No office rate
Both describe kyphectomy, but 22818 is for one or two segments; 22819 requires three or more.
On this page
CMS RVU26D · Effective 2026-10-01
22819 in Wyoming**
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$2130.75
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 22819: Kyphectomy, three or more segments
Reports kyphectomy involving resection across three or more vertebral segments during surgical correction of a kyphotic spinal deformity.
A kyphectomy removes vertebral portions within a kyphotic spinal deformity as part of surgical correction. CPT 22819 represents resection involving three or more vertebral segments. Orthopedic or neurosurgical spine surgeons typically perform the procedure in an operating room for a severe, fixed deformity. The operative report should describe the resection and identify its extent; fusion levels or instrumentation levels alone do not establish the segment count for this code.
Report this code when the documented kyphectomy meets the three-or-more-segment threshold, rather than the one- or two-segment threshold represented by 22818. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate because the descriptor and anatomy do not represent paired bilateral work. CMS permits payment for an assistant at surgery, co-surgeons, and team surgery.
CMS billing rules for 22819
- 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 RVU38.40 · 58%
- Practice expense (office) RVU19.34 · 29%
- Malpractice RVU8.18 · 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.
22819 compared with similar codes
Office rates for Wyoming**, from the same CMS release.
No office rate
22800 describes posterior arthrodesis for spinal deformity by fusion extent. It is not the kyphectomy resection code.
No office rate
22802 describes posterior deformity arthrodesis across its specified fusion-level range; 22819 is selected by the extent of kyphectomy resection.
No office rate
22804 is a posterior deformity arthrodesis code selected by fusion extent, not by the number of segments resected during kyphectomy.
The same code, a different location
How does Wyoming** compare?
22819 across payment areas
Same release and payment basis · bars start at $0
Wyoming** · 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 Wyoming 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 · 22819
Office
Unavailable
Facility
$2002.46
No comparable office rate is available.
Arkansas
Arkansas · 22819
Office
Unavailable
Facility
$1978.19
No comparable office rate is available.
Arizona
Arizona · 22819
Office
Unavailable
Facility
$2142.42
No comparable office rate is available.
Bakersfield
California · 22819
Office
Unavailable
Facility
$2181.34
No comparable office rate is available.
Chico
California · 22819
Office
Unavailable
Facility
$2158.83
No comparable office rate is available.
El Centro
California · 22819
Office
Unavailable
Facility
$2160.20
No comparable office rate is available.
Fresno
California · 22819
Office
Unavailable
Facility
$2158.83
No comparable office rate is available.
Hanford-Corcoran
California · 22819
Office
Unavailable
Facility
$2158.83
No comparable office rate is available.
Madera
California · 22819
Office
Unavailable
Facility
$2158.83
No comparable office rate is available.
Merced
California · 22819
Office
Unavailable
Facility
$2158.83
No comparable office rate is available.
Modesto
California · 22819
Office
Unavailable
Facility
$2158.83
No comparable office rate is available.
Napa
California · 22819
Office
Unavailable
Facility
$2353.59
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 22819
Office
Unavailable
Facility
$2252.26
No comparable office rate is available.
Redding
California · 22819
Office
Unavailable
Facility
$2158.83
No comparable office rate is available.
Rest Of California
California · 22819
Office
Unavailable
Facility
$2158.83
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 22819
Office
Unavailable
Facility
$2246.72
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 22819
Office
Unavailable
Facility
$2226.48
No comparable office rate is available.
Salinas
California · 22819
Office
Unavailable
Facility
$2217.48
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 22819
Office
Unavailable
Facility
$2241.74
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 22819
Office
Unavailable
Facility
$2440.67
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 22819
Office
Unavailable
Facility
$2431.38
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 22819
Office
Unavailable
Facility
$2501.62
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 22819
Office
Unavailable
Facility
$2463.64
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 22819
Office
Unavailable
Facility
$2186.61
No comparable office rate is available.
Santa Cruz-Watsonville
California · 22819
Office
Unavailable
Facility
$2240.83
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 22819
Office
Unavailable
Facility
$2218.16
No comparable office rate is available.
Santa Rosa-Petaluma
California · 22819
Office
Unavailable
Facility
$2260.77
No comparable office rate is available.
Stockton
California · 22819
Office
Unavailable
Facility
$2158.83
No comparable office rate is available.
Vallejo
California · 22819
Office
Unavailable
Facility
$2340.20
No comparable office rate is available.
Visalia
California · 22819
Office
Unavailable
Facility
$2158.83
No comparable office rate is available.
Yuba City
California · 22819
Office
Unavailable
Facility
$2158.83
No comparable office rate is available.
Colorado
Colorado · 22819
Office
Unavailable
Facility
$2198.69
No comparable office rate is available.
Connecticut
Connecticut · 22819
Office
Unavailable
Facility
$2334.56
No comparable office rate is available.
Delaware
Delaware · 22819
Office
Unavailable
Facility
$2172.85
No comparable office rate is available.
Fort Lauderdale
Florida · 22819
Office
Unavailable
Facility
$2430.95
No comparable office rate is available.
Rest Of Florida
Florida · 22819
Office
Unavailable
Facility
$2310.79
No comparable office rate is available.
Atlanta
Georgia · 22819
Office
Unavailable
Facility
$2270.89
No comparable office rate is available.
Rest Of Georgia
Georgia · 22819
Office
Unavailable
Facility
$2184.48
No comparable office rate is available.
Hawaii, Guam
Hawaii · 22819
Office
Unavailable
Facility
$2175.26
No comparable office rate is available.
Iowa
Iowa · 22819
Office
Unavailable
Facility
$1982.13
No comparable office rate is available.
Idaho
Idaho · 22819
Office
Unavailable
Facility
$2006.12
No comparable office rate is available.
East St. Louis
Illinois · 22819
Office
Unavailable
Facility
$2427.15
No comparable office rate is available.
Rest Of Illinois
Illinois · 22819
Office
Unavailable
Facility
$2299.41
No comparable office rate is available.
Suburban Chicago
Illinois · 22819
Office
Unavailable
Facility
$2439.13
No comparable office rate is available.
Indiana
Indiana · 22819
Office
Unavailable
Facility
$2014.20
No comparable office rate is available.
Kansas
Kansas · 22819
Office
Unavailable
Facility
$2004.26
No comparable office rate is available.
Kentucky
Kentucky · 22819
Office
Unavailable
Facility
$2106.86
No comparable office rate is available.
New Orleans
Louisiana · 22819
Office
Unavailable
Facility
$2200.83
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 22819
Office
Unavailable
Facility
$2116.03
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 22819
Office
Unavailable
Facility
$2349.64
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 22819
Office
Unavailable
Facility
$2201.08
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 22819
Office
Unavailable
Facility
$2334.22
No comparable office rate is available.
Rest Of Maryland
Maryland · 22819
Office
Unavailable
Facility
$2199.96
No comparable office rate is available.
Rest Of Maine
Maine · 22819
Office
Unavailable
Facility
$2046.83
No comparable office rate is available.
Southern Maine
Maine · 22819
Office
Unavailable
Facility
$2095.16
No comparable office rate is available.
Detroit
Michigan · 22819
Office
Unavailable
Facility
$2366.61
No comparable office rate is available.
Rest Of Michigan
Michigan · 22819
Office
Unavailable
Facility
$2180.83
No comparable office rate is available.
Minnesota
Minnesota · 22819
Office
Unavailable
Facility
$2028.17
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 22819
Office
Unavailable
Facility
$2156.10
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 22819
Office
Unavailable
Facility
$2171.33
No comparable office rate is available.
Rest Of Missouri
Missouri · 22819
Office
Unavailable
Facility
$2105.54
No comparable office rate is available.
Mississippi
Mississippi · 22819
Office
Unavailable
Facility
$2040.69
No comparable office rate is available.
Montana**
Montana · 22819
Office
Unavailable
Facility
$2201.24
No comparable office rate is available.
North Carolina
North Carolina · 22819
Office
Unavailable
Facility
$2059.87
No comparable office rate is available.
North Dakota**
North Dakota · 22819
Office
Unavailable
Facility
$2039.50
No comparable office rate is available.
Nebraska
Nebraska · 22819
Office
Unavailable
Facility
$1982.10
No comparable office rate is available.
New Hampshire
New Hampshire · 22819
Office
Unavailable
Facility
$2194.12
No comparable office rate is available.
Northern Nj
New Jersey · 22819
Office
Unavailable
Facility
$2404.53
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 22819
Office
Unavailable
Facility
$2339.02
No comparable office rate is available.
New Mexico
New Mexico · 22819
Office
Unavailable
Facility
$2203.09
No comparable office rate is available.
Nevada**
Nevada · 22819
Office
Unavailable
Facility
$2156.81
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 22819
Office
Unavailable
Facility
$2640.11
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 22819
Office
Unavailable
Facility
$2378.25
No comparable office rate is available.
Queens
New York · 22819
Office
Unavailable
Facility
$2522.20
No comparable office rate is available.
Rest Of New York
New York · 22819
Office
Unavailable
Facility
$2088.34
No comparable office rate is available.
Ohio
Ohio · 22819
Office
Unavailable
Facility
$2147.77
No comparable office rate is available.
Oklahoma
Oklahoma · 22819
Office
Unavailable
Facility
$2071.74
No comparable office rate is available.
Portland
Oregon · 22819
Office
Unavailable
Facility
$2224.07
No comparable office rate is available.
Rest Of Oregon
Oregon · 22819
Office
Unavailable
Facility
$2118.06
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 22819
Office
Unavailable
Facility
$2304.09
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 22819
Office
Unavailable
Facility
$2133.79
No comparable office rate is available.
Puerto Rico
Puerto Rico · 22819
Office
Unavailable
Facility
$2204.79
No comparable office rate is available.
Rhode Island
Rhode Island · 22819
Office
Unavailable
Facility
$2217.97
No comparable office rate is available.
South Carolina
South Carolina · 22819
Office
Unavailable
Facility
$2111.71
No comparable office rate is available.
South Dakota**
South Dakota · 22819
Office
Unavailable
Facility
$2020.37
No comparable office rate is available.
Tennessee
Tennessee · 22819
Office
Unavailable
Facility
$2016.50
No comparable office rate is available.
Austin
Texas · 22819
Office
Unavailable
Facility
$2210.67
No comparable office rate is available.
Beaumont
Texas · 22819
Office
Unavailable
Facility
$2124.25
No comparable office rate is available.
Brazoria
Texas · 22819
Office
Unavailable
Facility
$2146.13
No comparable office rate is available.
Dallas
Texas · 22819
Office
Unavailable
Facility
$2171.95
No comparable office rate is available.
Fort Worth
Texas · 22819
Office
Unavailable
Facility
$2169.04
No comparable office rate is available.
Galveston
Texas · 22819
Office
Unavailable
Facility
$2160.53
No comparable office rate is available.
Houston
Texas · 22819
Office
Unavailable
Facility
$2310.26
No comparable office rate is available.
Rest Of Texas
Texas · 22819
Office
Unavailable
Facility
$2142.34
No comparable office rate is available.
Utah
Utah · 22819
Office
Unavailable
Facility
$2135.16
No comparable office rate is available.
Virginia
Virginia · 22819
Office
Unavailable
Facility
$2110.48
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 22819
Office
Unavailable
Facility
$2204.79
No comparable office rate is available.
Vermont
Vermont · 22819
Office
Unavailable
Facility
$2060.36
No comparable office rate is available.
Rest Of Washington
Washington · 22819
Office
Unavailable
Facility
$2187.40
No comparable office rate is available.
Seattle (King Cnty)
Washington · 22819
Office
Unavailable
Facility
$2362.55
No comparable office rate is available.
Wisconsin
Wisconsin · 22819
Office
Unavailable
Facility
$1985.59
No comparable office rate is available.
West Virginia
West Virginia · 22819
Office
Unavailable
Facility
$2234.92
No comparable office rate is available.
See how rates vary across the country
22819 · 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?
Wyoming** is a Medicare payment area. Our Census mapping connects it to 205 cities and communities in Wyoming, 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 22819 in Wyoming**. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$2343.83
$2130.75 × 110% = $2343.83
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 22819 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
2,107
- Code
- 22819
- Physician work
- 38.40
- Practice expense
- 19.34
- Malpractice
- 8.18
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 38.40 | × 1.000 | 38.4000 |
| Practice expense | 19.34 | × 1.000 | 19.3400 |
| Malpractice | 8.18 | × 0.740 | 6.0532 |
| Total RVUs | 63.7932 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$2130.75
Open 22819 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 38.4 | 1 |
| Practice expense | 19.34 | 1 |
| Malpractice | 8.18 | 0.74 |
(38.4 × 1 + 19.34 × 1 + 8.18 × 0.74) × $33.4009 = $2130.75
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
22819 · 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 | $2130.75 | RVU26D |
| 2026-07-01 | Not available in this setting | $2130.75 | RVU26C |
| 2026-04-01 | Not available in this setting | $2130.75 | RVU26B |
| 2026-01-01 | Not available in this setting | $2130.75 | RVU26A |
| 2025-10-01 | Not available in this setting | $2347.44 | RVU25D |
| 2025-07-01 | Not available in this setting | $2347.44 | RVU25C |
| 2025-04-01 | Not available in this setting | $2347.44 | RVU25B |
| 2025-01-01 | Not available in this setting | $2347.44 | RVU25A |
22819 billing questions
How do I distinguish 22819 from 22818?
Use 22819 when the kyphectomy resects across three or more vertebral segments. Code 22818 is for resection across one or two segments.
Should I count fusion levels or instrumentation levels?
No. The threshold is based on the extent of the kyphectomy resection, as documented in the operative report—not the number of fused or instrumented levels.
Can a spinal arthrodesis be reported with 22819?
A separately performed posterior arthrodesis may be reported with the kyphectomy when the operative documentation supports both services. The multiple-procedure reduction may affect payment when procedures are performed in the same session.
Does modifier 50 belong on this code?
No. Modifier 50 is inappropriate for this descriptor and anatomy; the code represents the resection extent, not paired bilateral work.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be paid?
CMS permits payment for an assistant at surgery and permits co-surgeons and team surgery for this service.
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.
2,10422810,,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
2,11022837,,Ant thrc vrt body tethrg 8+,A,,34.61,11.46,NA,11.46,,3.69,49.76,49.76,0,090,0.10,0.69,0.21,2,0,0,2,1,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,