No office rate
Use 22846 when anterior fixation spans four to six vertebral segments. Use 22847 for seven to twelve.
On this page
CMS RVU26D · Effective 2026-10-01
22847 in Delaware
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$678.27
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 22847: Anterior spinal fixation, seven to twelve segments
Reports anterior spinal fixation spanning seven to twelve vertebral segments, typically added to a long-segment fusion or other eligible primary spine procedure.
This code represents placement of anterior fixation across seven to twelve vertebral segments. A spine surgeon may use a plate-and-screw construct or other anterior fixation to stabilize a long spinal reconstruction, often during multilevel fusion. The surgeon approaches the spine from the front, such as through the neck for cervical surgery or through the chest or abdomen for thoracic or lumbar surgery. The segment count is based on the vertebral levels instrumented, not the number of screws or implants used.
Report this code as an add-on with an eligible primary procedure; it is not billed by itself. The operative report should identify the anterior approach, the instrumented vertebral segments, and the fixation placed. Select this level when the construct spans seven through twelve vertebral segments, rather than the shorter ranges represented by 22845 or 22846. CMS treats payment as part of the primary procedure’s global period, so the add-on is paid within that period.
CMS billing rules for 22847
- 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 RVU13.44 · 65%
- Practice expense (office) RVU4.28 · 21%
- Malpractice RVU2.86 · 14%
30
Medicare services in 2024 · #5663 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.
22847 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
22845 is for anterior fixation across two to three vertebral segments; 22847 is for the longer seven-to-twelve-segment construct.
No office rate
Both codes represent segmental fixation over seven to twelve vertebral segments, but 22843 is for a posterior construct and 22847 for an anterior construct.
No office rate
22853 concerns an interbody biomechanical device, such as a cage placed in a disc space. 22847 represents anterior fixation spanning multiple vertebral segments.
The same code, a different location
How does Delaware compare?
22847 across payment areas
Same release and payment basis · bars start at $0
Delaware · This locality
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 Delaware 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
Alabama
Alabama · 22847
Office
Unavailable
Facility
$628.06
No comparable office rate is available.
Arkansas
Arkansas · 22847
Office
Unavailable
Facility
$620.90
No comparable office rate is available.
Arizona
Arizona · 22847
Office
Unavailable
Facility
$669.20
No comparable office rate is available.
Bakersfield
California · 22847
Office
Unavailable
Facility
$672.29
No comparable office rate is available.
Chico
California · 22847
Office
Unavailable
Facility
$664.42
No comparable office rate is available.
El Centro
California · 22847
Office
Unavailable
Facility
$664.90
No comparable office rate is available.
Fresno
California · 22847
Office
Unavailable
Facility
$664.42
No comparable office rate is available.
Hanford-Corcoran
California · 22847
Office
Unavailable
Facility
$664.42
No comparable office rate is available.
Madera
California · 22847
Office
Unavailable
Facility
$664.42
No comparable office rate is available.
Merced
California · 22847
Office
Unavailable
Facility
$664.42
No comparable office rate is available.
Modesto
California · 22847
Office
Unavailable
Facility
$664.42
No comparable office rate is available.
Napa
California · 22847
Office
Unavailable
Facility
$714.13
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 22847
Office
Unavailable
Facility
$689.96
No comparable office rate is available.
Redding
California · 22847
Office
Unavailable
Facility
$664.42
No comparable office rate is available.
Rest Of California
California · 22847
Office
Unavailable
Facility
$664.42
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 22847
Office
Unavailable
Facility
$695.15
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 22847
Office
Unavailable
Facility
$682.53
No comparable office rate is available.
Salinas
California · 22847
Office
Unavailable
Facility
$679.71
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 22847
Office
Unavailable
Facility
$685.13
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 22847
Office
Unavailable
Facility
$736.97
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 22847
Office
Unavailable
Facility
$733.72
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 22847
Office
Unavailable
Facility
$755.63
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 22847
Office
Unavailable
Facility
$742.35
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 22847
Office
Unavailable
Facility
$670.57
No comparable office rate is available.
Santa Cruz-Watsonville
California · 22847
Office
Unavailable
Facility
$683.23
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 22847
Office
Unavailable
Facility
$679.37
No comparable office rate is available.
Santa Rosa-Petaluma
California · 22847
Office
Unavailable
Facility
$689.13
No comparable office rate is available.
Stockton
California · 22847
Office
Unavailable
Facility
$664.42
No comparable office rate is available.
Vallejo
California · 22847
Office
Unavailable
Facility
$709.45
No comparable office rate is available.
Visalia
California · 22847
Office
Unavailable
Facility
$664.42
No comparable office rate is available.
Yuba City
California · 22847
Office
Unavailable
Facility
$664.42
No comparable office rate is available.
Colorado
Colorado · 22847
Office
Unavailable
Facility
$681.01
No comparable office rate is available.
Connecticut
Connecticut · 22847
Office
Unavailable
Facility
$727.44
No comparable office rate is available.
Fort Lauderdale
Florida · 22847
Office
Unavailable
Facility
$766.43
No comparable office rate is available.
Rest Of Florida
Florida · 22847
Office
Unavailable
Facility
$729.15
No comparable office rate is available.
Atlanta
Georgia · 22847
Office
Unavailable
Facility
$710.23
No comparable office rate is available.
Rest Of Georgia
Georgia · 22847
Office
Unavailable
Facility
$690.29
No comparable office rate is available.
Hawaii, Guam
Hawaii · 22847
Office
Unavailable
Facility
$666.76
No comparable office rate is available.
Iowa
Iowa · 22847
Office
Unavailable
Facility
$617.64
No comparable office rate is available.
Idaho
Idaho · 22847
Office
Unavailable
Facility
$625.61
No comparable office rate is available.
East St. Louis
Illinois · 22847
Office
Unavailable
Facility
$772.82
No comparable office rate is available.
Rest Of Illinois
Illinois · 22847
Office
Unavailable
Facility
$728.73
No comparable office rate is available.
Suburban Chicago
Illinois · 22847
Office
Unavailable
Facility
$768.14
No comparable office rate is available.
Indiana
Indiana · 22847
Office
Unavailable
Facility
$627.85
No comparable office rate is available.
Kansas
Kansas · 22847
Office
Unavailable
Facility
$626.29
No comparable office rate is available.
Kentucky
Kentucky · 22847
Office
Unavailable
Facility
$663.40
No comparable office rate is available.
New Orleans
Louisiana · 22847
Office
Unavailable
Facility
$691.95
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 22847
Office
Unavailable
Facility
$666.94
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 22847
Office
Unavailable
Facility
$723.02
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 22847
Office
Unavailable
Facility
$682.76
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 22847
Office
Unavailable
Facility
$727.65
No comparable office rate is available.
Rest Of Maryland
Maryland · 22847
Office
Unavailable
Facility
$685.76
No comparable office rate is available.
Rest Of Maine
Maine · 22847
Office
Unavailable
Facility
$639.85
No comparable office rate is available.
Southern Maine
Maine · 22847
Office
Unavailable
Facility
$650.85
No comparable office rate is available.
Detroit
Michigan · 22847
Office
Unavailable
Facility
$747.92
No comparable office rate is available.
Rest Of Michigan
Michigan · 22847
Office
Unavailable
Facility
$687.28
No comparable office rate is available.
Minnesota
Minnesota · 22847
Office
Unavailable
Facility
$624.29
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 22847
Office
Unavailable
Facility
$676.47
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 22847
Office
Unavailable
Facility
$680.72
No comparable office rate is available.
Rest Of Missouri
Missouri · 22847
Office
Unavailable
Facility
$665.18
No comparable office rate is available.
Mississippi
Mississippi · 22847
Office
Unavailable
Facility
$642.59
No comparable office rate is available.
Montana**
Montana · 22847
Office
Unavailable
Facility
$687.20
No comparable office rate is available.
North Carolina
North Carolina · 22847
Office
Unavailable
Facility
$643.33
No comparable office rate is available.
North Dakota**
North Dakota · 22847
Office
Unavailable
Facility
$630.65
No comparable office rate is available.
Nebraska
Nebraska · 22847
Office
Unavailable
Facility
$616.97
No comparable office rate is available.
New Hampshire
New Hampshire · 22847
Office
Unavailable
Facility
$681.31
No comparable office rate is available.
Northern Nj
New Jersey · 22847
Office
Unavailable
Facility
$745.04
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 22847
Office
Unavailable
Facility
$727.76
No comparable office rate is available.
New Mexico
New Mexico · 22847
Office
Unavailable
Facility
$694.73
No comparable office rate is available.
Nevada**
Nevada · 22847
Office
Unavailable
Facility
$671.58
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 22847
Office
Unavailable
Facility
$825.01
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 22847
Office
Unavailable
Facility
$741.23
No comparable office rate is available.
Queens
New York · 22847
Office
Unavailable
Facility
$784.36
No comparable office rate is available.
Rest Of New York
New York · 22847
Office
Unavailable
Facility
$651.87
No comparable office rate is available.
Ohio
Ohio · 22847
Office
Unavailable
Facility
$675.72
No comparable office rate is available.
Oklahoma
Oklahoma · 22847
Office
Unavailable
Facility
$650.79
No comparable office rate is available.
Portland
Oregon · 22847
Office
Unavailable
Facility
$685.99
No comparable office rate is available.
Rest Of Oregon
Oregon · 22847
Office
Unavailable
Facility
$658.45
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 22847
Office
Unavailable
Facility
$719.77
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 22847
Office
Unavailable
Facility
$670.41
No comparable office rate is available.
Puerto Rico
Puerto Rico · 22847
Office
Unavailable
Facility
$687.53
No comparable office rate is available.
Rhode Island
Rhode Island · 22847
Office
Unavailable
Facility
$690.32
No comparable office rate is available.
South Carolina
South Carolina · 22847
Office
Unavailable
Facility
$662.20
No comparable office rate is available.
South Dakota**
South Dakota · 22847
Office
Unavailable
Facility
$623.96
No comparable office rate is available.
Tennessee
Tennessee · 22847
Office
Unavailable
Facility
$630.15
No comparable office rate is available.
Austin
Texas · 22847
Office
Unavailable
Facility
$685.69
No comparable office rate is available.
Beaumont
Texas · 22847
Office
Unavailable
Facility
$667.74
No comparable office rate is available.
Brazoria
Texas · 22847
Office
Unavailable
Facility
$668.68
No comparable office rate is available.
Dallas
Texas · 22847
Office
Unavailable
Facility
$677.29
No comparable office rate is available.
Fort Worth
Texas · 22847
Office
Unavailable
Facility
$677.11
No comparable office rate is available.
Galveston
Texas · 22847
Office
Unavailable
Facility
$673.55
No comparable office rate is available.
Houston
Texas · 22847
Office
Unavailable
Facility
$725.90
No comparable office rate is available.
Rest Of Texas
Texas · 22847
Office
Unavailable
Facility
$670.83
No comparable office rate is available.
Utah
Utah · 22847
Office
Unavailable
Facility
$669.07
No comparable office rate is available.
Virginia
Virginia · 22847
Office
Unavailable
Facility
$656.88
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 22847
Office
Unavailable
Facility
$687.53
No comparable office rate is available.
Vermont
Vermont · 22847
Office
Unavailable
Facility
$638.77
No comparable office rate is available.
Rest Of Washington
Washington · 22847
Office
Unavailable
Facility
$677.97
No comparable office rate is available.
Seattle (King Cnty)
Washington · 22847
Office
Unavailable
Facility
$724.81
No comparable office rate is available.
Wisconsin
Wisconsin · 22847
Office
Unavailable
Facility
$615.28
No comparable office rate is available.
West Virginia
West Virginia · 22847
Office
Unavailable
Facility
$709.84
No comparable office rate is available.
Wyoming**
Wyoming · 22847
Office
Unavailable
Facility
$662.55
No comparable office rate is available.
See how rates vary across the country
22847 · 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?
Delaware is a Medicare payment area. Our Census mapping connects it to 79 cities and communities in Delaware, 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.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 22847 in Delaware. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$746.10
$678.27 × 110% = $746.10
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 22847 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
2,119
- Code
- 22847
- Physician work
- 13.44
- Practice expense
- 4.28
- Malpractice
- 2.86
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.44 | × 1.005 | 13.5072 |
| Practice expense | 4.28 | × 0.988 | 4.2286 |
| Malpractice | 2.86 | × 0.899 | 2.5711 |
| Total RVUs | 20.3070 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$678.27
Open 22847 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.44 | 1.005 |
| Practice expense | 4.28 | 0.988 |
| Malpractice | 2.86 | 0.899 |
(13.44 × 1.005 + 4.28 × 0.988 + 2.86 × 0.899) × $33.4009 = $678.27
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
22847 · 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 | $678.27 | RVU26D |
| 2026-07-01 | Not available in this setting | $678.27 | RVU26C |
| 2026-04-01 | Not available in this setting | $678.27 | RVU26B |
| 2026-01-01 | Not available in this setting | $678.27 | RVU26A |
| 2025-10-01 | Not available in this setting | $769.62 | RVU25D |
| 2025-07-01 | Not available in this setting | $769.62 | RVU25C |
| 2025-04-01 | Not available in this setting | $769.62 | RVU25B |
| 2025-01-01 | Not available in this setting | $769.62 | RVU25A |
22847 billing questions
How is this code distinguished from 22846?
Count the vertebral segments instrumented. This code is for seven to twelve segments; 22846 covers the shorter four-to-six-segment range.
Can this code be reported by itself?
No. It is an add-on code and must be reported with an eligible primary procedure.
Does the number of screws determine the code level?
No. The level is selected by the number of vertebral segments instrumented, not by the number of screws or other fixation pieces.
What documentation supports reporting this code?
The operative report should establish the anterior approach, identify the vertebral segments spanned, and describe the fixation construct placed.
How does this differ from 22843?
22847 represents anterior fixation across seven to twelve segments. 22843 represents posterior segmental fixation across that segment range.
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.
2,11622844,,Insert spine fixation device,A,,16.01,5.32,NA,5.32,,4.87,26.20,26.20,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11722845,,Insert spine fixation device,A,,11.64,3.90,NA,3.90,,3.85,19.39,19.39,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11822846,,Insert spine fixation device,A,,12.09,4.06,NA,4.06,,4.01,20.16,20.16,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11922847,,Insert spine fixation device,A,,13.44,4.28,NA,4.28,,2.86,20.58,20.58,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,12022848,,Insert pelv fixation device,A,,5.84,1.93,NA,1.93,,1.74,9.51,9.51,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,12122849,,Reinsert spinal fixation,A,,18.69,12.26,NA,12.26,,5.78,36.73,36.73,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,12222850,,Remove spine fixation device,A,,9.57,8.88,NA,8.88,,3.01,21.46,21.46,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503