Use 22222 for the anterior thoracic osteotomy that includes discectomy. Use 22212 when the thoracic osteotomy is performed through a posterior or posterolateral approach.
On this page
CMS RVU26D · Effective 2026-10-01
22222 in Austin
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$1780.48
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Spine surgery
About 22222: Anterior thoracic spinal osteotomy, one segment
Reports an anterior thoracic spinal osteotomy with discectomy at one vertebral segment, typically performed to release a rigid deformity during reconstruction.
A spine surgeon uses an anterior approach to perform an osteotomy at one thoracic vertebral segment, including the discectomy associated with the release. The procedure may be part of reconstruction for a rigid thoracic deformity, such as scoliosis or kyphosis, when anterior release is needed to help mobilize the spine. It is generally performed in a hospital operating room with an anterior exposure of the thoracic spine.
Select this code when the documented work is an anterior osteotomy at a single thoracic segment. The operative report should establish the spinal region, anterior approach, segment treated, and osteotomy and discectomy performed. This major surgery has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed 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 for this spinal segment service. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 22222
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU22.51 · 42%
- Practice expense (office) RVU21.11 · 40%
- Malpractice RVU9.50 · 18%
23
Medicare services in 2024 · #5834 by national volume
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.
22222 compared with similar codes
Office rates for Austin, from the same CMS release.
The approach and one-segment osteotomy are similar, but 22224 identifies the lumbar region; 22222 identifies the thoracic region.
22222 reports the first qualifying thoracic segment. 22226 reports each additional segment and is used as an add-on.
22206 describes a thoracic three-column osteotomy. Choose 22222 for the anterior osteotomy with discectomy at one thoracic segment.
The same code, a different location
How does Austin compare?
22222 across payment areas
Same release and payment basis · bars start at $0
Austin · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Rest Of Texas
Texas · 22222
Office
Unavailable
Facility
$1707.52
No comparable office rate is available.
Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)
California · 22222
Office
Unavailable
Facility
$1827.50
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 22222
Office
Unavailable
Facility
$1976.22
No comparable office rate is available.
Miami
Florida · 22222
Office
Unavailable
Facility
$2288.33
No comparable office rate is available.
Chicago
Illinois · 22222
Office
Unavailable
Facility
$2193.96
No comparable office rate is available.
Manhattan
New York · 22222
Office
Unavailable
Facility
$2122.54
No comparable office rate is available.
Alaska*
Alaska · 22222
Office
Unavailable
Facility
$2053.54
No comparable office rate is available.
Alabama
Alabama · 22222
Office
Unavailable
Facility
$1548.41
No comparable office rate is available.
Arkansas
Arkansas · 22222
Office
Unavailable
Facility
$1520.94
No comparable office rate is available.
Arizona
Arizona · 22222
Office
Unavailable
Facility
$1706.71
No comparable office rate is available.
Bakersfield
California · 22222
Office
Unavailable
Facility
$1732.16
No comparable office rate is available.
Chico
California · 22222
Office
Unavailable
Facility
$1707.50
No comparable office rate is available.
El Centro
California · 22222
Office
Unavailable
Facility
$1709.08
No comparable office rate is available.
Fresno
California · 22222
Office
Unavailable
Facility
$1707.50
No comparable office rate is available.
Hanford-Corcoran
California · 22222
Office
Unavailable
Facility
$1707.50
No comparable office rate is available.
Madera
California · 22222
Office
Unavailable
Facility
$1707.50
No comparable office rate is available.
Merced
California · 22222
Office
Unavailable
Facility
$1707.50
No comparable office rate is available.
Modesto
California · 22222
Office
Unavailable
Facility
$1707.50
No comparable office rate is available.
Napa
California · 22222
Office
Unavailable
Facility
$1889.73
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 22222
Office
Unavailable
Facility
$1804.01
No comparable office rate is available.
Redding
California · 22222
Office
Unavailable
Facility
$1707.50
No comparable office rate is available.
Rest Of California
California · 22222
Office
Unavailable
Facility
$1707.50
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 22222
Office
Unavailable
Facility
$1808.83
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 22222
Office
Unavailable
Facility
$1769.02
No comparable office rate is available.
Salinas
California · 22222
Office
Unavailable
Facility
$1762.44
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 22222
Office
Unavailable
Facility
$1789.68
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 22222
Office
Unavailable
Facility
$1963.11
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 22222
Office
Unavailable
Facility
$1952.32
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 22222
Office
Unavailable
Facility
$2021.38
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 22222
Office
Unavailable
Facility
$1977.27
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 22222
Office
Unavailable
Facility
$1737.81
No comparable office rate is available.
Santa Cruz-Watsonville
California · 22222
Office
Unavailable
Facility
$1794.41
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 22222
Office
Unavailable
Facility
$1765.12
No comparable office rate is available.
Santa Rosa-Petaluma
California · 22222
Office
Unavailable
Facility
$1810.34
No comparable office rate is available.
Stockton
California · 22222
Office
Unavailable
Facility
$1707.50
No comparable office rate is available.
Vallejo
California · 22222
Office
Unavailable
Facility
$1874.18
No comparable office rate is available.
Visalia
California · 22222
Office
Unavailable
Facility
$1707.50
No comparable office rate is available.
Yuba City
California · 22222
Office
Unavailable
Facility
$1707.50
No comparable office rate is available.
Colorado
Colorado · 22222
Office
Unavailable
Facility
$1758.91
No comparable office rate is available.
Connecticut
Connecticut · 22222
Office
Unavailable
Facility
$1910.22
No comparable office rate is available.
Delaware
Delaware · 22222
Office
Unavailable
Facility
$1737.51
No comparable office rate is available.
Fort Lauderdale
Florida · 22222
Office
Unavailable
Facility
$2039.81
No comparable office rate is available.
Rest Of Florida
Florida · 22222
Office
Unavailable
Facility
$1902.84
No comparable office rate is available.
Atlanta
Georgia · 22222
Office
Unavailable
Facility
$1851.57
No comparable office rate is available.
Rest Of Georgia
Georgia · 22222
Office
Unavailable
Facility
$1759.03
No comparable office rate is available.
Hawaii, Guam
Hawaii · 22222
Office
Unavailable
Facility
$1737.27
No comparable office rate is available.
Iowa
Iowa · 22222
Office
Unavailable
Facility
$1522.99
No comparable office rate is available.
Idaho
Idaho · 22222
Office
Unavailable
Facility
$1550.63
No comparable office rate is available.
East St. Louis
Illinois · 22222
Office
Unavailable
Facility
$2039.60
No comparable office rate is available.
Rest Of Illinois
Illinois · 22222
Office
Unavailable
Facility
$1891.56
No comparable office rate is available.
Suburban Chicago
Illinois · 22222
Office
Unavailable
Facility
$2043.52
No comparable office rate is available.
Indiana
Indiana · 22222
Office
Unavailable
Facility
$1559.69
No comparable office rate is available.
Kansas
Kansas · 22222
Office
Unavailable
Facility
$1549.18
No comparable office rate is available.
Kentucky
Kentucky · 22222
Office
Unavailable
Facility
$1669.02
No comparable office rate is available.
New Orleans
Louisiana · 22222
Office
Unavailable
Facility
$1775.81
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 22222
Office
Unavailable
Facility
$1679.84
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 22222
Office
Unavailable
Facility
$1906.97
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 22222
Office
Unavailable
Facility
$1759.24
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 22222
Office
Unavailable
Facility
$1912.96
No comparable office rate is available.
Rest Of Maryland
Maryland · 22222
Office
Unavailable
Facility
$1764.22
No comparable office rate is available.
Rest Of Maine
Maine · 22222
Office
Unavailable
Facility
$1597.91
No comparable office rate is available.
Southern Maine
Maine · 22222
Office
Unavailable
Facility
$1650.82
No comparable office rate is available.
Detroit
Michigan · 22222
Office
Unavailable
Facility
$1967.25
No comparable office rate is available.
Rest Of Michigan
Michigan · 22222
Office
Unavailable
Facility
$1753.85
No comparable office rate is available.
Minnesota
Minnesota · 22222
Office
Unavailable
Facility
$1571.32
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 22222
Office
Unavailable
Facility
$1723.95
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 22222
Office
Unavailable
Facility
$1741.05
No comparable office rate is available.
Rest Of Missouri
Missouri · 22222
Office
Unavailable
Facility
$1668.70
No comparable office rate is available.
Mississippi
Mississippi · 22222
Office
Unavailable
Facility
$1593.43
No comparable office rate is available.
Montana**
Montana · 22222
Office
Unavailable
Facility
$1773.62
No comparable office rate is available.
North Carolina
North Carolina · 22222
Office
Unavailable
Facility
$1612.47
No comparable office rate is available.
North Dakota**
North Dakota · 22222
Office
Unavailable
Facility
$1585.77
No comparable office rate is available.
Nebraska
Nebraska · 22222
Office
Unavailable
Facility
$1522.60
No comparable office rate is available.
New Hampshire
New Hampshire · 22222
Office
Unavailable
Facility
$1763.50
No comparable office rate is available.
Northern Nj
New Jersey · 22222
Office
Unavailable
Facility
$1956.01
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 22222
Office
Unavailable
Facility
$1899.98
No comparable office rate is available.
New Mexico
New Mexico · 22222
Office
Unavailable
Facility
$1779.51
No comparable office rate is available.
Nevada**
Nevada · 22222
Office
Unavailable
Facility
$1721.97
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 22222
Office
Unavailable
Facility
$2227.57
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 22222
Office
Unavailable
Facility
$1941.71
No comparable office rate is available.
Queens
New York · 22222
Office
Unavailable
Facility
$2090.95
No comparable office rate is available.
Rest Of New York
New York · 22222
Office
Unavailable
Facility
$1644.76
No comparable office rate is available.
Ohio
Ohio · 22222
Office
Unavailable
Facility
$1715.45
No comparable office rate is available.
Oklahoma
Oklahoma · 22222
Office
Unavailable
Facility
$1628.05
No comparable office rate is available.
Portland
Oregon · 22222
Office
Unavailable
Facility
$1783.32
No comparable office rate is available.
Rest Of Oregon
Oregon · 22222
Office
Unavailable
Facility
$1677.19
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 22222
Office
Unavailable
Facility
$1877.94
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 22222
Office
Unavailable
Facility
$1698.99
No comparable office rate is available.
Puerto Rico
Puerto Rico · 22222
Office
Unavailable
Facility
$1777.25
No comparable office rate is available.
Rhode Island
Rhode Island · 22222
Office
Unavailable
Facility
$1777.54
No comparable office rate is available.
South Carolina
South Carolina · 22222
Office
Unavailable
Facility
$1673.07
No comparable office rate is available.
South Dakota**
South Dakota · 22222
Office
Unavailable
Facility
$1563.56
No comparable office rate is available.
Tennessee
Tennessee · 22222
Office
Unavailable
Facility
$1563.18
No comparable office rate is available.
Utah
Utah · 22222
Office
Unavailable
Facility
$1699.58
No comparable office rate is available.
Virginia
Virginia · 22222
Office
Unavailable
Facility
$1668.98
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 22222
Office
Unavailable
Facility
$1777.25
No comparable office rate is available.
Vermont
Vermont · 22222
Office
Unavailable
Facility
$1610.45
No comparable office rate is available.
Rest Of Washington
Washington · 22222
Office
Unavailable
Facility
$1745.56
No comparable office rate is available.
Seattle (King Cnty)
Washington · 22222
Office
Unavailable
Facility
$1913.84
No comparable office rate is available.
Wisconsin
Wisconsin · 22222
Office
Unavailable
Facility
$1525.06
No comparable office rate is available.
West Virginia
West Virginia · 22222
Office
Unavailable
Facility
$1818.65
No comparable office rate is available.
Wyoming**
Wyoming · 22222
Office
Unavailable
Facility
$1691.76
No comparable office rate is available.
See how rates vary across the country
22222 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
Austin is a Medicare payment area. Our Census mapping connects it to 31 cities and communities in Texas, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
- 22222 in Austin
Multiple payment areas
- 22222 in Barton Creek
- 22222 in Bee Cave
- 22222 in Briarcliff
- 22222 in Cedar Park
Multiple payment areas
- 22222 in Creedmoor
Multiple payment areas
- 22222 in Elgin
Multiple payment areas
- 22222 in Garfield
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 22222 in Austin. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$1958.53
$1780.48 × 110% = $1958.53
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 22222 in Austin.
PPRRVU2026_Oct_nonQPP.csv
2,059
- Code
- 22222
- Physician work
- 22.51
- Practice expense
- 21.11
- Malpractice
- 9.50
GPCI2026.csv
96
- Locality
- Austin
- Physician work
- 1.002
- Practice expense
- 1.058
- Malpractice
- 0.886
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 22.51 | × 1.002 | 22.5550 |
| Practice expense | 21.11 | × 1.058 | 22.3344 |
| Malpractice | 9.50 | × 0.886 | 8.4170 |
| Total RVUs | 53.3064 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Austin$1780.48
Open 22222 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 22.51 | 1.002 |
| Practice expense | 21.11 | 1.058 |
| Malpractice | 9.5 | 0.886 |
(22.51 × 1.002 + 21.11 × 1.058 + 9.5 × 0.886) × $33.4009 = $1780.48
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
22222 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $1780.48 | RVU26D |
| 2026-07-01 | Not available in this setting | $1780.48 | RVU26C |
| 2026-04-01 | Not available in this setting | $1780.48 | RVU26B |
| 2026-01-01 | Not available in this setting | $1780.48 | RVU26A |
| 2025-10-01 | Not available in this setting | $1755.57 | RVU25D |
| 2025-07-01 | Not available in this setting | $1755.57 | RVU25C |
| 2025-04-01 | Not available in this setting | $1755.57 | RVU25B |
| 2025-01-01 | Not available in this setting | $1755.57 | RVU25A |
22222 billing questions
How does this differ from 22212?
22222 describes an anterior thoracic osteotomy that includes discectomy. 22212 is a thoracic osteotomy performed through a posterior or posterolateral approach.
Can the discectomy be billed separately?
The discectomy associated with this anterior osteotomy is included in the service. The operative report should document it as part of the osteotomy rather than treating it as a separate service.
When should 22226 be reported with 22222?
22226 is the add-on code for each additional vertebral segment treated with the qualifying anterior osteotomy. Report 22222 for the first thoracic segment and document the additional segment work.
Should modifier 50 be appended for bilateral thoracic work?
No. Modifier 50 is inappropriate because this code identifies a spinal segment, not paired anatomy.
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 co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and the service cannot be billed as team surgery.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
