No office rate
Use 22840 for posterior nonsegmental fixation; 22842 describes segmental posterior instrumentation across 3 to 6 vertebral segments.
On this page
CMS RVU26D · Effective 2026-10-01
22840 in Austin
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$662.68
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 instrumentation
About 22840: Posterior nonsegmental spinal fixation
Reports posterior spinal fixation using a nonsegmental construct, typically as an add-on to a primary spinal procedure such as fusion.
This add-on represents posterior fixation that stabilizes the spine without segmental attachment at each vertebral level, such as a construct spanning one interspace. It may be used during instrumented spinal fusion or another primary spine operation when posterior stabilization is performed. Orthopedic spine surgeons and neurosurgeons commonly place this hardware in an operating room, including for cases involving spinal instability or deformity.
Report 22840 with the primary procedure performed in the same operative session; it is not a standalone service. The operative report should identify the posterior fixation method, the vertebral levels or interspace spanned, and how the construct differs from segmental fixation. CMS treats this as an add-on code: payment is made within the primary procedure’s global period. The segmental extent and fixation pattern help distinguish it from codes for longer posterior segmental constructs.
CMS billing rules for 22840
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU12.21 · 61%
- Practice expense (office) RVU4.04 · 20%
- Malpractice RVU3.76 · 19%
59.7K
Medicare services in 2024 · #716 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.
22840 compared with similar codes
Office rates for Austin, from the same CMS release.
22841
No office rateInsert spine fixation device
22841 describes internal fixation by wiring spinous processes, while 22840 covers a nonsegmental posterior fixation construct.
No office rate
22845 describes anterior instrumentation across 2 to 3 vertebral segments. Choose based on the approach and instrumentation performed, not simply the number of levels fused.
No office rate
22853 covers placement of an interbody biomechanical device; 22840 covers posterior spinal fixation. Both may be relevant when both services are performed.
The same code, a different location
How does Austin compare?
22840 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 · 22840
Office
Unavailable
Facility
$649.29
No comparable office rate is available.
Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)
California · 22840
Office
Unavailable
Facility
$667.57
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 22840
Office
Unavailable
Facility
$728.59
No comparable office rate is available.
Miami
Florida · 22840
Office
Unavailable
Facility
$865.91
No comparable office rate is available.
Chicago
Illinois · 22840
Office
Unavailable
Facility
$834.52
No comparable office rate is available.
Manhattan
New York · 22840
Office
Unavailable
Facility
$789.91
No comparable office rate is available.
Alaska*
Alaska · 22840
Office
Unavailable
Facility
$824.65
No comparable office rate is available.
Alabama
Alabama · 22840
Office
Unavailable
Facility
$596.98
No comparable office rate is available.
Arkansas
Arkansas · 22840
Office
Unavailable
Facility
$588.42
No comparable office rate is available.
Arizona
Arizona · 22840
Office
Unavailable
Facility
$646.08
No comparable office rate is available.
Bakersfield
California · 22840
Office
Unavailable
Facility
$639.95
No comparable office rate is available.
Chico
California · 22840
Office
Unavailable
Facility
$629.97
No comparable office rate is available.
El Centro
California · 22840
Office
Unavailable
Facility
$630.59
No comparable office rate is available.
Fresno
California · 22840
Office
Unavailable
Facility
$629.97
No comparable office rate is available.
Hanford-Corcoran
California · 22840
Office
Unavailable
Facility
$629.97
No comparable office rate is available.
Madera
California · 22840
Office
Unavailable
Facility
$629.97
No comparable office rate is available.
Merced
California · 22840
Office
Unavailable
Facility
$629.97
No comparable office rate is available.
Modesto
California · 22840
Office
Unavailable
Facility
$629.97
No comparable office rate is available.
Napa
California · 22840
Office
Unavailable
Facility
$675.17
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 22840
Office
Unavailable
Facility
$656.98
No comparable office rate is available.
Redding
California · 22840
Office
Unavailable
Facility
$629.97
No comparable office rate is available.
Rest Of California
California · 22840
Office
Unavailable
Facility
$629.97
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 22840
Office
Unavailable
Facility
$670.19
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 22840
Office
Unavailable
Facility
$646.76
No comparable office rate is available.
Salinas
California · 22840
Office
Unavailable
Facility
$644.18
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 22840
Office
Unavailable
Facility
$649.52
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 22840
Office
Unavailable
Facility
$694.48
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 22840
Office
Unavailable
Facility
$690.21
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 22840
Office
Unavailable
Facility
$714.58
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 22840
Office
Unavailable
Facility
$697.13
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 22840
Office
Unavailable
Facility
$635.77
No comparable office rate is available.
Santa Cruz-Watsonville
California · 22840
Office
Unavailable
Facility
$647.66
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 22840
Office
Unavailable
Facility
$643.90
No comparable office rate is available.
Santa Rosa-Petaluma
California · 22840
Office
Unavailable
Facility
$653.08
No comparable office rate is available.
Stockton
California · 22840
Office
Unavailable
Facility
$629.97
No comparable office rate is available.
Vallejo
California · 22840
Office
Unavailable
Facility
$669.01
No comparable office rate is available.
Visalia
California · 22840
Office
Unavailable
Facility
$629.97
No comparable office rate is available.
Yuba City
California · 22840
Office
Unavailable
Facility
$629.97
No comparable office rate is available.
Colorado
Colorado · 22840
Office
Unavailable
Facility
$654.38
No comparable office rate is available.
Connecticut
Connecticut · 22840
Office
Unavailable
Facility
$713.27
No comparable office rate is available.
Delaware
Delaware · 22840
Office
Unavailable
Facility
$656.09
No comparable office rate is available.
Fort Lauderdale
Florida · 22840
Office
Unavailable
Facility
$771.58
No comparable office rate is available.
Rest Of Florida
Florida · 22840
Office
Unavailable
Facility
$725.59
No comparable office rate is available.
Atlanta
Georgia · 22840
Office
Unavailable
Facility
$696.98
No comparable office rate is available.
Rest Of Georgia
Georgia · 22840
Office
Unavailable
Facility
$677.89
No comparable office rate is available.
Hawaii, Guam
Hawaii · 22840
Office
Unavailable
Facility
$633.97
No comparable office rate is available.
Iowa
Iowa · 22840
Office
Unavailable
Facility
$581.15
No comparable office rate is available.
Idaho
Idaho · 22840
Office
Unavailable
Facility
$591.37
No comparable office rate is available.
East St. Louis
Illinois · 22840
Office
Unavailable
Facility
$784.90
No comparable office rate is available.
Rest Of Illinois
Illinois · 22840
Office
Unavailable
Facility
$727.32
No comparable office rate is available.
Suburban Chicago
Illinois · 22840
Office
Unavailable
Facility
$771.80
No comparable office rate is available.
Indiana
Indiana · 22840
Office
Unavailable
Facility
$593.95
No comparable office rate is available.
Kansas
Kansas · 22840
Office
Unavailable
Facility
$593.11
No comparable office rate is available.
Kentucky
Kentucky · 22840
Office
Unavailable
Facility
$642.70
No comparable office rate is available.
New Orleans
Louisiana · 22840
Office
Unavailable
Facility
$677.47
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 22840
Office
Unavailable
Facility
$647.56
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 22840
Office
Unavailable
Facility
$697.44
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 22840
Office
Unavailable
Facility
$656.53
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 22840
Office
Unavailable
Facility
$714.49
No comparable office rate is available.
Rest Of Maryland
Maryland · 22840
Office
Unavailable
Facility
$663.75
No comparable office rate is available.
Rest Of Maine
Maine · 22840
Office
Unavailable
Facility
$610.08
No comparable office rate is available.
Southern Maine
Maine · 22840
Office
Unavailable
Facility
$620.80
No comparable office rate is available.
Detroit
Michigan · 22840
Office
Unavailable
Facility
$749.78
No comparable office rate is available.
Rest Of Michigan
Michigan · 22840
Office
Unavailable
Facility
$672.81
No comparable office rate is available.
Minnesota
Minnesota · 22840
Office
Unavailable
Facility
$583.85
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 22840
Office
Unavailable
Facility
$657.23
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 22840
Office
Unavailable
Facility
$662.13
No comparable office rate is available.
Rest Of Missouri
Missouri · 22840
Office
Unavailable
Facility
$646.47
No comparable office rate is available.
Mississippi
Mississippi · 22840
Office
Unavailable
Facility
$616.82
No comparable office rate is available.
Montana**
Montana · 22840
Office
Unavailable
Facility
$668.10
No comparable office rate is available.
North Carolina
North Carolina · 22840
Office
Unavailable
Facility
$613.97
No comparable office rate is available.
North Dakota**
North Dakota · 22840
Office
Unavailable
Facility
$593.75
No comparable office rate is available.
Nebraska
Nebraska · 22840
Office
Unavailable
Facility
$579.85
No comparable office rate is available.
New Hampshire
New Hampshire · 22840
Office
Unavailable
Facility
$658.19
No comparable office rate is available.
Northern Nj
New Jersey · 22840
Office
Unavailable
Facility
$724.18
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 22840
Office
Unavailable
Facility
$709.26
No comparable office rate is available.
New Mexico
New Mexico · 22840
Office
Unavailable
Facility
$682.40
No comparable office rate is available.
Nevada**
Nevada · 22840
Office
Unavailable
Facility
$647.51
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 22840
Office
Unavailable
Facility
$827.58
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 22840
Office
Unavailable
Facility
$725.90
No comparable office rate is available.
Queens
New York · 22840
Office
Unavailable
Facility
$774.52
No comparable office rate is available.
Rest Of New York
New York · 22840
Office
Unavailable
Facility
$624.31
No comparable office rate is available.
Ohio
Ohio · 22840
Office
Unavailable
Facility
$657.62
No comparable office rate is available.
Oklahoma
Oklahoma · 22840
Office
Unavailable
Facility
$625.91
No comparable office rate is available.
Portland
Oregon · 22840
Office
Unavailable
Facility
$657.71
No comparable office rate is available.
Rest Of Oregon
Oregon · 22840
Office
Unavailable
Facility
$630.51
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 22840
Office
Unavailable
Facility
$705.46
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 22840
Office
Unavailable
Facility
$650.38
No comparable office rate is available.
Puerto Rico
Puerto Rico · 22840
Office
Unavailable
Facility
$667.95
No comparable office rate is available.
Rhode Island
Rhode Island · 22840
Office
Unavailable
Facility
$666.99
No comparable office rate is available.
South Carolina
South Carolina · 22840
Office
Unavailable
Facility
$639.26
No comparable office rate is available.
South Dakota**
South Dakota · 22840
Office
Unavailable
Facility
$584.96
No comparable office rate is available.
Tennessee
Tennessee · 22840
Office
Unavailable
Facility
$597.93
No comparable office rate is available.
Utah
Utah · 22840
Office
Unavailable
Facility
$647.45
No comparable office rate is available.
Virginia
Virginia · 22840
Office
Unavailable
Facility
$629.14
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 22840
Office
Unavailable
Facility
$667.95
No comparable office rate is available.
Vermont
Vermont · 22840
Office
Unavailable
Facility
$604.96
No comparable office rate is available.
Rest Of Washington
Washington · 22840
Office
Unavailable
Facility
$650.79
No comparable office rate is available.
Seattle (King Cnty)
Washington · 22840
Office
Unavailable
Facility
$696.39
No comparable office rate is available.
Wisconsin
Wisconsin · 22840
Office
Unavailable
Facility
$575.78
No comparable office rate is available.
West Virginia
West Virginia · 22840
Office
Unavailable
Facility
$704.80
No comparable office rate is available.
Wyoming**
Wyoming · 22840
Office
Unavailable
Facility
$635.70
No comparable office rate is available.
See how rates vary across the country
22840 · 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.
- 22840 in Austin
Multiple payment areas
- 22840 in Barton Creek
- 22840 in Bee Cave
- 22840 in Briarcliff
- 22840 in Cedar Park
Multiple payment areas
- 22840 in Creedmoor
Multiple payment areas
- 22840 in Elgin
Multiple payment areas
- 22840 in Garfield
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 22840 in Austin. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$728.95
$662.68 × 110% = $728.95
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 22840 in Austin.
PPRRVU2026_Oct_nonQPP.csv
2,112
- Code
- 22840
- Physician work
- 12.21
- Practice expense
- 4.04
- Malpractice
- 3.76
GPCI2026.csv
96
- Locality
- Austin
- Physician work
- 1.002
- Practice expense
- 1.058
- Malpractice
- 0.886
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 12.21 | × 1.002 | 12.2344 |
| Practice expense | 4.04 | × 1.058 | 4.2743 |
| Malpractice | 3.76 | × 0.886 | 3.3314 |
| Total RVUs | 19.8401 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Austin$662.68
Open 22840 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 12.21 | 1.002 |
| Practice expense | 4.04 | 1.058 |
| Malpractice | 3.76 | 0.886 |
(12.21 × 1.002 + 4.04 × 1.058 + 3.76 × 0.886) × $33.4009 = $662.68
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
22840 · 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 | $662.68 | RVU26D |
| 2026-07-01 | Not available in this setting | $662.68 | RVU26C |
| 2026-04-01 | Not available in this setting | $662.68 | RVU26B |
| 2026-01-01 | Not available in this setting | $662.68 | RVU26A |
| 2025-10-01 | Not available in this setting | $731.33 | RVU25D |
| 2025-07-01 | Not available in this setting | $731.33 | RVU25C |
| 2025-04-01 | Not available in this setting | $731.33 | RVU25B |
| 2025-01-01 | Not available in this setting | $731.33 | RVU25A |
22840 billing questions
How is 22840 distinguished from 22842?
22840 describes posterior nonsegmental fixation, such as a construct spanning one interspace. 22842 is for posterior segmental instrumentation across 3 to 6 vertebral segments.
Can 22840 be billed by itself?
No. It is an add-on code and must be reported with a primary procedure performed in the operative session.
Does 22840 include an interbody cage?
No. Posterior fixation and an interbody biomechanical device are different services. Code 22853 may be relevant when an interbody device is also placed.
What should the operative report document?
Document the posterior fixation method, the vertebral levels or interspace spanned, and whether fixation is nonsegmental rather than attached segmentally across multiple levels.
How does the add-on status affect Medicare payment?
CMS pays 22840 within the global period of the primary procedure. Report it only with that primary procedure.
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.
2,10922836,,Ant thrc vrt body tethrg <7,A,,31.20,16.33,NA,16.33,,6.64,54.17,54.17,0,090,0.10,0.69,0.21,2,0,0,2,1,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11022837,,Ant thrc vrt body tethrg 8+,A,,34.61,11.46,NA,11.46,,3.69,49.76,49.76,0,090,0.10,0.69,0.21,2,0,0,2,1,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11122838,,Rev rplc/rmv thrc vrt tethrg,A,,35.10,11.57,NA,11.57,,3.75,50.42,50.42,0,090,0.10,0.69,0.21,2,0,0,2,1,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11222840,,Insert spine fixation device,A,,12.21,4.04,NA,4.04,,3.76,20.01,20.01,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11322841,,Insert spine fixation device,B,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11422842,,Insert spine fixation device,A,,12.25,4.10,NA,4.10,,4.01,20.36,20.36,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11522843,,Insert spine fixation device,A,,13.10,4.40,NA,4.40,,4.31,21.81,21.81,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,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