$33.26
Use 98925 for osteopathic manipulative treatment involving one or two regions. Code 22505 describes spinal manipulation performed with anesthesia.
On this page
CMS RVU26D · Effective 2026-10-01
22505 in Austin
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$154.67
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.
Spinal procedures
About 22505: Spinal manipulation under anesthesia
Reports spinal manipulation performed with anesthesia, for a documented condition affecting any spinal region, in settings such as a hospital outpatient department or ASC.
Code 22505 represents a clinician’s manipulation of the spine while the patient is under anesthesia. The code can apply to manipulation involving the cervical, thoracic, or lumbar region; selection is not based on a region-specific code level. It is distinct from routine hands-on spinal treatment performed while the patient is awake. The service is commonly furnished in a facility setting, such as a hospital outpatient department or ambulatory surgical center.
Report the service when the record supports the spinal condition, the region treated, the manipulation performed, and the use of anesthesia. Related postoperative visits during the 10-day global period are included. 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% multiple-procedure reduction. Do not use modifier 50 for bilateral reporting. Medicare does not pay an assistant at surgery for this code, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 22505
- Global period
- Minor procedure with a 10-day global period: related postoperative visits for 10 days 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.82 · 40%
- Practice expense (office) RVU2.00 · 43%
- Malpractice RVU0.78 · 17%
86
Medicare services in 2024 · #4989 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.
22505 compared with similar codes
Office rates for Austin, from the same CMS release.
$87.76
Use 98929 for osteopathic manipulative treatment involving five regions. The count of regions distinguishes it from 22505, which is selected for manipulation under anesthesia.
$28.47
Use 97140 for timed manual therapy techniques. It does not describe spinal manipulation performed with anesthesia.
The same code, a different location
How does Austin compare?
22505 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 · 22505
Office
Unavailable
Facility
$147.71
No comparable office rate is available.
Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)
California · 22505
Office
Unavailable
Facility
$159.61
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 22505
Office
Unavailable
Facility
$171.76
No comparable office rate is available.
Miami
Florida · 22505
Office
Unavailable
Facility
$196.22
No comparable office rate is available.
Chicago
Illinois · 22505
Office
Unavailable
Facility
$188.14
No comparable office rate is available.
Manhattan
New York · 22505
Office
Unavailable
Facility
$183.62
No comparable office rate is available.
Alaska*
Alaska · 22505
Office
Unavailable
Facility
$176.68
No comparable office rate is available.
Alabama
Alabama · 22505
Office
Unavailable
Facility
$133.99
No comparable office rate is available.
Arkansas
Arkansas · 22505
Office
Unavailable
Facility
$131.59
No comparable office rate is available.
Arizona
Arizona · 22505
Office
Unavailable
Facility
$147.82
No comparable office rate is available.
Bakersfield
California · 22505
Office
Unavailable
Facility
$151.03
No comparable office rate is available.
Chico
California · 22505
Office
Unavailable
Facility
$149.00
No comparable office rate is available.
El Centro
California · 22505
Office
Unavailable
Facility
$149.13
No comparable office rate is available.
Fresno
California · 22505
Office
Unavailable
Facility
$149.00
No comparable office rate is available.
Hanford-Corcoran
California · 22505
Office
Unavailable
Facility
$149.00
No comparable office rate is available.
Madera
California · 22505
Office
Unavailable
Facility
$149.00
No comparable office rate is available.
Merced
California · 22505
Office
Unavailable
Facility
$149.00
No comparable office rate is available.
Modesto
California · 22505
Office
Unavailable
Facility
$149.00
No comparable office rate is available.
Napa
California · 22505
Office
Unavailable
Facility
$165.90
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 22505
Office
Unavailable
Facility
$157.68
No comparable office rate is available.
Redding
California · 22505
Office
Unavailable
Facility
$149.00
No comparable office rate is available.
Rest Of California
California · 22505
Office
Unavailable
Facility
$149.00
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 22505
Office
Unavailable
Facility
$157.32
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 22505
Office
Unavailable
Facility
$154.63
No comparable office rate is available.
Salinas
California · 22505
Office
Unavailable
Facility
$154.06
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 22505
Office
Unavailable
Facility
$156.63
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 22505
Office
Unavailable
Facility
$172.71
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 22505
Office
Unavailable
Facility
$171.83
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 22505
Office
Unavailable
Facility
$177.77
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 22505
Office
Unavailable
Facility
$174.15
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 22505
Office
Unavailable
Facility
$151.87
No comparable office rate is available.
Santa Cruz-Watsonville
California · 22505
Office
Unavailable
Facility
$157.19
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 22505
Office
Unavailable
Facility
$154.35
No comparable office rate is available.
Santa Rosa-Petaluma
California · 22505
Office
Unavailable
Facility
$158.61
No comparable office rate is available.
Stockton
California · 22505
Office
Unavailable
Facility
$149.00
No comparable office rate is available.
Vallejo
California · 22505
Office
Unavailable
Facility
$164.62
No comparable office rate is available.
Visalia
California · 22505
Office
Unavailable
Facility
$149.00
No comparable office rate is available.
Yuba City
California · 22505
Office
Unavailable
Facility
$149.00
No comparable office rate is available.
Colorado
Colorado · 22505
Office
Unavailable
Facility
$152.94
No comparable office rate is available.
Connecticut
Connecticut · 22505
Office
Unavailable
Facility
$165.47
No comparable office rate is available.
Delaware
Delaware · 22505
Office
Unavailable
Facility
$150.52
No comparable office rate is available.
Fort Lauderdale
Florida · 22505
Office
Unavailable
Facility
$175.56
No comparable office rate is available.
Rest Of Florida
Florida · 22505
Office
Unavailable
Facility
$163.81
No comparable office rate is available.
Atlanta
Georgia · 22505
Office
Unavailable
Facility
$160.13
No comparable office rate is available.
Rest Of Georgia
Georgia · 22505
Office
Unavailable
Facility
$151.43
No comparable office rate is available.
Hawaii, Guam
Hawaii · 22505
Office
Unavailable
Facility
$151.83
No comparable office rate is available.
Iowa
Iowa · 22505
Office
Unavailable
Facility
$132.26
No comparable office rate is available.
Idaho
Idaho · 22505
Office
Unavailable
Facility
$134.57
No comparable office rate is available.
East St. Louis
Illinois · 22505
Office
Unavailable
Facility
$174.72
No comparable office rate is available.
Rest Of Illinois
Illinois · 22505
Office
Unavailable
Facility
$162.50
No comparable office rate is available.
Suburban Chicago
Illinois · 22505
Office
Unavailable
Facility
$175.99
No comparable office rate is available.
Indiana
Indiana · 22505
Office
Unavailable
Facility
$135.38
No comparable office rate is available.
Kansas
Kansas · 22505
Office
Unavailable
Facility
$134.31
No comparable office rate is available.
Kentucky
Kentucky · 22505
Office
Unavailable
Facility
$144.01
No comparable office rate is available.
New Orleans
Louisiana · 22505
Office
Unavailable
Facility
$153.25
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 22505
Office
Unavailable
Facility
$144.87
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 22505
Office
Unavailable
Facility
$166.23
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 22505
Office
Unavailable
Facility
$152.87
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 22505
Office
Unavailable
Facility
$165.67
No comparable office rate is available.
Rest Of Maryland
Maryland · 22505
Office
Unavailable
Facility
$152.92
No comparable office rate is available.
Rest Of Maine
Maine · 22505
Office
Unavailable
Facility
$138.45
No comparable office rate is available.
Southern Maine
Maine · 22505
Office
Unavailable
Facility
$143.43
No comparable office rate is available.
Detroit
Michigan · 22505
Office
Unavailable
Facility
$169.18
No comparable office rate is available.
Rest Of Michigan
Michigan · 22505
Office
Unavailable
Facility
$151.19
No comparable office rate is available.
Minnesota
Minnesota · 22505
Office
Unavailable
Facility
$137.24
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 22505
Office
Unavailable
Facility
$148.97
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 22505
Office
Unavailable
Facility
$150.49
No comparable office rate is available.
Rest Of Missouri
Missouri · 22505
Office
Unavailable
Facility
$143.75
No comparable office rate is available.
Mississippi
Mississippi · 22505
Office
Unavailable
Facility
$137.56
No comparable office rate is available.
Montana**
Montana · 22505
Office
Unavailable
Facility
$153.59
No comparable office rate is available.
North Carolina
North Carolina · 22505
Office
Unavailable
Facility
$139.76
No comparable office rate is available.
North Dakota**
North Dakota · 22505
Office
Unavailable
Facility
$138.17
No comparable office rate is available.
Nebraska
Nebraska · 22505
Office
Unavailable
Facility
$132.30
No comparable office rate is available.
New Hampshire
New Hampshire · 22505
Office
Unavailable
Facility
$153.13
No comparable office rate is available.
Northern Nj
New Jersey · 22505
Office
Unavailable
Facility
$169.93
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 22505
Office
Unavailable
Facility
$164.75
No comparable office rate is available.
New Mexico
New Mexico · 22505
Office
Unavailable
Facility
$153.34
No comparable office rate is available.
Nevada**
Nevada · 22505
Office
Unavailable
Facility
$149.36
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 22505
Office
Unavailable
Facility
$192.49
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 22505
Office
Unavailable
Facility
$168.20
No comparable office rate is available.
Queens
New York · 22505
Office
Unavailable
Facility
$181.21
No comparable office rate is available.
Rest Of New York
New York · 22505
Office
Unavailable
Facility
$142.57
No comparable office rate is available.
Ohio
Ohio · 22505
Office
Unavailable
Facility
$148.04
No comparable office rate is available.
Oklahoma
Oklahoma · 22505
Office
Unavailable
Facility
$140.69
No comparable office rate is available.
Portland
Oregon · 22505
Office
Unavailable
Facility
$155.36
No comparable office rate is available.
Rest Of Oregon
Oregon · 22505
Office
Unavailable
Facility
$145.64
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 22505
Office
Unavailable
Facility
$162.51
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 22505
Office
Unavailable
Facility
$146.73
No comparable office rate is available.
Puerto Rico
Puerto Rico · 22505
Office
Unavailable
Facility
$153.99
No comparable office rate is available.
Rhode Island
Rhode Island · 22505
Office
Unavailable
Facility
$154.19
No comparable office rate is available.
South Carolina
South Carolina · 22505
Office
Unavailable
Facility
$144.66
No comparable office rate is available.
South Dakota**
South Dakota · 22505
Office
Unavailable
Facility
$136.35
No comparable office rate is available.
Tennessee
Tennessee · 22505
Office
Unavailable
Facility
$135.50
No comparable office rate is available.
Utah
Utah · 22505
Office
Unavailable
Facility
$146.98
No comparable office rate is available.
Virginia
Virginia · 22505
Office
Unavailable
Facility
$144.85
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 22505
Office
Unavailable
Facility
$153.99
No comparable office rate is available.
Vermont
Vermont · 22505
Office
Unavailable
Facility
$140.11
No comparable office rate is available.
Rest Of Washington
Washington · 22505
Office
Unavailable
Facility
$151.75
No comparable office rate is available.
Seattle (King Cnty)
Washington · 22505
Office
Unavailable
Facility
$167.08
No comparable office rate is available.
Wisconsin
Wisconsin · 22505
Office
Unavailable
Facility
$132.81
No comparable office rate is available.
West Virginia
West Virginia · 22505
Office
Unavailable
Facility
$156.12
No comparable office rate is available.
Wyoming**
Wyoming · 22505
Office
Unavailable
Facility
$146.87
No comparable office rate is available.
See how rates vary across the country
22505 · 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.
- 22505 in Austin
Multiple payment areas
- 22505 in Barton Creek
- 22505 in Bee Cave
- 22505 in Briarcliff
- 22505 in Cedar Park
Multiple payment areas
- 22505 in Creedmoor
Multiple payment areas
- 22505 in Elgin
Multiple payment areas
- 22505 in Garfield
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 22505 in Austin. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$170.14
$154.67 × 110% = $170.14
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 22505 in Austin.
PPRRVU2026_Oct_nonQPP.csv
2,070
- Code
- 22505
- Physician work
- 1.82
- Practice expense
- 2.00
- Malpractice
- 0.78
GPCI2026.csv
96
- Locality
- Austin
- Physician work
- 1.002
- Practice expense
- 1.058
- Malpractice
- 0.886
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.82 | × 1.002 | 1.8236 |
| Practice expense | 2.00 | × 1.058 | 2.1160 |
| Malpractice | 0.78 | × 0.886 | 0.6911 |
| Total RVUs | 4.6307 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Austin$154.67
Open 22505 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.82 | 1.002 |
| Practice expense | 2 | 1.058 |
| Malpractice | 0.78 | 0.886 |
(1.82 × 1.002 + 2 × 1.058 + 0.78 × 0.886) × $33.4009 = $154.67
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
22505 · 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 | $154.67 | RVU26D |
| 2026-07-01 | Not available in this setting | $154.67 | RVU26C |
| 2026-04-01 | Not available in this setting | $154.67 | RVU26B |
| 2026-01-01 | Not available in this setting | $154.67 | RVU26A |
| 2025-10-01 | Not available in this setting | $148.89 | RVU25D |
| 2025-07-01 | Not available in this setting | $148.89 | RVU25C |
| 2025-04-01 | Not available in this setting | $148.89 | RVU25B |
| 2025-01-01 | Not available in this setting | $148.89 | RVU25A |
22505 billing questions
How is 22505 different from office-based spinal manipulation?
22505 is for spinal manipulation performed with anesthesia. Routine osteopathic manipulative treatment or manual therapy without anesthesia is reported under the code that describes that service.
What documentation supports reporting 22505?
Document the spinal condition, the region treated, the manipulation performed, and that anesthesia was used. The record should make clear that this was not routine awake manual treatment.
Can modifier 50 be used when more than one side is treated?
No. CMS identifies bilateral adjustment as inappropriate for this code, so do not append modifier 50.
Are postoperative visits separately reportable?
Related postoperative visits during the 10-day global period are included in the procedure.
How does payment work if other procedures are performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard 50% multiple-procedure reduction. Medicare does not pay an assistant at surgery for 22505; co-surgeons and team surgery are not permitted.
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.
2,06722326,,Treat neck spine fracture,A,,20.32,16.37,NA,16.37,,7.43,44.12,44.12,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,06822327,,Treat thorax spine fracture,A,,20.25,17.55,NA,17.55,,7.21,45.01,45.01,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,06922328,,Treat each add spine fx,A,,4.49,1.51,NA,1.51,,1.56,7.56,7.56,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,07022505,,Manipulation of spine,A,,1.82,2.00,NA,2.00,,0.78,4.60,4.60,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,07122510,,Perq cervicothoracic inject,A,,7.70,43.93,,2.61,,1.16,52.79,11.47,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,07222511,,Perq lumbosacral injection,A,,7.15,44.89,,2.60,,1.07,53.11,10.82,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,07322512,,Vertebroplasty addl inject,A,,3.90,17.53,,0.81,,0.72,22.15,5.43,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780
9904412,TX,11,DALLAS,1.009,0.996,0.858