No office rate
Both describe posterior operative treatment of vertebral fracture or dislocation; 22325 is for lumbar levels, while 22326 is for cervical levels.
On this page
CMS RVU26D · Effective 2026-10-01
22326 Spine fracture repair Medicare reimbursement rates in Delaware
Open posterior operative treatment of a cervical vertebral fracture or dislocation, reported when the surgeon reduces or treats the injured cervical segment or segments. Compare 22326 office and facility rates across CMS payment localities in Delaware.
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 22326 in Delaware?
Delaware 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
$1445.41
1 of 1 localities have a supported rate.
Payment area: Delaware
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 22326: Posterior cervical fracture treatment
Open posterior operative treatment of a cervical vertebral fracture or dislocation, reported when the surgeon reduces or treats the injured cervical segment or segments.
Code 22326 represents operative treatment or reduction of a cervical vertebral fracture or dislocation through a posterior approach. An orthopedic spine surgeon or neurosurgeon typically performs it in a hospital operating room for an injury requiring open surgical management. It is distinct from closed treatment using manipulation and external immobilization alone.
Report the operation with documentation identifying the cervical injury level or levels, posterior approach, and treatment or reduction performed. Use 22328 for each additional vertebral segment treated. The 90-day global includes the day-before preoperative visit and related postoperative care during the 90 days after surgery. For multiple procedures in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team-surgery payment is not permitted.
CMS billing rules for 22326
- 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 RVU20.32 · 46%
- Practice expense (office) RVU16.37 · 37%
- Malpractice RVU7.43 · 17%
2.3K
Medicare services in 2024 · #2370 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.
22326 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
22327 applies to thoracic levels. Use 22326 for cervical injuries treated through a posterior approach.
No office rate
22328 is an add-on for each additional vertebral segment treated; it is reported with the applicable primary-level code rather than instead of 22326.
No office rate
22318 is for open treatment of an odontoid fracture without graft. Code 22326 describes posterior operative treatment of cervical vertebral fracture or dislocation more broadly.
Compare 22326 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
Delaware →
Office / nonfacility
Unavailable
Facility
$1445.41
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 22326 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
2,067
- Code
- 22326
- Physician work
- 20.32
- Practice expense
- 16.37
- Malpractice
- 7.43
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 20.32 | × 1.005 | 20.4216 |
| Practice expense | 16.37 | × 0.988 | 16.1736 |
| Malpractice | 7.43 | × 0.899 | 6.6796 |
| Total RVUs | 43.2747 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$1445.41
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 20.32 | 1.005 |
| Practice expense | 16.37 | 0.988 |
| Malpractice | 7.43 | 0.899 |
(20.32 × 1.005 + 16.37 × 0.988 + 7.43 × 0.899) × $33.4009 = $1445.41
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.
22326 billing questions
How is 22326 different from 22325 or 22327?
22326 applies to posterior operative treatment of cervical vertebral injuries. Use 22325 for lumbar injuries and 22327 for thoracic injuries.
When should 22328 be reported with 22326?
Report 22328 for each additional vertebral segment treated beyond the segment represented by the primary procedure. Document the levels treated.
Is 22326 appropriate for closed treatment?
No. It represents open posterior operative treatment. Codes 22310 and 22315 describe closed vertebral fracture treatment, with the distinction based on whether manipulation is performed.
Does the 90-day global include postoperative visits?
Yes. Related postoperative care during the 90 days after surgery is included, along with the day-before preoperative visit.
Can modifier 50 be used for bilateral cervical treatment?
No. The anatomy and service descriptor make modifier 50 inappropriate for 22326.
What documentation supports 22326?
The operative report should identify the cervical fracture or dislocation, the treated level or levels, the posterior approach, and the operative treatment or reduction performed.
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.
2,06422318,,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
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
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
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503