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Billing code 22869: Spinal stabilizationMedicare rate & RVUs

Reports placement of a lumbar interspinous stabilization device at one level when the surgeon does not perform open decompression or discectomy.

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

Medicare pays $395.13 for 22869 nationally in a facility.

Medicare rate · 22869

Spinal stabilization

Work RVUs
6.85
Total RVUs
11.83
Global days
090

National rate · 2026

$395.13

Facility setting, before claim adjustments.

See every locality for 22869 →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 22869 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 22869 covers

billing code 22869 covers placement of a device between lumbar spinous processes to stabilize or distract one spinal level, without open decompression or discectomy. A spine surgeon typically performs the procedure in an operating room for a patient whose lumbar condition is treated with this interspinous implant approach. The operative report should identify the lumbar level, the implanted device, and whether decompression or discectomy was performed.

Report one unit for the single treated level. For an additional level treated with the same no-decompression approach, 22870 is the add-on code. This is major surgery with 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% reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeons and team surgery are 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 22869 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

22869 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$367.53
Alaska*Unavailable$509.01
ArizonaUnavailable$387.49
ArkansasUnavailable$364.10
AtlantaUnavailable$402.56
AustinUnavailable$401.45
BakersfieldUnavailable$404.71
Baltimore/Surr. CntysUnavailable$414.55
BeaumontUnavailable$380.58
BrazoriaUnavailable$390.81

22869 rates by state

Office rate range in each state. Select a state to see its payment localities.

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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
22869 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 22869 rate is calculated

Each of 22869’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 · 22869

RVUs × geographic indexes × conversion factor

Work6.85

6.85 RVUs× 1.000 GPCI

Practice expense4.32

4.32 RVUs× 1.000 GPCI

Malpractice0.66

0.66 RVUs× 1.000 GPCI

Adjusted RVUs

11.8300

Conversion factor

$33.4009

Medicare rate

$395.13

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

Payment rules and modifiers for 22869

22869 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 22869

Spinal stabilization

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)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.80/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 22869

Spinal stabilization

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned 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

22869 without 51 · national facility

$395.13

Spinal stabilization

22869-51 · Second procedure: 50%

$197.57

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

22869 compared with similar codes

Compare codes · National

4 codes, side by side

  • 22869

    Spinal stabilization6.85 wRVU

    Not priced

  • 22867

    Spinal stabilization14.63 wRVU

    Not priced

  • 22870

    Spinal stabilization2.28 wRVU

    Not priced

  • 22853

    Interbody device4.14 wRVU

    Not priced

How to choose

22867Spinal stabilization
Both describe lumbar interspinous stabilization, but 22867 includes open decompression; 22869 is for the procedure without it.
22870Spinal stabilization
22870 reports each additional lumbar level after the first level treated without open decompression or discectomy; 22869 is the single-level code.
22853Interbody device
22853 concerns a biomechanical device placed in an intervertebral space, typically in a fusion procedure. 22869 describes a stabilizing device placed between lumbar spinous processes.

Codes related to 22869

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

Codes related to 22869
CodeHow it relatesNational office range
Add-on codes
22870Spinal stabilizationAdd-on code for each additional lumbar level treated with the same no-decompression approach.No office rate
Used instead
22867Spinal stabilizationUse for the lumbar interspinous device procedure when open decompression is also performed.No office rate
22868Lumbar stabilizationAdditional-level code for the related procedure that includes open decompression.No office rate

22869 billing questions

How does 22869 differ from 22867?

22869 describes lumbar interspinous stabilization without open decompression or discectomy. Use 22867 when the procedure includes open decompression.

How should an additional treated level be reported?

Report 22870 for each additional lumbar level treated with the no-decompression approach. The operative report should support the levels treated.

Can modifier 50 be used when both sides are treated?

No. The code's anatomy and descriptor make a bilateral adjustment inappropriate.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or another surgeon be reported?

An assistant at surgery may be paid. Co-surgeons and team surgery are not permitted for this code.

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

The highest-valued procedure is paid in full; other procedures are subject to the standard multiple-procedure reduction.

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 22869PPRRVU2026_Oct_nonQPP.csv, line 2,138 (RVU26D)

Open CMS sourceHow we calculate rates

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