
Total RVUs
19.39
Global days
ZZZ

National rate · 2026

$647.64

Facility setting, before claim adjustments.

See every locality for 22845 → · 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 22845 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 22845 covers

22845 reports placement of anterior spinal fixation across two or three vertebral segments as part of a spine operation. A common example is an anterior cervical plate secured with screws across the operative vertebrae during cervical fusion; anterior fixation may also be used with thoracic or lumbar procedures. The work is typically performed by an orthopedic spine surgeon or neurosurgeon in an operating room. This code represents supplemental stabilization, not an interbody cage or the fusion itself.

Select the code based on the vertebral segments actually instrumented, not simply the number of disc spaces treated. The operative report should identify the anterior approach, device placement, segments spanned, and associated primary procedure. 22845 is an add-on code: report it only with an eligible primary procedure, and Medicare payment is handled within that procedure’s global period. It is not a standalone service. For fixation spanning more segments, use the applicable higher segment-count code when supported by the operative details.

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 22845 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

22845 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$575.55
Alaska*Unavailable$792.77
ArizonaUnavailable$625.09
ArkansasUnavailable$566.91
AtlantaUnavailable$676.74
AustinUnavailable$641.32
BakersfieldUnavailable$617.26
Baltimore/Surr. CntysUnavailable$693.85
BeaumontUnavailable$626.79
BrazoriaUnavailable$621.29

22845 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
22845 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 22845 rate is calculated

Each of 22845’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 · 22845

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 11.64Practice expense 3.90Malpractice 3.85

19.3900 adjusted RVUs×$33.4009 conversion factor=$647.64

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

Payment rules and modifiers for 22845

The CMS indicators that decide how 22845 is paid alongside other services.

CMS payment indicators · 22845

Anterior 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

22845 without 80 · national facility

$647.64

Anterior fixation

22845-80 · Assistant: 16%

$103.62

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

When to use modifier 80

22845 compared with similar codes

Compare codes

22845 vs 22846 vs 22847 vs 22842 vs 22853: national Medicare rates

Swap in your local Medicare rate.

  • 22845
    Anterior fixation · 11.64 wRVU
    —
  • 22846
    Spinal fixation · 12.09 wRVU
    —
  • 22847
    Spinal fixation · 13.44 wRVU
    —
  • 22842
    Spinal fixation · 12.25 wRVU
    —
  • 22853
    Interbody device · 4.14 wRVU
    —

How to choose

22846Spinal fixation
Both describe anterior fixation, but 22846 is selected for four to seven vertebral segments rather than two or three.
22847Spinal fixation
22847 describes anterior fixation spanning eight or more vertebral segments; 22845 is limited to two or three.
22842Spinal fixation
22842 describes posterior segmental fixation. Choose based on the documented approach and construct, not simply because the same fusion was performed.
22853Interbody device
22853 describes an interbody biomechanical device placed in a disc space; 22845 describes anterior spinal fixation across vertebral segments.

Codes related to 22845

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

Codes related to 22845
CodeHow it relatesNational office range
Same family
22846Spinal fixationAnterior fixation spanning four to seven vertebral segments.No office rate
22847Spinal fixationAnterior fixation spanning eight or more vertebral segments.No office rate
Often billed with
22551ACDFAnterior cervical fusion may be performed with anterior fixation reported separately.No office rate
22853Interbody deviceDescribes an interbody device, a distinct service that may accompany fusion and fixation.No office rate
Used instead
22842Spinal fixationPosterior segmental fixation for a different approach and segment-count range.No office rate

22845 billing questions

How is 22845 distinguished from 22846?

22845 is for anterior fixation spanning two or three vertebral segments. 22846 applies when the anterior fixation spans four to seven segments.

Can 22845 be billed by itself?

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

What documentation supports the segment count?

The operative report should describe the anterior fixation device and identify the vertebral segments it spans. Count the instrumented segments rather than assuming the count from the number of treated disc spaces.

Is an interbody cage reported with 22845?

The codes describe different work: 22845 represents anterior fixation, while 22853 describes placement of an interbody biomechanical device. They may be reported for distinct work in the same fusion operation when documented.

Does 22845 describe the fusion itself?

No. It describes supplemental anterior stabilization. Report the applicable primary fusion or other procedure separately.

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 22845PPRRVU2026_Oct_nonQPP.csv, line 2,117 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 22845 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 22845 and the rest of your codes on one sheet

Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.

Build my fee sheetOr price your code list free →