No office rate
22325 reports the primary posterior open treatment of an initial lumbar segment; 22328 reports each additional segment treated during that operative service.
On this page
CMS RVU26D · Effective 2026-10-01
22328 Spine fracture treatment Medicare reimbursement rates in Colorado
Reports open posterior treatment of each additional vertebral segment affected by fracture or dislocation during an operation that treats an initial segment. Compare 22328 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 22328 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
$246.13
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 22328: Additional posterior vertebral fracture treatment
Reports open posterior treatment of each additional vertebral segment affected by fracture or dislocation during an operation that treats an initial segment.
This add-on represents open posterior treatment of an additional vertebral segment affected by fracture or dislocation during the same operative service as the first treated segment. The surgeon addresses the additional injured level through a posterior approach; internal fixation may be included when performed. The service is typically performed in a hospital operating room by an orthopedic spine surgeon or neurosurgeon.
Report 22328 with the applicable primary posterior open-treatment code for the initial cervical, thoracic, or lumbar segment: 22326, 22327, or 22325, respectively. It is not reported alone. Count additional vertebral segments actually treated, and document the injured levels, posterior approach, and treatment performed at each level. CMS identifies this as an add-on code paid within the primary procedure’s global period.
CMS billing rules for 22328
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU4.49 · 59%
- Practice expense (office) RVU1.51 · 20%
- Malpractice RVU1.56 · 21%
1.2K
Medicare services in 2024 · #2847 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.
22328 compared with similar codes
Office rates for Colorado, from the same CMS release.
No office rate
22326 is the primary code for an initial cervical segment. Use 22328 for additional treated segments, not in place of the primary code.
No office rate
22327 is the primary code for an initial thoracic segment; 22328 captures additional treated segments.
$349.90
22310 describes closed fracture treatment, whereas 22328 applies to an additional segment treated through the open posterior operative service.
Compare 22328 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
$246.13
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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 22328 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
2,069
- Code
- 22328
- Physician work
- 4.49
- Practice expense
- 1.51
- Malpractice
- 1.56
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.49 | × 1.012 | 4.5439 |
| Practice expense | 1.51 | × 1.064 | 1.6066 |
| Malpractice | 1.56 | × 0.781 | 1.2184 |
| Total RVUs | 7.3689 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Colorado$246.13
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.49 | 1.012 |
| Practice expense | 1.51 | 1.064 |
| Malpractice | 1.56 | 0.781 |
(4.49 × 1.012 + 1.51 × 1.064 + 1.56 × 0.781) × $33.4009 = $246.13
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.
22328 billing questions
Which primary code is reported with 22328?
Pair it with the primary posterior open-treatment code for the initial segment: 22325 for lumbar, 22326 for cervical, or 22327 for thoracic treatment.
Can 22328 be reported by itself?
No. It is an add-on for treatment of an additional vertebral segment and must be billed with the applicable primary procedure.
How many units should be reported?
Report each additional vertebral segment treated beyond the initial segment. The operative report should support the specific additional levels treated.
Does instrumentation alone support 22328?
No. The additional segment must undergo treatment for a fracture or dislocation; hardware placement alone does not describe the service.
What documentation supports the add-on?
Document the fracture or dislocation level, the posterior approach, and the treatment performed at each additional vertebral segment.
How does the global period affect payment?
CMS pays 22328 within the global period of the primary procedure. It is not a stand-alone 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.
2,06622325,,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
2,06922328,,Treat each add spine fx,A,,4.49,1.51,NA,1.51,,1.56,7.56,7.56,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,07022505,,Manipulation of spine,A,,1.82,2.00,NA,2.00,,0.78,4.60,4.60,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,07122510,,Perq cervicothoracic inject,A,,7.70,43.93,,2.61,,1.16,52.79,11.47,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,07222511,,Perq lumbosacral injection,A,,7.15,44.89,,2.60,,1.07,53.11,10.82,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,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