No office rate
Choose 22852 for removal of posterior segmental instrumentation. 22850 describes removal of posterior nonsegmental instrumentation.
On this page
CMS RVU26D · Effective 2026-10-01
22852 Spinal hardware removal Medicare reimbursement rates in Guam
Reports surgical removal of posterior segmental spinal fixation hardware, such as a multilevel screw-and-rod construct, when the construct is taken out. Compare 22852 office and facility rates across CMS payment localities in Guam.
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 22852 in Guam?
Guam 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
$691.94
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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 22852: Posterior segmental spinal hardware removal
Reports surgical removal of posterior segmental spinal fixation hardware, such as a multilevel screw-and-rod construct, when the construct is taken out.
A spine surgeon typically reports this service when removing posterior segmental fixation hardware, such as screws and connecting rods spanning multiple vertebral segments. Removal may occur during revision surgery when hardware is no longer needed, is prominent or painful, or must be taken out as part of treatment for a hardware-related problem. The operative report should identify the posterior construct and document the work performed to remove it; the code is distinct from removal of posterior nonsegmental or anterior instrumentation.
Report the service for the removal performed, not as separate left- and right-sided procedures; modifier 50 is inappropriate. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When performed with other procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 22852
- 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 RVU9.14 · 44%
- Practice expense (office) RVU8.73 · 42%
- Malpractice RVU2.85 · 14%
4.8K
Medicare services in 2024 · #1903 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.
22852 compared with similar codes
Office rates for Guam, from the same CMS release.
No office rate
22855 describes removal of anterior instrumentation. 22852 is for posterior segmental instrumentation.
No office rate
22842 describes insertion of posterior segmental instrumentation across a specified span; 22852 reports removal of an existing segmental construct.
Compare 22852 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
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$691.94
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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 22852 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
2,123
- Code
- 22852
- Physician work
- 9.14
- Practice expense
- 8.73
- Malpractice
- 2.85
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.14 | × 1.000 | 9.1400 |
| Practice expense | 8.73 | × 1.137 | 9.9260 |
| Malpractice | 2.85 | × 0.579 | 1.6502 |
| Total RVUs | 20.7162 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$691.94
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.14 | 1 |
| Practice expense | 8.73 | 1.137 |
| Malpractice | 2.85 | 0.579 |
(9.14 × 1 + 8.73 × 1.137 + 2.85 × 0.579) × $33.4009 = $691.94
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.
22852 billing questions
How does 22852 differ from 22850?
22852 is for removal of posterior segmental instrumentation. 22850 is used for removal of posterior nonsegmental instrumentation.
Can 22852 be reported for anterior hardware removal?
No. 22852 describes removal of posterior segmental instrumentation; 22855 is the related code for anterior instrumentation removal.
Does 22852 include placement of replacement hardware?
No. It identifies removal of the existing posterior segmental construct. Any replacement or reinsertion must be supported by the operative record and coded under the applicable service code.
Should the removal be billed with modifier 50?
No. This is reported for the construct removed, not as separate right- and left-sided services, and modifier 50 is inappropriate.
What documentation supports 22852?
The operative report should identify the posterior segmental instrumentation and describe its removal. It should also make clear that the work was not removal of nonsegmental posterior or anterior instrumentation.
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.
2,12022848,,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
2,12322852,,Remove spine fixation device,A,,9.14,8.73,NA,8.73,,2.85,20.72,20.72,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,12422853,,Insj biomechanical device,A,,4.14,1.38,NA,1.38,,1.33,6.85,6.85,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,12522854,,Insj biomechanical device,A,,5.36,1.80,NA,1.80,,1.84,9.00,9.00,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,12622855,,Removal anterior instrmj,A,,15.46,11.10,NA,11.10,,4.90,31.46,31.46,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014