No office rate
Use 22319 when graft is used in open odontoid-fracture treatment. Use 22318 for the corresponding open treatment without graft.
On this page
CMS RVU26D · Effective 2026-10-01
22319 in Merced
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$1723.13
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 22319: Odontoid fracture treatment with graft
Open surgical treatment of a C2 odontoid fracture with bone grafting, reported when the operative repair includes graft rather than treatment without graft.
This code describes open surgical treatment of an odontoid fracture—the dens portion of the C2 vertebra—with bone grafting. A spine surgeon, commonly an orthopedic spine surgeon or neurosurgeon, performs the operation in a hospital operating room. Reduction and stabilization may be part of the repair; internal fixation is included when performed. The graft distinguishes this service from odontoid-fracture treatment without graft.
Report the code when the operative record supports open treatment of an odontoid fracture and documents graft use. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, Medicare pays the highest-valued procedure in full and reduces others to 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available, co-surgeons are permitted, and team surgery is not permitted.
CMS billing rules for 22319
- 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 RVU24.70 · 46%
- Practice expense (office) RVU19.05 · 35%
- Malpractice RVU10.43 · 19%
24
Medicare services in 2024 · #5803 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.
22319 compared with similar codes
Office rates for Merced, from the same CMS release.
$350.48
22310 describes closed vertebral-fracture treatment without manipulation. 22319 is open treatment of an odontoid fracture with graft.
$1,027.99
22315 describes closed vertebral-fracture treatment with manipulation; it is not the open grafted odontoid repair represented by 22319.
No office rate
22326 is for open treatment of a cervical spine fracture, while 22319 specifically identifies open treatment of an odontoid fracture with graft.
The same code, a different location
How does Merced compare?
22319 across payment areas
Same release and payment basis · bars start at $0
Merced · 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.
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
Madera
California · 22319
Office
Unavailable
Facility
$1723.13
No comparable office rate is available.
Modesto
California · 22319
Office
Unavailable
Facility
$1723.13
No comparable office rate is available.
Napa
California · 22319
Office
Unavailable
Facility
$1892.58
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 22319
Office
Unavailable
Facility
$1817.23
No comparable office rate is available.
Redding
California · 22319
Office
Unavailable
Facility
$1723.13
No comparable office rate is available.
Rest Of California
California · 22319
Office
Unavailable
Facility
$1723.13
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 22319
Office
Unavailable
Facility
$1834.38
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 22319
Office
Unavailable
Facility
$1781.43
No comparable office rate is available.
Salinas
California · 22319
Office
Unavailable
Facility
$1774.76
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 22319
Office
Unavailable
Facility
$1799.57
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 22319
Office
Unavailable
Facility
$1960.44
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 22319
Office
Unavailable
Facility
$1948.60
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 22319
Office
Unavailable
Facility
$2020.01
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 22319
Office
Unavailable
Facility
$1971.58
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 22319
Office
Unavailable
Facility
$1750.49
No comparable office rate is available.
Santa Cruz-Watsonville
California · 22319
Office
Unavailable
Facility
$1802.14
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 22319
Office
Unavailable
Facility
$1776.74
No comparable office rate is available.
Santa Rosa-Petaluma
California · 22319
Office
Unavailable
Facility
$1817.84
No comparable office rate is available.
Stockton
California · 22319
Office
Unavailable
Facility
$1723.13
No comparable office rate is available.
Vallejo
California · 22319
Office
Unavailable
Facility
$1875.51
No comparable office rate is available.
Visalia
California · 22319
Office
Unavailable
Facility
$1723.13
No comparable office rate is available.
Yuba City
California · 22319
Office
Unavailable
Facility
$1723.13
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 22319
Office
Unavailable
Facility
$2006.84
No comparable office rate is available.
Miami
Florida · 22319
Office
Unavailable
Facility
$2368.41
No comparable office rate is available.
Chicago
Illinois · 22319
Office
Unavailable
Facility
$2269.76
No comparable office rate is available.
Manhattan
New York · 22319
Office
Unavailable
Facility
$2169.69
No comparable office rate is available.
Alaska*
Alaska · 22319
Office
Unavailable
Facility
$2107.10
No comparable office rate is available.
Alabama
Alabama · 22319
Office
Unavailable
Facility
$1578.93
No comparable office rate is available.
Arkansas
Arkansas · 22319
Office
Unavailable
Facility
$1550.98
No comparable office rate is available.
Arizona
Arizona · 22319
Office
Unavailable
Facility
$1739.77
No comparable office rate is available.
Colorado
Colorado · 22319
Office
Unavailable
Facility
$1783.99
No comparable office rate is available.
Connecticut
Connecticut · 22319
Office
Unavailable
Facility
$1948.31
No comparable office rate is available.
Delaware
Delaware · 22319
Office
Unavailable
Facility
$1770.96
No comparable office rate is available.
Fort Lauderdale
Florida · 22319
Office
Unavailable
Facility
$2099.42
No comparable office rate is available.
Rest Of Florida
Florida · 22319
Office
Unavailable
Facility
$1956.89
No comparable office rate is available.
Atlanta
Georgia · 22319
Office
Unavailable
Facility
$1892.34
No comparable office rate is available.
Rest Of Georgia
Georgia · 22319
Office
Unavailable
Facility
$1807.83
No comparable office rate is available.
Hawaii, Guam
Hawaii · 22319
Office
Unavailable
Facility
$1750.17
No comparable office rate is available.
Iowa
Iowa · 22319
Office
Unavailable
Facility
$1545.51
No comparable office rate is available.
Idaho
Idaho · 22319
Office
Unavailable
Facility
$1575.17
No comparable office rate is available.
East St. Louis
Illinois · 22319
Office
Unavailable
Facility
$2112.01
No comparable office rate is available.
Rest Of Illinois
Illinois · 22319
Office
Unavailable
Facility
$1950.44
No comparable office rate is available.
Suburban Chicago
Illinois · 22319
Office
Unavailable
Facility
$2101.56
No comparable office rate is available.
Indiana
Indiana · 22319
Office
Unavailable
Facility
$1584.15
No comparable office rate is available.
Kansas
Kansas · 22319
Office
Unavailable
Facility
$1575.78
No comparable office rate is available.
Kentucky
Kentucky · 22319
Office
Unavailable
Facility
$1709.42
No comparable office rate is available.
New Orleans
Louisiana · 22319
Office
Unavailable
Facility
$1819.50
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 22319
Office
Unavailable
Facility
$1721.86
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 22319
Office
Unavailable
Facility
$1928.60
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 22319
Office
Unavailable
Facility
$1785.86
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 22319
Office
Unavailable
Facility
$1951.87
No comparable office rate is available.
Rest Of Maryland
Maryland · 22319
Office
Unavailable
Facility
$1796.98
No comparable office rate is available.
Rest Of Maine
Maine · 22319
Office
Unavailable
Facility
$1627.07
No comparable office rate is available.
Southern Maine
Maine · 22319
Office
Unavailable
Facility
$1675.39
No comparable office rate is available.
Detroit
Michigan · 22319
Office
Unavailable
Facility
$2026.37
No comparable office rate is available.
Rest Of Michigan
Michigan · 22319
Office
Unavailable
Facility
$1799.24
No comparable office rate is available.
Minnesota
Minnesota · 22319
Office
Unavailable
Facility
$1582.86
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 22319
Office
Unavailable
Facility
$1762.83
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 22319
Office
Unavailable
Facility
$1779.82
No comparable office rate is available.
Rest Of Missouri
Missouri · 22319
Office
Unavailable
Facility
$1712.80
No comparable office rate is available.
Mississippi
Mississippi · 22319
Office
Unavailable
Facility
$1630.29
No comparable office rate is available.
Montana**
Montana · 22319
Office
Unavailable
Facility
$1808.96
No comparable office rate is available.
North Carolina
North Carolina · 22319
Office
Unavailable
Facility
$1641.27
No comparable office rate is available.
North Dakota**
North Dakota · 22319
Office
Unavailable
Facility
$1602.73
No comparable office rate is available.
Nebraska
Nebraska · 22319
Office
Unavailable
Facility
$1543.98
No comparable office rate is available.
New Hampshire
New Hampshire · 22319
Office
Unavailable
Facility
$1792.20
No comparable office rate is available.
Northern Nj
New Jersey · 22319
Office
Unavailable
Facility
$1987.13
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 22319
Office
Unavailable
Facility
$1934.99
No comparable office rate is available.
New Mexico
New Mexico · 22319
Office
Unavailable
Facility
$1826.87
No comparable office rate is available.
Nevada**
Nevada · 22319
Office
Unavailable
Facility
$1752.12
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 22319
Office
Unavailable
Facility
$2281.27
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 22319
Office
Unavailable
Facility
$1980.39
No comparable office rate is available.
Queens
New York · 22319
Office
Unavailable
Facility
$2132.25
No comparable office rate is available.
Rest Of New York
New York · 22319
Office
Unavailable
Facility
$1674.38
No comparable office rate is available.
Ohio
Ohio · 22319
Office
Unavailable
Facility
$1757.09
No comparable office rate is available.
Oklahoma
Oklahoma · 22319
Office
Unavailable
Facility
$1663.89
No comparable office rate is available.
Portland
Oregon · 22319
Office
Unavailable
Facility
$1804.31
No comparable office rate is available.
Rest Of Oregon
Oregon · 22319
Office
Unavailable
Facility
$1703.65
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 22319
Office
Unavailable
Facility
$1917.83
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 22319
Office
Unavailable
Facility
$1738.32
No comparable office rate is available.
Puerto Rico
Puerto Rico · 22319
Office
Unavailable
Facility
$1811.43
No comparable office rate is available.
Rhode Island
Rhode Island · 22319
Office
Unavailable
Facility
$1808.71
No comparable office rate is available.
South Carolina
South Carolina · 22319
Office
Unavailable
Facility
$1709.05
No comparable office rate is available.
South Dakota**
South Dakota · 22319
Office
Unavailable
Facility
$1578.34
No comparable office rate is available.
Tennessee
Tennessee · 22319
Office
Unavailable
Facility
$1590.46
No comparable office rate is available.
Austin
Texas · 22319
Office
Unavailable
Facility
$1808.50
No comparable office rate is available.
Beaumont
Texas · 22319
Office
Unavailable
Facility
$1727.66
No comparable office rate is available.
Brazoria
Texas · 22319
Office
Unavailable
Facility
$1733.89
No comparable office rate is available.
Dallas
Texas · 22319
Office
Unavailable
Facility
$1765.07
No comparable office rate is available.
Fort Worth
Texas · 22319
Office
Unavailable
Facility
$1763.24
No comparable office rate is available.
Galveston
Texas · 22319
Office
Unavailable
Facility
$1751.89
No comparable office rate is available.
Houston
Texas · 22319
Office
Unavailable
Facility
$1942.79
No comparable office rate is available.
Rest Of Texas
Texas · 22319
Office
Unavailable
Facility
$1743.42
No comparable office rate is available.
Utah
Utah · 22319
Office
Unavailable
Facility
$1735.95
No comparable office rate is available.
Virginia
Virginia · 22319
Office
Unavailable
Facility
$1696.42
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 22319
Office
Unavailable
Facility
$1811.43
No comparable office rate is available.
Vermont
Vermont · 22319
Office
Unavailable
Facility
$1631.20
No comparable office rate is available.
Rest Of Washington
Washington · 22319
Office
Unavailable
Facility
$1770.85
No comparable office rate is available.
Seattle (King Cnty)
Washington · 22319
Office
Unavailable
Facility
$1931.60
No comparable office rate is available.
Wisconsin
Wisconsin · 22319
Office
Unavailable
Facility
$1541.86
No comparable office rate is available.
West Virginia
West Virginia · 22319
Office
Unavailable
Facility
$1876.46
No comparable office rate is available.
Wyoming**
Wyoming · 22319
Office
Unavailable
Facility
$1719.08
No comparable office rate is available.
See how rates vary across the country
22319 · 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?
Merced is a Medicare payment area. Our Census mapping connects it to 24 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 22319 in Merced. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$1895.44
$1723.13 × 110% = $1895.44
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 22319 in Merced.
PPRRVU2026_Oct_nonQPP.csv
2,065
- Code
- 22319
- Physician work
- 24.70
- Practice expense
- 19.05
- Malpractice
- 10.43
GPCI2026.csv
15
- Locality
- Merced
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 24.70 | × 1.017 | 25.1199 |
| Practice expense | 19.05 | × 1.096 | 20.8788 |
| Malpractice | 10.43 | × 0.536 | 5.5905 |
| Total RVUs | 51.5892 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Merced$1723.13
Open 22319 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 24.7 | 1.017 |
| Practice expense | 19.05 | 1.096 |
| Malpractice | 10.43 | 0.536 |
(24.7 × 1.017 + 19.05 × 1.096 + 10.43 × 0.536) × $33.4009 = $1723.13
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
22319 · 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 | $1723.13 | RVU26D |
| 2026-07-01 | Not available in this setting | $1723.13 | RVU26C |
| 2026-04-01 | Not available in this setting | $1723.13 | RVU26B |
| 2026-01-01 | Not available in this setting | $1723.30 | RVU26A |
| 2025-10-01 | Not available in this setting | $1741.15 | RVU25D |
| 2025-07-01 | Not available in this setting | $1741.15 | RVU25C |
| 2025-04-01 | Not available in this setting | $1741.15 | RVU25B |
| 2025-01-01 | Not available in this setting | $1741.15 | RVU25A |
22319 billing questions
How is this code distinguished from 22318?
Both describe open treatment of an odontoid fracture. Choose 22319 when the operative record documents graft use; 22318 is the corresponding treatment without graft.
What documentation supports reporting 22319?
The operative report should identify the odontoid fracture, describe the open treatment, and document that bone graft was used. It should also describe the repair and any fixation performed.
Is internal fixation separately represented by this code?
Internal fixation, when performed as part of the odontoid-fracture repair, is included in the service. The defining distinction from 22318 is use of graft.
Can modifier 50 be reported?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate for the odontoid-fracture service.
How are assistant and co-surgeon claims handled?
CMS permits payment for an assistant at surgery and permits co-surgeons. Team surgery is not permitted for this code.
What happens when other procedures are performed in the same session?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. Related postoperative care is included in this code's 90-day 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.
2,06222310,,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
2,06822327,,Treat thorax spine fracture,A,,20.25,17.55,NA,17.55,,7.21,45.01,45.01,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
1401112,CA,58,MADERA,1.017,1.096,0.536
1501112,CA,59,MERCED,1.017,1.096,0.536
1601112,CA,60,MODESTO,1.017,1.096,0.536
1701112,CA,51,NAPA,1.063,1.318,0.508
1801182,CA,17,OXNARD-THOUSAND OAKS-VENTURA,1.028,1.182,0.623