No office rate
Use 22595 for posterior C1-C2 arthrodesis. Use 22548 when the fusion is performed through an anterior transoral or transpharyngeal approach.
On this page
CMS RVU26D · Effective 2026-10-01
22548 C1-C2 fusion Medicare reimbursement rates in Alabama
Anterior transoral or transpharyngeal fusion of C1-C2 is reported for selected atlantoaxial disorders requiring stabilization, often with ventral decompression. Compare 22548 office and facility rates across CMS payment localities in Alabama.
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.
What does Medicare pay for 22548 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1695.71
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Spinal arthrodesis
About 22548: Anterior transoral C1-C2 fusion
Anterior transoral or transpharyngeal fusion of C1-C2 is reported for selected atlantoaxial disorders requiring stabilization, often with ventral decompression.
This code represents fusion of the atlas and axis through an approach via the mouth or pharynx. The surgeon may remove the odontoid process to relieve ventral compression before stabilizing the joint. Typical situations include odontoid-related compression of the upper spinal cord or brainstem and complex atlantoaxial instability. A neurosurgeon or orthopedic spine surgeon performs the operation in a hospital operating room; another surgeon may assist with exposure or participate as a co-surgeon.
Report the code when the operative documentation supports an anterior transoral or transpharyngeal C1-C2 arthrodesis. Document the indication, levels, approach, fusion work, and whether odontoidectomy was performed. This major surgery has a 90-day global period that 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 not appropriate for this single midline procedure. Assistant-at-surgery payment and co-surgeons are permitted; team surgery is not permitted.
CMS billing rules for 22548
- 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 RVU26.38 · 45%
- Practice expense (office) RVU20.66 · 36%
- Malpractice RVU11.15 · 19%
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.
22548 compared with similar codes
Office rates for Alabama, from the same CMS release.
No office rate
22590 describes posterior craniocervical arthrodesis, generally involving the occiput and upper cervical spine. 22548 is an anterior transoral or transpharyngeal C1-C2 fusion.
No office rate
22551 is anterior interbody fusion in the cervical spine with discectomy, typically at subaxial levels. It is not the transoral C1-C2 arthrodesis described by 22548.
Compare 22548 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
Unavailable
Facility
$1695.71
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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 22548 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
2,082
- Code
- 22548
- Physician work
- 26.38
- Practice expense
- 20.66
- Malpractice
- 11.15
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 26.38 | × 1.000 | 26.3800 |
| Practice expense | 20.66 | × 0.875 | 18.0775 |
| Malpractice | 11.15 | × 0.566 | 6.3109 |
| Total RVUs | 50.7684 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Alabama$1695.71
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 26.38 | 1 |
| Practice expense | 20.66 | 0.875 |
| Malpractice | 11.15 | 0.566 |
(26.38 × 1 + 20.66 × 0.875 + 11.15 × 0.566) × $33.4009 = $1695.71
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.
22548 billing questions
How does this differ from 22595?
22548 describes anterior fusion of C1-C2 through a transoral or transpharyngeal route. 22595 describes posterior fusion of the atlas and axis.
Is odontoidectomy separately represented by this code?
Odontoidectomy, when performed as part of the transoral or transpharyngeal C1-C2 arthrodesis, is included in this code. Document whether it was performed and the clinical indication.
Can an assistant or co-surgeon be reported?
CMS permits assistant-at-surgery payment and co-surgeons for this service. Team surgery is not permitted.
Does modifier 50 apply?
No. This is a midline C1-C2 procedure, and bilateral adjustment is not appropriate.
How does the 90-day global period affect follow-up billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. Separately report only services that are distinct from included care under applicable coding rules.
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.
2,07922532,,Arthrd lat xtrcvtry tq thrc,A,,25.34,17.77,NA,17.77,,8.75,51.86,51.86,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,08022533,,Arthrd lat xtrcvtry tq lmbr,A,,24.17,15.51,NA,15.51,,6.66,46.34,46.34,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,08122534,,Arthrd lat xtrcvtry tq ea ad,A,,5.84,1.94,NA,1.94,,1.91,9.69,9.69,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,08222548,,Arthrd ant toral/xoral c1-c2,A,,26.38,20.66,NA,20.66,,11.15,58.19,58.19,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,08322551,,Arthrd ant ntrbdy cervical,A,,24.38,15.43,NA,15.43,,8.24,48.05,48.05,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,08422552,,Arthrd ant ntrbd cervical ea,A,,6.34,2.13,NA,2.13,,2.10,10.57,10.57,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,08522554,,Arthrd ant ntrbd min dsc crv,A,,17.25,13.35,NA,13.35,,5.80,36.40,36.40,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515