No office rate
Both address anterior operative treatment of an odontoid fracture. Choose 22319 when graft is used; choose 22318 when it is not.
On this page
CMS RVU26D · Effective 2026-10-01
22318 Odontoid fixation Medicare reimbursement rates in Colorado
Report this operation for anterior surgical reduction and internal fixation of an odontoid fracture when no bone graft is used. Compare 22318 office and facility rates across CMS payment localities in Colorado.
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 22318 in Colorado?
Colorado 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
$1605.34
1 of 1 localities have a supported rate.
Payment area: Colorado
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.
Spine surgery
About 22318: Anterior fixation of odontoid fracture without graft
Report this operation for anterior surgical reduction and internal fixation of an odontoid fracture when no bone graft is used.
This operation treats a fracture of the odontoid, the upward-projecting portion of C2, through an anterior approach in the neck. The surgeon reduces the fracture and places internal fixation; bone graft is not used. It is typically performed by an orthopedic spine surgeon or neurosurgeon in an operating room for a fracture requiring operative stabilization.
Select this code when the operative report supports an odontoid fracture, an anterior approach, internal fixation, and no graft. The 90-day global period includes the day-before preoperative visit and related postoperative care during the following 90 days. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment and co-surgeon billing are permitted; team-surgery billing is not permitted.
CMS billing rules for 22318
- 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 RVU22.15 · 46%
- Practice expense (office) RVU17.52 · 36%
- Malpractice RVU8.97 · 18%
207
Medicare services in 2024 · #4293 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.
22318 compared with similar codes
Office rates for Colorado, from the same CMS release.
No office rate
This code is specific to anterior treatment of an odontoid fracture without graft. Code 22326 describes posterior treatment of a cervical spine fracture.
$349.90
22310 describes closed vertebral fracture treatment without manipulation. It does not represent the anterior operative reduction and fixation reported with 22318.
$1,028.22
22315 describes closed vertebral fracture treatment with manipulation; 22318 represents anterior surgery with internal fixation for an odontoid fracture.
Compare 22318 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
Colorado →
Office / nonfacility
Unavailable
Facility
$1605.34
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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 22318 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
2,064
- Code
- 22318
- Physician work
- 22.15
- Practice expense
- 17.52
- Malpractice
- 8.97
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 22.15 | × 1.012 | 22.4158 |
| Practice expense | 17.52 | × 1.064 | 18.6413 |
| Malpractice | 8.97 | × 0.781 | 7.0056 |
| Total RVUs | 48.0626 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Colorado$1605.34
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 22.15 | 1.012 |
| Practice expense | 17.52 | 1.064 |
| Malpractice | 8.97 | 0.781 |
(22.15 × 1.012 + 17.52 × 1.064 + 8.97 × 0.781) × $33.4009 = $1605.34
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.
22318 billing questions
When is 22318 chosen instead of 22319?
Use 22318 when the odontoid fracture is treated through an anterior approach with fixation and no graft. The grafted service is represented by 22319.
What operative details support reporting 22318?
Document the odontoid fracture, anterior surgical approach, reduction and internal fixation, and whether graft was used.
Is the day-before visit or routine postoperative care separately included?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures in that session are subject to the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment and co-surgeon billing are permitted for this code. Team-surgery billing is not permitted.
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.
2,06122226,,Osteot dsc ant 1vrt sgm ea,A,,5.88,1.93,NA,1.93,,1.76,9.57,9.57,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899