Billing code 22548: C1-C2 fusionMedicare rate & RVUs in Georgia
Anterior transoral or transpharyngeal fusion of C1-C2 is reported for selected atlantoaxial disorders requiring stabilization, often with ventral decompression.
CMS doesn’t publish an office rate for 22548 in Georgia.
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 22548 covers
This code represents fusion of the atlas and axis through an approach via the mouth or pharynx. The surgeon may remove the odontoid process to relieve ventral compression before stabilizing the joint. Typical situations include odontoid-related compression of the upper spinal cord or brainstem and complex atlantoaxial instability. A neurosurgeon or orthopedic spine surgeon performs the operation in a hospital operating room; another surgeon may assist with exposure or participate as a co-surgeon.
Report the code when the operative documentation supports an anterior transoral or transpharyngeal C1-C2 arthrodesis. Document the indication, levels, approach, fusion work, and whether odontoidectomy was performed. This major surgery has a 90-day global period that includes 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 other procedures are subject to the standard 50% reduction. Modifier 50 is not appropriate for this single midline procedure. Assistant-at-surgery payment and co-surgeons are permitted; 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.
Where 22548 pays more and less in Georgia
| Payment locality | Office | Facility |
|---|---|---|
| Atlanta | Unavailable | $2,032.14 |
| Rest Of Georgia | Unavailable | $1,940.58 |
How the 22548 rate is calculated
Each of 22548’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 · 22548
RVUs × geographic indexes × conversion factor
Work26.38
26.38 RVUs× 1.000 GPCI
Practice expense20.66
20.66 RVUs× 1.000 GPCI
Malpractice11.15
11.15 RVUs× 1.000 GPCI
Adjusted RVUs
58.1900
Conversion factor
$33.4009
Medicare rate
$1,943.60
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 22548
22548 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 22548
C1-C2 fusion
| 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) | 2 | Permitted. |
| 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 · 22548
C1-C2 fusion
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
22548 without 51 · national facility
$1,943.60
C1-C2 fusion
22548-51 · Second procedure: 50%
$971.80
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%).
22548 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 22595Cervical fusion
- Use 22595 for posterior C1-C2 arthrodesis. Use 22548 when the fusion is performed through an anterior transoral or transpharyngeal approach.
- 22590Posterior fusion
- 22590 describes posterior craniocervical arthrodesis, generally involving the occiput and upper cervical spine. 22548 is an anterior transoral or transpharyngeal C1-C2 fusion.
- 22551ACDF
- 22551 is anterior interbody fusion in the cervical spine with discectomy, typically at subaxial levels. It is not the transoral C1-C2 arthrodesis described by 22548.
22548 billing questions
How does this differ from 22595?
22548 describes anterior fusion of C1-C2 through a transoral or transpharyngeal route. 22595 describes posterior fusion of the atlas and axis.
Is odontoidectomy separately represented by this code?
Odontoidectomy, when performed as part of the transoral or transpharyngeal C1-C2 arthrodesis, is included in this code. Document whether it was performed and the clinical indication.
Can an assistant or co-surgeon be reported?
CMS permits assistant-at-surgery payment and co-surgeons for this service. Team surgery is not permitted.
Does modifier 50 apply?
No. This is a midline C1-C2 procedure, and bilateral adjustment is not appropriate.
How does the 90-day global period affect follow-up billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. Separately report only services that are distinct from included care under applicable coding rules.
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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