Billing code 22224: Spinal osteotomyMedicare rate & RVUs in Delaware
Reports an anterior osteotomy with disc removal at one lumbar vertebral segment to mobilize the spine, commonly during correction of a fixed deformity.
CMS doesn’t publish an office rate for 22224 in Delaware.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 22224 covers
A spine surgeon uses an anterior approach to remove disc and adjacent bone at one lumbar vertebral segment, creating mobility for correction of a fixed spinal deformity or alignment problem. This work may be part of a larger reconstruction that includes lumbar fusion. The code includes the discectomy integral to the osteotomy at that segment; it is not simply a code for routine disc removal or an interbody fusion.
Report one unit for the treated lumbar segment and document the operative level, anterior approach, bone and disc work, and its role in the correction. When osteotomy is performed at another segment, 22226 is the add-on code for each additional segment. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
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.
22224 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $1,458.28 |
How the 22224 rate is calculated
Each of 22224’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 22224
RVUs × geographic indexes × conversion factor
Work22.51
22.51 RVUs× 1.000 GPCI
Practice expense16.07
16.07 RVUs× 1.000 GPCI
Malpractice5.74
5.74 RVUs× 1.000 GPCI
Adjusted RVUs
44.3200
Conversion factor
$33.4009
Medicare rate
$1,480.33
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 22224
22224 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 22224
Spinal osteotomy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 22224
Spinal osteotomy
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
22224 without 51 · national facility
$1,480.33
Spinal osteotomy
22224-51 · Second procedure: 50%
$740.17
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
22224 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 22214Spine osteotomy
- Use 22224 for the anterior lumbar osteotomy; 22214 describes a single-segment lumbar osteotomy performed through a posterior or posterolateral approach.
- 22207Spinal osteotomy
- 22207 is for a posterior lumbar osteotomy involving three columns. 22224 describes the anterior approach at one lumbar segment.
- 22222Spinal osteotomy
- 22222 describes the corresponding anterior single-segment osteotomy in the thoracic spine; 22224 is for the lumbar spine.
- 22226Spinal osteotomy
- 22224 reports the primary lumbar segment. 22226 is an add-on for each additional qualifying segment, not a substitute for the primary code.
22224 billing questions
How is 22224 different from 22214?
22224 describes an anterior lumbar osteotomy. 22214 describes a posterior or posterolateral osteotomy at one lumbar segment.
When is 22226 reported with 22224?
Report 22226 for each additional vertebral segment treated with the qualifying anterior osteotomy. Document the separate additional level; do not use it for another service at the same segment.
Can the discectomy at the osteotomy level be billed separately?
Disc removal integral to the osteotomy at that segment is included in 22224. A separate discectomy code should not describe that same work.
Can 22224 be billed with a lumbar fusion code?
An osteotomy may be performed as part of a lumbar reconstruction that also includes fusion. Report the fusion service only when performed and separately supported by the operative record.
Should modifier 50 be used for a bilateral approach?
No. The code represents work at a lumbar vertebral segment, not a paired structure, so modifier 50 is inappropriate.
What supports assistant or co-surgeon reporting?
CMS allows assistant-at-surgery payment for this code. Co-surgeon payment requires supporting documentation; team surgery 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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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