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Billing code 22850: Spinal hardware removalMedicare rate & RVUs

Reports operative removal of posterior nonsegmental spinal fixation, such as a Harrington rod, when the surgeon removes the construct from the spine.

CMS RVU26DEffective Oct 1, 2026109 payment localities2.8K Medicare services in 2024

Medicare pays $716.78 for 22850 nationally in a facility.

Medicare rate · 22850

Spinal hardware removal

Swap in your local Medicare rate.

Work RVUs
9.57
Total RVUs
21.46
Global days
090

National rate · 2026

$716.78

Facility setting, before claim adjustments.

See every locality for 22850 → · 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 22850 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 22850 covers

A spine surgeon reports this service for operative removal of posterior nonsegmental fixation hardware, classically an older rod construct such as a Harrington rod. Removal may be part of a revision for painful or prominent hardware, infection, or another documented clinical reason. The service is typically performed in an operating room; the surgeon’s report should identify the posterior approach, the hardware removed, and the work performed to extract it.

Choose this code for nonsegmental posterior instrumentation, not segmental posterior hardware or anterior instrumentation. Document the construct and the reason for removal, along with any separately performed revision work. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

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 22850 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

22850 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$636.08
Alaska*Unavailable$850.74
ArizonaUnavailable$693.11
ArkansasUnavailable$626.20
AtlantaUnavailable$742.70
AustinUnavailable$723.16
BakersfieldUnavailable$712.02
Baltimore/Surr. CntysUnavailable$767.38
BeaumontUnavailable$682.95
BrazoriaUnavailable$694.55

22850 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
22850 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 22850 rate is calculated

Each of 22850’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 · 22850

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 9.57Practice expense 8.88Malpractice 3.01

21.4600 adjusted RVUs×$33.4009 conversion factor=$716.78

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

Payment rules and modifiers for 22850

22850 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 22850

Spinal hardware removal

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 · 22850

Spinal hardware removal

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

22850 without 51 · national facility

$716.78

Spinal hardware removal

22850-51 · Second procedure: 50%

$358.39

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

22850 compared with similar codes

Compare codes

22850 vs 22852 vs 22855 vs 22849: national Medicare rates

Swap in your local Medicare rate.

  • 22850
    Spinal hardware removal · 9.57 wRVU
    —
  • 22852
    Spinal hardware removal · 9.14 wRVU
    —
  • 22855
    Hardware removal · 15.46 wRVU
    —
  • 22849
    Spinal fixation · 18.69 wRVU
    —

How to choose

22852Spinal hardware removal
Choose 22850 for posterior nonsegmental instrumentation and 22852 for posterior segmental instrumentation. The operative report should make the construct type clear.
22855Hardware removal
22855 addresses removal of anterior instrumentation; 22850 is for posterior nonsegmental instrumentation.
22849Spinal fixation
22849 describes reinsertion of spinal fixation in a revision. It does not describe removal alone as 22850 does.

Codes related to 22850

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

Codes related to 22850
CodeHow it relatesNational office range
Same family
22852Spinal hardware removalRemoval of posterior segmental instrumentation rather than a nonsegmental construct.No office rate
Used instead
22855Hardware removalRemoval code for anterior instrumentation instead of posterior nonsegmental hardware.No office rate
Often billed with
22849Spinal fixationMay be reported in a revision that includes removal and reinsertion of spinal fixation.No office rate

22850 billing questions

How do I distinguish this from 22852?

This code is for removal of posterior nonsegmental instrumentation. Use 22852 for removal of posterior segmental instrumentation; document the type of construct removed.

Is anterior hardware removal reported with this code?

No. This code describes posterior nonsegmental hardware removal. Anterior instrumentation removal is represented by 22855.

What documentation supports reporting the removal?

The operative report should identify the posterior nonsegmental construct, the reason for removal, and the removal work performed. Include any revision or replacement work separately in the operative description.

How does the 90-day global period affect postoperative care?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period for this major surgery.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted for this code.

What happens when another procedure is performed in the same session?

Medicare pays the highest-valued procedure in full and applies the standard multiple-procedure reduction to the other procedures in that session.

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 22850PPRRVU2026_Oct_nonQPP.csv, line 2,122 (RVU26D)

Open CMS sourceHow we calculate rates

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