No office rate
Use 22846 when anterior fixation spans four to six vertebral segments. Use 22847 for seven to twelve.
On this page
CMS RVU26D · Effective 2026-10-01
22847 Spinal fixation Medicare reimbursement rates in Delaware
Reports anterior spinal fixation spanning seven to twelve vertebral segments, typically added to a long-segment fusion or other eligible primary spine procedure. Compare 22847 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 22847 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
$678.27
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 22847: Anterior spinal fixation, seven to twelve segments
Reports anterior spinal fixation spanning seven to twelve vertebral segments, typically added to a long-segment fusion or other eligible primary spine procedure.
This code represents placement of anterior fixation across seven to twelve vertebral segments. A spine surgeon may use a plate-and-screw construct or other anterior fixation to stabilize a long spinal reconstruction, often during multilevel fusion. The surgeon approaches the spine from the front, such as through the neck for cervical surgery or through the chest or abdomen for thoracic or lumbar surgery. The segment count is based on the vertebral levels instrumented, not the number of screws or implants used.
Report this code as an add-on with an eligible primary procedure; it is not billed by itself. The operative report should identify the anterior approach, the instrumented vertebral segments, and the fixation placed. Select this level when the construct spans seven through twelve vertebral segments, rather than the shorter ranges represented by 22845 or 22846. CMS treats payment as part of the primary procedure’s global period, so the add-on is paid within that period.
CMS billing rules for 22847
- 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 RVU13.44 · 65%
- Practice expense (office) RVU4.28 · 21%
- Malpractice RVU2.86 · 14%
30
Medicare services in 2024 · #5663 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.
22847 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
22845 is for anterior fixation across two to three vertebral segments; 22847 is for the longer seven-to-twelve-segment construct.
No office rate
Both codes represent segmental fixation over seven to twelve vertebral segments, but 22843 is for a posterior construct and 22847 for an anterior construct.
No office rate
22853 concerns an interbody biomechanical device, such as a cage placed in a disc space. 22847 represents anterior fixation spanning multiple vertebral segments.
Compare 22847 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
$678.27
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 22847 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
2,119
- Code
- 22847
- Physician work
- 13.44
- Practice expense
- 4.28
- Malpractice
- 2.86
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.44 | × 1.005 | 13.5072 |
| Practice expense | 4.28 | × 0.988 | 4.2286 |
| Malpractice | 2.86 | × 0.899 | 2.5711 |
| Total RVUs | 20.3070 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$678.27
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.44 | 1.005 |
| Practice expense | 4.28 | 0.988 |
| Malpractice | 2.86 | 0.899 |
(13.44 × 1.005 + 4.28 × 0.988 + 2.86 × 0.899) × $33.4009 = $678.27
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.
22847 billing questions
How is this code distinguished from 22846?
Count the vertebral segments instrumented. This code is for seven to twelve segments; 22846 covers the shorter four-to-six-segment range.
Can this code be reported by itself?
No. It is an add-on code and must be reported with an eligible primary procedure.
Does the number of screws determine the code level?
No. The level is selected by the number of vertebral segments instrumented, not by the number of screws or other fixation pieces.
What documentation supports reporting this code?
The operative report should establish the anterior approach, identify the vertebral segments spanned, and describe the fixation construct placed.
How does this differ from 22843?
22847 represents anterior fixation across seven to twelve segments. 22843 represents posterior segmental fixation across that segment range.
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.
2,11622844,,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
2,12122849,,Reinsert spinal fixation,A,,18.69,12.26,NA,12.26,,5.78,36.73,36.73,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,12222850,,Remove spine fixation device,A,,9.57,8.88,NA,8.88,,3.01,21.46,21.46,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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