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CMS RVU26D · Effective 2026-10-01

22804 Spinal deformity fusion Medicare reimbursement rates in Alaska

Posterior fusion of 13 or more vertebral segments to correct a spinal deformity, such as extensive scoliosis or kyphosis. Compare 22804 office and facility rates across CMS payment localities in Alaska.

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 22804 in Alaska?

Alaska 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

$2720.29

1 of 1 localities have a supported rate.

Payment area: Alaska*

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.

Find 22804 in your payment locality →

Spinal surgery

About 22804: Posterior spinal deformity fusion, 13 or more segments

Posterior fusion of 13 or more vertebral segments to correct a spinal deformity, such as extensive scoliosis or kyphosis.

This code represents a posterior fusion spanning 13 or more vertebral segments to correct a spinal deformity, such as extensive scoliosis or kyphosis. An orthopedic spine surgeon or neurosurgeon typically performs the operation in a hospital operating room. The operative report should identify the posterior approach, the deformity being corrected, and the vertebral segments included in the fusion. Segment count is based on the vertebrae fused, not the number of screws or rods used.

Report this code when the documented posterior fusion reaches the 13-segment threshold; the shorter posterior deformity-fusion codes apply to smaller spans. Report spinal instrumentation separately when performed and supported by the operative details. The 90-day global includes the day-before preoperative visit and related care for 90 days after surgery. When multiple procedures occur in the same session, the highest-valued is paid in full and the others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeons require supporting documentation, and team surgery is not permitted.

CMS billing rules for 22804

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 paid only with supporting documentation.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU36.56 · 55%
  • Practice expense (office) RVU19.62 · 29%
  • Malpractice RVU10.36 · 16%

264

Medicare services in 2024 · #4091 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.

22804 compared with similar codes

Office rates for Alaska, from the same CMS release.

22800

Spinal fusion

Posterior, up to six segments

No office rate

22800 is the posterior deformity-fusion code for fewer than 6 vertebral segments; 22804 requires 13 or more.

22802

Spinal fusion

Posterior deformity, 7-12 segments

No office rate

22802 covers a posterior deformity fusion spanning 7 through 12 segments. The segment count must reach 13 for 22804.

22812

Anterior spinal fusion

Eight or more segments

No office rate

22812 describes anterior deformity fusion for 8 or more segments. Choose between it and 22804 based on the operative approach.

22844

Spinal fixation

Posterior, 13 or more segments

No office rate

22844 reports posterior segmental instrumentation for 13 or more segments, not the fusion itself; it may accompany 22804 when instrumentation is performed.

Compare 22804 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

Office and facility base rates · shared scale starting at $0
  • Alaska* →

    Office / nonfacility

    Unavailable

    Facility

    $2720.29

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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 22804 in Alaska*.

PPRRVU2026_Oct_nonQPP.csv

2,102

Code
22804
Physician work
36.56
Practice expense
19.62
Malpractice
10.36

GPCI2026.csv

5

Locality
Alaska*
Physician work
1.500
Practice expense
1.065
Malpractice
0.551
Facility calculation for 22804 in Alaska*
ComponentRVULocality factorAdjusted
Physician work36.56× 1.50054.8400
Practice expense19.62× 1.06520.8953
Malpractice10.36× 0.5515.7084
Total RVUs81.4437
Conversion factor× 33.4009

Facility rate, Alaska*$2720.29

Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work36.561.5
Practice expense19.621.065
Malpractice10.360.551

(36.56 × 1.5 + 19.62 × 1.065 + 10.36 × 0.551) × $33.4009 = $2720.29

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.

22804 billing questions

How is 22804 distinguished from 22802?

Use 22804 for posterior deformity fusion of 13 or more vertebral segments. Use 22802 when the posterior fusion spans 7 through 12 segments.

Does the fusion code include spinal instrumentation?

Instrumentation is reported separately when it is performed and supported by the operative documentation. For a posterior construct spanning 13 or more segments, 22844 may describe the instrumentation.

What documentation supports the segment count?

The operative report should state the posterior approach and identify the vertebral segments included in the fusion. Count the fused vertebral segments, not the implanted screws or rods.

How does the multiple-procedure rule affect payment?

For multiple procedures performed in the same session, the highest-valued procedure is paid in full and the others at 50%.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be available. Co-surgeons are paid only with supporting documentation; team surgery is not permitted.

What care is included in the global period?

The 90-day global includes the day-before preoperative visit and related postoperative care for 90 days after surgery.

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.

RVUs for 22804PPRRVU2026_Oct_nonQPP.csv, line 2,102 (RVU26D)
Geographic factors for Alaska*GPCI2026.csv, line 5 (RVU26D)