No office rate
Both address anterior operative treatment of an odontoid fracture. Choose 22319 when graft is used; choose 22318 when it is not.
On this page
CMS RVU26D · Effective 2026-10-01
22318 in El Centro
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$1555.86
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 22318: Anterior fixation of odontoid fracture without graft
Report this operation for anterior surgical reduction and internal fixation of an odontoid fracture when no bone graft is used.
This operation treats a fracture of the odontoid, the upward-projecting portion of C2, through an anterior approach in the neck. The surgeon reduces the fracture and places internal fixation; bone graft is not used. It is typically performed by an orthopedic spine surgeon or neurosurgeon in an operating room for a fracture requiring operative stabilization.
Select this code when the operative report supports an odontoid fracture, an anterior approach, internal fixation, and no graft. The 90-day global period includes the day-before preoperative visit and related postoperative care during the following 90 days. 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. Assistant-at-surgery payment and co-surgeon billing are permitted; team-surgery billing is not permitted.
CMS billing rules for 22318
- 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 permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU22.15 · 46%
- Practice expense (office) RVU17.52 · 36%
- Malpractice RVU8.97 · 18%
207
Medicare services in 2024 · #4293 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.
22318 compared with similar codes
Office rates for El Centro, from the same CMS release.
No office rate
This code is specific to anterior treatment of an odontoid fracture without graft. Code 22326 describes posterior treatment of a cervical spine fracture.
$350.62
22310 describes closed vertebral fracture treatment without manipulation. It does not represent the anterior operative reduction and fixation reported with 22318.
$1,028.41
22315 describes closed vertebral fracture treatment with manipulation; 22318 represents anterior surgery with internal fixation for an odontoid fracture.
The same code, a different location
How does El Centro compare?
22318 across payment areas
Same release and payment basis · bars start at $0
El Centro · 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.
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in California 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
Merced
California · 22318
Office
Unavailable
Facility
$1554.36
No comparable office rate is available.
Modesto
California · 22318
Office
Unavailable
Facility
$1554.36
No comparable office rate is available.
Napa
California · 22318
Office
Unavailable
Facility
$1709.91
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 22318
Office
Unavailable
Facility
$1638.89
No comparable office rate is available.
Redding
California · 22318
Office
Unavailable
Facility
$1554.36
No comparable office rate is available.
Rest Of California
California · 22318
Office
Unavailable
Facility
$1554.36
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 22318
Office
Unavailable
Facility
$1650.07
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 22318
Office
Unavailable
Facility
$1607.62
No comparable office rate is available.
Salinas
California · 22318
Office
Unavailable
Facility
$1601.58
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 22318
Office
Unavailable
Facility
$1624.29
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 22318
Office
Unavailable
Facility
$1772.74
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 22318
Office
Unavailable
Facility
$1762.56
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 22318
Office
Unavailable
Facility
$1825.64
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 22318
Office
Unavailable
Facility
$1783.99
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 22318
Office
Unavailable
Facility
$1579.52
No comparable office rate is available.
Santa Cruz-Watsonville
California · 22318
Office
Unavailable
Facility
$1626.95
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 22318
Office
Unavailable
Facility
$1603.46
No comparable office rate is available.
Santa Rosa-Petaluma
California · 22318
Office
Unavailable
Facility
$1641.22
No comparable office rate is available.
Stockton
California · 22318
Office
Unavailable
Facility
$1554.36
No comparable office rate is available.
Vallejo
California · 22318
Office
Unavailable
Facility
$1695.23
No comparable office rate is available.
Visalia
California · 22318
Office
Unavailable
Facility
$1554.36
No comparable office rate is available.
Yuba City
California · 22318
Office
Unavailable
Facility
$1554.36
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 22318
Office
Unavailable
Facility
$1802.59
No comparable office rate is available.
Miami
Florida · 22318
Office
Unavailable
Facility
$2106.71
No comparable office rate is available.
Chicago
Illinois · 22318
Office
Unavailable
Facility
$2020.71
No comparable office rate is available.
Manhattan
New York · 22318
Office
Unavailable
Facility
$1942.34
No comparable office rate is available.
Alaska*
Alaska · 22318
Office
Unavailable
Facility
$1898.05
No comparable office rate is available.
Alabama
Alabama · 22318
Office
Unavailable
Facility
$1421.44
No comparable office rate is available.
Arkansas
Arkansas · 22318
Office
Unavailable
Facility
$1396.80
No comparable office rate is available.
Arizona
Arizona · 22318
Office
Unavailable
Facility
$1563.34
No comparable office rate is available.
Colorado
Colorado · 22318
Office
Unavailable
Facility
$1605.34
No comparable office rate is available.
Connecticut
Connecticut · 22318
Office
Unavailable
Facility
$1747.39
No comparable office rate is available.
Delaware
Delaware · 22318
Office
Unavailable
Facility
$1591.04
No comparable office rate is available.
Fort Lauderdale
Florida · 22318
Office
Unavailable
Facility
$1874.31
No comparable office rate is available.
Rest Of Florida
Florida · 22318
Office
Unavailable
Facility
$1749.57
No comparable office rate is available.
Atlanta
Georgia · 22318
Office
Unavailable
Facility
$1696.42
No comparable office rate is available.
Rest Of Georgia
Georgia · 22318
Office
Unavailable
Facility
$1618.94
No comparable office rate is available.
Hawaii, Guam
Hawaii · 22318
Office
Unavailable
Facility
$1578.66
No comparable office rate is available.
Iowa
Iowa · 22318
Office
Unavailable
Facility
$1394.22
No comparable office rate is available.
Idaho
Idaho · 22318
Office
Unavailable
Facility
$1419.91
No comparable office rate is available.
East St. Louis
Illinois · 22318
Office
Unavailable
Facility
$1881.61
No comparable office rate is available.
Rest Of Illinois
Illinois · 22318
Office
Unavailable
Facility
$1742.39
No comparable office rate is available.
Suburban Chicago
Illinois · 22318
Office
Unavailable
Facility
$1876.89
No comparable office rate is available.
Indiana
Indiana · 22318
Office
Unavailable
Facility
$1427.90
No comparable office rate is available.
Kansas
Kansas · 22318
Office
Unavailable
Facility
$1419.84
No comparable office rate is available.
Kentucky
Kentucky · 22318
Office
Unavailable
Facility
$1534.20
No comparable office rate is available.
New Orleans
Louisiana · 22318
Office
Unavailable
Facility
$1630.84
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 22318
Office
Unavailable
Facility
$1544.74
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 22318
Office
Unavailable
Facility
$1735.52
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 22318
Office
Unavailable
Facility
$1606.65
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 22318
Office
Unavailable
Facility
$1750.18
No comparable office rate is available.
Rest Of Maryland
Maryland · 22318
Office
Unavailable
Facility
$1614.47
No comparable office rate is available.
Rest Of Maine
Maine · 22318
Office
Unavailable
Facility
$1464.55
No comparable office rate is available.
Southern Maine
Maine · 22318
Office
Unavailable
Facility
$1508.80
No comparable office rate is available.
Detroit
Michigan · 22318
Office
Unavailable
Facility
$1809.67
No comparable office rate is available.
Rest Of Michigan
Michigan · 22318
Office
Unavailable
Facility
$1612.36
No comparable office rate is available.
Minnesota
Minnesota · 22318
Office
Unavailable
Facility
$1430.67
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 22318
Office
Unavailable
Facility
$1582.03
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 22318
Office
Unavailable
Facility
$1597.13
No comparable office rate is available.
Rest Of Missouri
Missouri · 22318
Office
Unavailable
Facility
$1536.07
No comparable office rate is available.
Mississippi
Mississippi · 22318
Office
Unavailable
Facility
$1465.08
No comparable office rate is available.
Montana**
Montana · 22318
Office
Unavailable
Facility
$1624.02
No comparable office rate is available.
North Carolina
North Carolina · 22318
Office
Unavailable
Facility
$1477.25
No comparable office rate is available.
North Dakota**
North Dakota · 22318
Office
Unavailable
Facility
$1446.65
No comparable office rate is available.
Nebraska
Nebraska · 22318
Office
Unavailable
Facility
$1393.21
No comparable office rate is available.
New Hampshire
New Hampshire · 22318
Office
Unavailable
Facility
$1611.16
No comparable office rate is available.
Northern Nj
New Jersey · 22318
Office
Unavailable
Facility
$1785.23
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 22318
Office
Unavailable
Facility
$1737.11
No comparable office rate is available.
New Mexico
New Mexico · 22318
Office
Unavailable
Facility
$1636.27
No comparable office rate is available.
Nevada**
Nevada · 22318
Office
Unavailable
Facility
$1575.17
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 22318
Office
Unavailable
Facility
$2039.33
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 22318
Office
Unavailable
Facility
$1776.42
No comparable office rate is available.
Queens
New York · 22318
Office
Unavailable
Facility
$1910.90
No comparable office rate is available.
Rest Of New York
New York · 22318
Office
Unavailable
Facility
$1506.38
No comparable office rate is available.
Ohio
Ohio · 22318
Office
Unavailable
Facility
$1576.11
No comparable office rate is available.
Oklahoma
Oklahoma · 22318
Office
Unavailable
Facility
$1495.19
No comparable office rate is available.
Portland
Oregon · 22318
Office
Unavailable
Facility
$1624.71
No comparable office rate is available.
Rest Of Oregon
Oregon · 22318
Office
Unavailable
Facility
$1533.30
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 22318
Office
Unavailable
Facility
$1719.75
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 22318
Office
Unavailable
Facility
$1560.16
No comparable office rate is available.
Puerto Rico
Puerto Rico · 22318
Office
Unavailable
Facility
$1626.56
No comparable office rate is available.
Rhode Island
Rhode Island · 22318
Office
Unavailable
Facility
$1625.63
No comparable office rate is available.
South Carolina
South Carolina · 22318
Office
Unavailable
Facility
$1535.20
No comparable office rate is available.
South Dakota**
South Dakota · 22318
Office
Unavailable
Facility
$1425.68
No comparable office rate is available.
Tennessee
Tennessee · 22318
Office
Unavailable
Facility
$1432.65
No comparable office rate is available.
Austin
Texas · 22318
Office
Unavailable
Facility
$1625.89
No comparable office rate is available.
Beaumont
Texas · 22318
Office
Unavailable
Facility
$1550.68
No comparable office rate is available.
Brazoria
Texas · 22318
Office
Unavailable
Facility
$1559.36
No comparable office rate is available.
Dallas
Texas · 22318
Office
Unavailable
Facility
$1586.39
No comparable office rate is available.
Fort Worth
Texas · 22318
Office
Unavailable
Facility
$1584.44
No comparable office rate is available.
Galveston
Texas · 22318
Office
Unavailable
Facility
$1574.91
No comparable office rate is available.
Houston
Texas · 22318
Office
Unavailable
Facility
$1739.09
No comparable office rate is available.
Rest Of Texas
Texas · 22318
Office
Unavailable
Facility
$1565.71
No comparable office rate is available.
Utah
Utah · 22318
Office
Unavailable
Facility
$1558.95
No comparable office rate is available.
Virginia
Virginia · 22318
Office
Unavailable
Facility
$1526.59
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 22318
Office
Unavailable
Facility
$1626.56
No comparable office rate is available.
Vermont
Vermont · 22318
Office
Unavailable
Facility
$1470.76
No comparable office rate is available.
Rest Of Washington
Washington · 22318
Office
Unavailable
Facility
$1593.65
No comparable office rate is available.
Seattle (King Cnty)
Washington · 22318
Office
Unavailable
Facility
$1739.62
No comparable office rate is available.
Wisconsin
Wisconsin · 22318
Office
Unavailable
Facility
$1392.71
No comparable office rate is available.
West Virginia
West Virginia · 22318
Office
Unavailable
Facility
$1677.09
No comparable office rate is available.
Wyoming**
Wyoming · 22318
Office
Unavailable
Facility
$1546.72
No comparable office rate is available.
See how rates vary across the country
22318 · 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?
El Centro is a Medicare payment area. Our Census mapping connects it to 18 cities and communities in California, 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 22318 in El Centro. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$1711.45
$1555.86 × 110% = $1711.45
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 22318 in El Centro.
PPRRVU2026_Oct_nonQPP.csv
2,064
- Code
- 22318
- Physician work
- 22.15
- Practice expense
- 17.52
- Malpractice
- 8.97
GPCI2026.csv
10
- Locality
- El Centro
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.541
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 22.15 | × 1.017 | 22.5265 |
| Practice expense | 17.52 | × 1.096 | 19.2019 |
| Malpractice | 8.97 | × 0.541 | 4.8528 |
| Total RVUs | 46.5812 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, El Centro$1555.86
Open 22318 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 22.15 | 1.017 |
| Practice expense | 17.52 | 1.096 |
| Malpractice | 8.97 | 0.541 |
(22.15 × 1.017 + 17.52 × 1.096 + 8.97 × 0.541) × $33.4009 = $1555.86
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
22318 · 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 | $1555.86 | RVU26D |
| 2026-07-01 | Not available in this setting | $1555.86 | RVU26C |
| 2026-04-01 | Not available in this setting | $1555.86 | RVU26B |
| 2026-01-01 | Not available in this setting | $1555.86 | RVU26A |
| 2025-10-01 | Not available in this setting | $1578.39 | RVU25D |
| 2025-07-01 | Not available in this setting | $1578.39 | RVU25C |
| 2025-04-01 | Not available in this setting | $1578.39 | RVU25B |
| 2025-01-01 | Not available in this setting | $1578.39 | RVU25A |
22318 billing questions
When is 22318 chosen instead of 22319?
Use 22318 when the odontoid fracture is treated through an anterior approach with fixation and no graft. The grafted service is represented by 22319.
What operative details support reporting 22318?
Document the odontoid fracture, anterior surgical approach, reduction and internal fixation, and whether graft was used.
Is the day-before visit or routine postoperative care separately included?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures in that session are subject to the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment and co-surgeon billing are permitted for this code. Team-surgery billing is 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.
2,06122226,,Osteot dsc ant 1vrt sgm ea,A,,5.88,1.93,NA,1.93,,1.76,9.57,9.57,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,06222310,,Closed tx vert fx w/o manj,A,,3.36,6.07,,4.58,,0.79,10.22,8.73,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,06322315,,Closed tx vert fx w/manj,A,,9.86,17.69,,10.23,,2.54,30.09,22.63,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,06422318,,Treat odontoid fx w/o graft,A,,22.15,17.52,NA,17.52,,8.97,48.64,48.64,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,06522319,,Treat odontoid fx w/graft,A,,24.70,19.05,NA,19.05,,10.43,54.18,54.18,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,06622325,,Treat spine fracture,A,,19.37,17.07,NA,17.07,,6.80,43.24,43.24,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,06722326,,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
707102,AR,13,ARKANSAS,1.000,0.859,0.515
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609
901112,CA,55,CHICO,1.017,1.096,0.536
1001182,CA,71,EL CENTRO,1.017,1.096,0.541
1101112,CA,56,FRESNO,1.017,1.096,0.536
1201112,CA,57,HANFORD-CORCORAN,1.017,1.096,0.536
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664