Billing code 22325: Spine fractureMedicare rate & RVUs in Delaware
Open posterior surgery to reduce a lumbar vertebral fracture or dislocation is reported for operative treatment of one affected vertebral segment.
CMS doesn’t publish an office rate for 22325 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 22325 covers
This code describes open operative treatment of a fracture or dislocation involving one lumbar vertebra or segment through a posterior approach. The surgeon exposes the affected level and treats the injury directly; these procedures are commonly performed by orthopedic spine surgeons or neurosurgeons in a hospital operating room after traumatic spinal injury. The code is specific to the lumbar region, not cervical or thoracic levels.
Select the code based on the documented spinal region, operative approach, and number of treated segments. The operative report should identify the injured level or levels, the posterior approach, and the treatment performed. An additional treated vertebral segment may be reported with 22328 when supported. Medicare assigns a 90-day global period, including 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 others at 50%. 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.
22325 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $1,417.71 |
How the 22325 rate is calculated
Each of 22325’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 · 22325
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 19.37Practice expense 17.07Malpractice 6.80
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 22325
22325 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 22325
Spine fracture
| 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 · 22325
Spine fracture
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
22325 without 51 · national facility
$1,444.25
Spine fracture
22325-51 · Second procedure: 50%
$722.13
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%).
22325 compared with similar codes
Compare codes
22325 vs 22326 vs 22327 vs 22328 vs 22315: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 22326Spine fracture repair
- Use 22326 for the cervical region. This code describes posterior open treatment at a lumbar level.
- 22327Fracture treatment
- Use 22327 for the thoracic region. This code describes posterior open treatment at a lumbar level.
- 22328Spine fracture treatment
- 22328 reports each additional treated vertebral segment; this code reports the initial lumbar segment.
- 22315Vertebral fracture care
- 22315 is for closed treatment with manipulation. This code describes open posterior operative treatment.
22325 billing questions
How is this code distinguished from 22326 or 22327?
This code is for a lumbar vertebral fracture or dislocation treated through a posterior approach. Codes 22326 and 22327 describe the corresponding treatment in the cervical and thoracic regions.
When is 22328 reported with this procedure?
Report 22328 for each additional treated vertebral segment when the operative documentation supports treatment beyond the first segment.
Can this code be used for closed fracture treatment?
No. It describes open posterior operative treatment. Codes 22310 and 22315 are closed-treatment alternatives when their respective treatment circumstances are met.
What documentation supports reporting this code?
The operative report should establish the lumbar level, the fracture or dislocation treated, the posterior approach, and the number of treated segments.
How does Medicare handle multiple procedures in the same session?
The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple procedure reduction.
May an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. 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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