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CPT 22847: Spinal fixationMedicare rate & RVUs

Reports anterior spinal fixation spanning seven to twelve vertebral segments, typically added to a long-segment fusion or other eligible primary spine procedure.

CMS RVU26DEffective Oct 1, 2026109 payment localities30 Medicare services in 2024

Medicare pays $687.39 for 22847 nationally in a facility.

Medicare rate · 22847

Spinal fixation

Swap in your local Medicare rate.

Work RVUs
13.44
Total RVUs
20.58
Global days
ZZZ

National rate · 2026

$687.39

Facility setting, before claim adjustments.

See every locality for 22847 →

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 22847 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 22847 covers

This code represents placement of anterior fixation across seven to twelve vertebral segments. A spine surgeon may use a plate-and-screw construct or other anterior fixation to stabilize a long spinal reconstruction, often during multilevel fusion. The surgeon approaches the spine from the front, such as through the neck for cervical surgery or through the chest or abdomen for thoracic or lumbar surgery. The segment count is based on the vertebral levels instrumented, not the number of screws or implants used.

Report this code as an add-on with an eligible primary procedure; it is not billed by itself. The operative report should identify the anterior approach, the instrumented vertebral segments, and the fixation placed. Select this level when the construct spans seven through twelve vertebral segments, rather than the shorter ranges represented by 22845 or 22846. CMS treats payment as part of the primary procedure’s global period, so the add-on is paid within that 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 22847 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

22847 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$628.06
Alaska*Unavailable$878.25
ArizonaUnavailable$669.20
ArkansasUnavailable$620.90
AtlantaUnavailable$710.23
AustinUnavailable$685.69
BakersfieldUnavailable$672.29
Baltimore/Surr. CntysUnavailable$727.65
BeaumontUnavailable$667.74
BrazoriaUnavailable$668.68

22847 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
22847 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 22847 rate is calculated

Each of 22847’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 · 22847

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 13.44Practice expense 4.28Malpractice 2.86

20.5800 adjusted RVUs×$33.4009 conversion factor=$687.39

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

Payment rules and modifiers for 22847

The CMS indicators that decide how 22847 is paid alongside other services.

CMS payment indicators · 22847

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

22847 without 80 · national facility

$687.39

Spinal fixation

22847-80 · Assistant: 16%

$109.98

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

When to use modifier 80

22847 compared with similar codes

Compare codes

22847 vs 22846 vs 22845 vs 22843 vs 22853: national Medicare rates

Swap in your local Medicare rate.

  • 22847
    Spinal fixation · 13.44 wRVU
    —
  • 22846
    Spinal fixation · 12.09 wRVU
    —
  • 22845
    Anterior fixation · 11.64 wRVU
    —
  • 22843
    Spinal fixation · 13.1 wRVU
    —
  • 22853
    Interbody device · 4.14 wRVU
    —

How to choose

22846Spinal fixation
Use 22846 when anterior fixation spans four to six vertebral segments. Use 22847 for seven to twelve.
22845Anterior fixation
22845 is for anterior fixation across two to three vertebral segments; 22847 is for the longer seven-to-twelve-segment construct.
22843Spinal fixation
Both codes represent segmental fixation over seven to twelve vertebral segments, but 22843 is for a posterior construct and 22847 for an anterior construct.
22853Interbody device
22853 concerns an interbody biomechanical device, such as a cage placed in a disc space. 22847 represents anterior fixation spanning multiple vertebral segments.

Codes related to 22847

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

Codes related to 22847
CodeHow it relatesNational office range
Same family
22845Anterior fixationAnterior fixation for the shorter two-to-three-segment range.No office rate
22846Spinal fixationAnterior fixation for four to six vertebral segments.No office rate
Used instead
22843Spinal fixationPosterior segmental fixation for seven to twelve vertebral segments.No office rate
Primary code
22551ACDFAnterior cervical fusion procedure that may serve as the primary procedure.No office rate
22558Anterior fusionAnterior lumbar fusion procedure that may serve as the primary procedure.No office rate
22556Thoracic fusionAnterior thoracic fusion procedure that may serve as the primary procedure.No office rate

22847 billing questions

How is this code distinguished from 22846?

Count the vertebral segments instrumented. This code is for seven to twelve segments; 22846 covers the shorter four-to-six-segment range.

Can this code be reported by itself?

No. It is an add-on code and must be reported with an eligible primary procedure.

Does the number of screws determine the code level?

No. The level is selected by the number of vertebral segments instrumented, not by the number of screws or other fixation pieces.

What documentation supports reporting this code?

The operative report should establish the anterior approach, identify the vertebral segments spanned, and describe the fixation construct placed.

How does this differ from 22843?

22847 represents anterior fixation across seven to twelve segments. 22843 represents posterior segmental fixation across that segment range.

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 22847PPRRVU2026_Oct_nonQPP.csv, line 2,119 (RVU26D)

Open CMS sourceHow we calculate rates

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