No office rate
Use 22819 when the resection involves three or more vertebral segments; 22818 is limited to one or two.
On this page
CMS RVU26D · Effective 2026-10-01
22818 in El Centro
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$1874.73
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 surgery
About 22818: Kyphectomy, one or two vertebral segments
Surgical resection of one or two vertebral segments to correct a focal kyphotic deformity, selected by the number of segments removed.
Kyphectomy removes one or two vertebral segments at the apex of a kyphotic deformity to correct a sharp spinal angulation. It may be performed for severe congenital kyphosis or a prominent deformity in a patient with myelomeningocele that interferes with sitting or creates pressure over the prominence. An orthopedic spine surgeon or neurosurgeon typically performs the operation in a hospital operating room.
Choose this code by the number of vertebral segments resected, not the number fused or instrumented. The operative report should identify the resection levels and extent; use 22819 when three or more segments are removed. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For other procedures in the same session, the highest-valued procedure is paid in full and others at 50%. Do not use modifier 50 to represent bilateral work. Assistant-at-surgery payment may be available, and co-surgeons and team surgery are permitted.
CMS billing rules for 22818
- 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 permitted.
Where the value comes from
- Work RVU33.47 · 58%
- Practice expense (office) RVU16.63 · 29%
- Malpractice RVU7.14 · 12%
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.
22818 compared with similar codes
Office rates for El Centro, from the same CMS release.
No office rate
22800 describes posterior fusion for spinal deformity, not resection of the kyphotic apex.
No office rate
22802 is posterior arthrodesis for deformity across a longer fusion span; 22818 is selected by the number of segments resected.
The same code, a different location
How does El Centro compare?
22818 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 · 22818
Office
Unavailable
Facility
$1873.54
No comparable office rate is available.
Modesto
California · 22818
Office
Unavailable
Facility
$1873.54
No comparable office rate is available.
Napa
California · 22818
Office
Unavailable
Facility
$2041.60
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 22818
Office
Unavailable
Facility
$1954.35
No comparable office rate is available.
Redding
California · 22818
Office
Unavailable
Facility
$1873.54
No comparable office rate is available.
Rest Of California
California · 22818
Office
Unavailable
Facility
$1873.54
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 22818
Office
Unavailable
Facility
$1950.26
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 22818
Office
Unavailable
Facility
$1932.00
No comparable office rate is available.
Salinas
California · 22818
Office
Unavailable
Facility
$1924.19
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 22818
Office
Unavailable
Facility
$1945.05
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 22818
Office
Unavailable
Facility
$2116.79
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 22818
Office
Unavailable
Facility
$2108.68
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 22818
Office
Unavailable
Facility
$2169.70
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 22818
Office
Unavailable
Facility
$2136.55
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 22818
Office
Unavailable
Facility
$1897.42
No comparable office rate is available.
Santa Cruz-Watsonville
California · 22818
Office
Unavailable
Facility
$1944.11
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 22818
Office
Unavailable
Facility
$1924.72
No comparable office rate is available.
Santa Rosa-Petaluma
California · 22818
Office
Unavailable
Facility
$1961.39
No comparable office rate is available.
Stockton
California · 22818
Office
Unavailable
Facility
$1873.54
No comparable office rate is available.
Vallejo
California · 22818
Office
Unavailable
Facility
$2029.91
No comparable office rate is available.
Visalia
California · 22818
Office
Unavailable
Facility
$1873.54
No comparable office rate is available.
Yuba City
California · 22818
Office
Unavailable
Facility
$1873.54
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 22818
Office
Unavailable
Facility
$2098.06
No comparable office rate is available.
Miami
Florida · 22818
Office
Unavailable
Facility
$2299.28
No comparable office rate is available.
Chicago
Illinois · 22818
Office
Unavailable
Facility
$2231.31
No comparable office rate is available.
Manhattan
New York · 22818
Office
Unavailable
Facility
$2213.15
No comparable office rate is available.
Alaska*
Alaska · 22818
Office
Unavailable
Facility
$2399.86
No comparable office rate is available.
Alabama
Alabama · 22818
Office
Unavailable
Facility
$1738.93
No comparable office rate is available.
Arkansas
Arkansas · 22818
Office
Unavailable
Facility
$1717.88
No comparable office rate is available.
Arizona
Arizona · 22818
Office
Unavailable
Facility
$1860.31
No comparable office rate is available.
Colorado
Colorado · 22818
Office
Unavailable
Facility
$1908.60
No comparable office rate is available.
Connecticut
Connecticut · 22818
Office
Unavailable
Facility
$2027.08
No comparable office rate is available.
Delaware
Delaware · 22818
Office
Unavailable
Facility
$1886.70
No comparable office rate is available.
Fort Lauderdale
Florida · 22818
Office
Unavailable
Facility
$2111.78
No comparable office rate is available.
Rest Of Florida
Florida · 22818
Office
Unavailable
Facility
$2007.38
No comparable office rate is available.
Atlanta
Georgia · 22818
Office
Unavailable
Facility
$1972.04
No comparable office rate is available.
Rest Of Georgia
Georgia · 22818
Office
Unavailable
Facility
$1897.67
No comparable office rate is available.
Hawaii, Guam
Hawaii · 22818
Office
Unavailable
Facility
$1887.56
No comparable office rate is available.
Iowa
Iowa · 22818
Office
Unavailable
Facility
$1720.85
No comparable office rate is available.
Idaho
Idaho · 22818
Office
Unavailable
Facility
$1741.75
No comparable office rate is available.
East St. Louis
Illinois · 22818
Office
Unavailable
Facility
$2109.25
No comparable office rate is available.
Rest Of Illinois
Illinois · 22818
Office
Unavailable
Facility
$1997.81
No comparable office rate is available.
Suburban Chicago
Illinois · 22818
Office
Unavailable
Facility
$2118.80
No comparable office rate is available.
Indiana
Indiana · 22818
Office
Unavailable
Facility
$1748.74
No comparable office rate is available.
Kansas
Kansas · 22818
Office
Unavailable
Facility
$1740.26
No comparable office rate is available.
Kentucky
Kentucky · 22818
Office
Unavailable
Facility
$1829.94
No comparable office rate is available.
New Orleans
Louisiana · 22818
Office
Unavailable
Facility
$1911.53
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 22818
Office
Unavailable
Facility
$1837.97
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 22818
Office
Unavailable
Facility
$2039.23
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 22818
Office
Unavailable
Facility
$1910.78
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 22818
Office
Unavailable
Facility
$2026.82
No comparable office rate is available.
Rest Of Maryland
Maryland · 22818
Office
Unavailable
Facility
$1910.16
No comparable office rate is available.
Rest Of Maine
Maine · 22818
Office
Unavailable
Facility
$1777.28
No comparable office rate is available.
Southern Maine
Maine · 22818
Office
Unavailable
Facility
$1818.87
No comparable office rate is available.
Detroit
Michigan · 22818
Office
Unavailable
Facility
$2056.03
No comparable office rate is available.
Rest Of Michigan
Michigan · 22818
Office
Unavailable
Facility
$1894.31
No comparable office rate is available.
Minnesota
Minnesota · 22818
Office
Unavailable
Facility
$1760.08
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 22818
Office
Unavailable
Facility
$1872.50
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 22818
Office
Unavailable
Facility
$1885.68
No comparable office rate is available.
Rest Of Missouri
Missouri · 22818
Office
Unavailable
Facility
$1829.01
No comparable office rate is available.
Mississippi
Mississippi · 22818
Office
Unavailable
Facility
$1772.42
No comparable office rate is available.
Montana**
Montana · 22818
Office
Unavailable
Facility
$1911.39
No comparable office rate is available.
North Carolina
North Carolina · 22818
Office
Unavailable
Facility
$1788.56
No comparable office rate is available.
North Dakota**
North Dakota · 22818
Office
Unavailable
Facility
$1770.21
No comparable office rate is available.
Nebraska
Nebraska · 22818
Office
Unavailable
Facility
$1720.76
No comparable office rate is available.
New Hampshire
New Hampshire · 22818
Office
Unavailable
Facility
$1904.83
No comparable office rate is available.
Northern Nj
New Jersey · 22818
Office
Unavailable
Facility
$2087.39
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 22818
Office
Unavailable
Facility
$2030.82
No comparable office rate is available.
New Mexico
New Mexico · 22818
Office
Unavailable
Facility
$1913.70
No comparable office rate is available.
Nevada**
Nevada · 22818
Office
Unavailable
Facility
$1872.60
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 22818
Office
Unavailable
Facility
$2292.78
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 22818
Office
Unavailable
Facility
$2065.02
No comparable office rate is available.
Queens
New York · 22818
Office
Unavailable
Facility
$2189.92
No comparable office rate is available.
Rest Of New York
New York · 22818
Office
Unavailable
Facility
$1813.27
No comparable office rate is available.
Ohio
Ohio · 22818
Office
Unavailable
Facility
$1865.45
No comparable office rate is available.
Oklahoma
Oklahoma · 22818
Office
Unavailable
Facility
$1799.25
No comparable office rate is available.
Portland
Oregon · 22818
Office
Unavailable
Facility
$1930.36
No comparable office rate is available.
Rest Of Oregon
Oregon · 22818
Office
Unavailable
Facility
$1838.82
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 22818
Office
Unavailable
Facility
$2000.79
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 22818
Office
Unavailable
Facility
$1853.20
No comparable office rate is available.
Puerto Rico
Puerto Rico · 22818
Office
Unavailable
Facility
$1914.40
No comparable office rate is available.
Rhode Island
Rhode Island · 22818
Office
Unavailable
Facility
$1925.68
No comparable office rate is available.
South Carolina
South Carolina · 22818
Office
Unavailable
Facility
$1833.88
No comparable office rate is available.
South Dakota**
South Dakota · 22818
Office
Unavailable
Facility
$1753.52
No comparable office rate is available.
Tennessee
Tennessee · 22818
Office
Unavailable
Facility
$1750.90
No comparable office rate is available.
Austin
Texas · 22818
Office
Unavailable
Facility
$1919.13
No comparable office rate is available.
Beaumont
Texas · 22818
Office
Unavailable
Facility
$1844.94
No comparable office rate is available.
Brazoria
Texas · 22818
Office
Unavailable
Facility
$1863.35
No comparable office rate is available.
Dallas
Texas · 22818
Office
Unavailable
Facility
$1885.84
No comparable office rate is available.
Fort Worth
Texas · 22818
Office
Unavailable
Facility
$1883.39
No comparable office rate is available.
Galveston
Texas · 22818
Office
Unavailable
Facility
$1875.90
No comparable office rate is available.
Houston
Texas · 22818
Office
Unavailable
Facility
$2006.59
No comparable office rate is available.
Rest Of Texas
Texas · 22818
Office
Unavailable
Facility
$1860.41
No comparable office rate is available.
Utah
Utah · 22818
Office
Unavailable
Facility
$1854.21
No comparable office rate is available.
Virginia
Virginia · 22818
Office
Unavailable
Facility
$1832.31
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 22818
Office
Unavailable
Facility
$1914.40
No comparable office rate is available.
Vermont
Vermont · 22818
Office
Unavailable
Facility
$1788.50
No comparable office rate is available.
Rest Of Washington
Washington · 22818
Office
Unavailable
Facility
$1898.84
No comparable office rate is available.
Seattle (King Cnty)
Washington · 22818
Office
Unavailable
Facility
$2050.21
No comparable office rate is available.
Wisconsin
Wisconsin · 22818
Office
Unavailable
Facility
$1723.51
No comparable office rate is available.
West Virginia
West Virginia · 22818
Office
Unavailable
Facility
$1941.89
No comparable office rate is available.
Wyoming**
Wyoming · 22818
Office
Unavailable
Facility
$1849.86
No comparable office rate is available.
See how rates vary across the country
22818 · 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 22818 in El Centro. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$2062.20
$1874.73 × 110% = $2062.20
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 22818 in El Centro.
PPRRVU2026_Oct_nonQPP.csv
2,106
- Code
- 22818
- Physician work
- 33.47
- Practice expense
- 16.63
- Malpractice
- 7.14
GPCI2026.csv
10
- Locality
- El Centro
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.541
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 33.47 | × 1.017 | 34.0390 |
| Practice expense | 16.63 | × 1.096 | 18.2265 |
| Malpractice | 7.14 | × 0.541 | 3.8627 |
| Total RVUs | 56.1282 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, El Centro$1874.73
Open 22818 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 33.47 | 1.017 |
| Practice expense | 16.63 | 1.096 |
| Malpractice | 7.14 | 0.541 |
(33.47 × 1.017 + 16.63 × 1.096 + 7.14 × 0.541) × $33.4009 = $1874.73
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
22818 · 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 | $1874.73 | RVU26D |
| 2026-07-01 | Not available in this setting | $1874.73 | RVU26C |
| 2026-04-01 | Not available in this setting | $1874.73 | RVU26B |
| 2026-01-01 | Not available in this setting | $1874.73 | RVU26A |
| 2025-10-01 | Not available in this setting | $2087.33 | RVU25D |
| 2025-07-01 | Not available in this setting | $2087.33 | RVU25C |
| 2025-04-01 | Not available in this setting | $2087.33 | RVU25B |
| 2025-01-01 | Not available in this setting | $2087.33 | RVU25A |
22818 billing questions
How do I choose between 22818 and 22819?
Count the vertebral segments resected: 22818 is for one or two, while 22819 is for three or more. The count is based on the resection, not the fusion or instrumentation span.
Is this the same as posterior arthrodesis for deformity?
No. Kyphectomy reports resection of vertebral segments at the kyphotic apex; posterior arthrodesis codes describe fusion for spinal deformity.
Can spinal instrumentation be reported with 22818?
Instrumentation may accompany the resection when performed. Document the fixation construct and report the applicable instrumentation service separately when supported by the operative work and coding edits.
Should modifier 50 be appended?
No. This is a midline spinal resection, not a paired-side service, so modifier 50 is not appropriate.
What documentation supports the segment count?
The operative report should identify the vertebral levels and state how many segments were resected. Do not use the number of fused or instrumented segments as a substitute.
How does the 90-day global affect postoperative reporting?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
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.
2,10322808,,Arthrd ant dfrm 2-3 vrt sgm,A,,26.82,17.22,NA,17.22,,8.49,52.53,52.53,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,10422810,,Arthrd ant dfrm 4-7 vrt sgm,A,,30.71,16.51,NA,16.51,,6.55,53.77,53.77,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,10522812,,Arthrd ant dfrm 8+ vrt sgm,A,,33.39,18.50,NA,18.50,,7.12,59.01,59.01,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,10622818,,Kyphectomy 1-2 segments,A,,33.47,16.63,NA,16.63,,7.14,57.24,57.24,0,090,0.11,0.76,0.13,2,0,2,2,2,9,,33.4009,09,0,99,0.00,0.00,0.00
2,10722819,,Kyphectomy 3 or more,A,,38.40,19.34,NA,19.34,,8.18,65.92,65.92,0,090,0.11,0.76,0.13,2,0,2,2,2,9,,33.4009,09,0,99,0.00,0.00,0.00
2,10822830,,Exploration of spinal fusion,A,,10.94,9.42,NA,9.42,,3.34,23.70,23.70,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,10922836,,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
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