No office rate
Both describe anterior fixation, but 22846 is selected for four to seven vertebral segments rather than two or three.
On this page
CMS RVU26D · Effective 2026-10-01
22845 Anterior fixation Medicare reimbursement rates in Delaware
Reports anterior spinal fixation spanning two or three vertebral segments during a qualifying spine operation, such as fusion with an anterior plate. Compare 22845 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 22845 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
$635.04
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.
Spinal instrumentation
About 22845: Anterior spinal instrumentation, two to three segments
Reports anterior spinal fixation spanning two or three vertebral segments during a qualifying spine operation, such as fusion with an anterior plate.
22845 reports placement of anterior spinal fixation across two or three vertebral segments as part of a spine operation. A common example is an anterior cervical plate secured with screws across the operative vertebrae during cervical fusion; anterior fixation may also be used with thoracic or lumbar procedures. The work is typically performed by an orthopedic spine surgeon or neurosurgeon in an operating room. This code represents supplemental stabilization, not an interbody cage or the fusion itself.
Select the code based on the vertebral segments actually instrumented, not simply the number of disc spaces treated. The operative report should identify the anterior approach, device placement, segments spanned, and associated primary procedure. 22845 is an add-on code: report it only with an eligible primary procedure, and Medicare payment is handled within that procedure’s global period. It is not a standalone service. For fixation spanning more segments, use the applicable higher segment-count code when supported by the operative details.
CMS billing rules for 22845
- 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 RVU11.64 · 60%
- Practice expense (office) RVU3.90 · 20%
- Malpractice RVU3.85 · 20%
42.5K
Medicare services in 2024 · #844 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.
22845 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
22847 describes anterior fixation spanning eight or more vertebral segments; 22845 is limited to two or three.
No office rate
22842 describes posterior segmental fixation. Choose based on the documented approach and construct, not simply because the same fusion was performed.
No office rate
22853 describes an interbody biomechanical device placed in a disc space; 22845 describes anterior spinal fixation across vertebral segments.
Compare 22845 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
$635.04
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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 22845 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
2,117
- Code
- 22845
- Physician work
- 11.64
- Practice expense
- 3.90
- Malpractice
- 3.85
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 11.64 | × 1.005 | 11.6982 |
| Practice expense | 3.90 | × 0.988 | 3.8532 |
| Malpractice | 3.85 | × 0.899 | 3.4611 |
| Total RVUs | 19.0125 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$635.04
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 11.64 | 1.005 |
| Practice expense | 3.9 | 0.988 |
| Malpractice | 3.85 | 0.899 |
(11.64 × 1.005 + 3.9 × 0.988 + 3.85 × 0.899) × $33.4009 = $635.04
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.
22845 billing questions
How is 22845 distinguished from 22846?
22845 is for anterior fixation spanning two or three vertebral segments. 22846 applies when the anterior fixation spans four to seven segments.
Can 22845 be billed by itself?
No. It is an add-on code and must be reported with an eligible primary procedure; Medicare payment is handled within that procedure’s global period.
What documentation supports the segment count?
The operative report should describe the anterior fixation device and identify the vertebral segments it spans. Count the instrumented segments rather than assuming the count from the number of treated disc spaces.
Is an interbody cage reported with 22845?
The codes describe different work: 22845 represents anterior fixation, while 22853 describes placement of an interbody biomechanical device. They may be reported for distinct work in the same fusion operation when documented.
Does 22845 describe the fusion itself?
No. It describes supplemental anterior stabilization. Report the applicable primary fusion or other procedure separately.
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.
2,11422842,,Insert spine fixation device,A,,12.25,4.10,NA,4.10,,4.01,20.36,20.36,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11522843,,Insert spine fixation device,A,,13.10,4.40,NA,4.40,,4.31,21.81,21.81,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11622844,,Insert spine fixation device,A,,16.01,5.32,NA,5.32,,4.87,26.20,26.20,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11722845,,Insert spine fixation device,A,,11.64,3.90,NA,3.90,,3.85,19.39,19.39,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11822846,,Insert spine fixation device,A,,12.09,4.06,NA,4.06,,4.01,20.16,20.16,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11922847,,Insert spine fixation device,A,,13.44,4.28,NA,4.28,,2.86,20.58,20.58,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,12022848,,Insert pelv fixation device,A,,5.84,1.93,NA,1.93,,1.74,9.51,9.51,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,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