No office rate
Use 22595 for posterior fusion specifically at C1-C2. Code 22590 describes posterior fusion at the craniocervical junction.
On this page
CMS RVU26D · Effective 2026-10-01
22595 Cervical fusion Medicare reimbursement rates in Idaho
Reports posterior fusion of the atlas and axis to stabilize atlantoaxial instability, such as instability associated with trauma or structural disease. Compare 22595 office and facility rates across CMS payment localities in Idaho.
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 22595 in Idaho?
Idaho 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
$1318.36
1 of 1 localities have a supported rate.
Payment area: Idaho
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 surgery
About 22595: Posterior C1-C2 spinal fusion
Reports posterior fusion of the atlas and axis to stabilize atlantoaxial instability, such as instability associated with trauma or structural disease.
This service fuses the first and second cervical vertebrae through a posterior surgical approach. A spine surgeon prepares the C1-C2 surfaces for fusion and may use bone graft and fixation to stabilize the junction. Typical indications include atlantoaxial instability related to trauma, rheumatoid disease, or a congenital abnormality. The procedure is generally performed in an operating room rather than an office setting.
Select this code when the documented fusion is specifically at C1-C2 and performed posteriorly; record the approach, levels fused, indication, graft use, and any instrumentation. Report once for the C1-C2 fusion; modifier 50 is inappropriate. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple-procedure reduction. Assistant-at-surgery and co-surgeon payment may be allowed; team surgery is not permitted.
CMS billing rules for 22595
- 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 permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU20.12 · 45%
- Practice expense (office) RVU17.09 · 38%
- Malpractice RVU7.67 · 17%
2.6K
Medicare services in 2024 · #2257 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.
22595 compared with similar codes
Office rates for Idaho, from the same CMS release.
No office rate
Both address C1-C2 fusion, but 22548 is for an anterior transoral or transpharyngeal approach; 22595 is posterior.
No office rate
Code 22600 describes posterior or posterolateral cervical fusion at levels below C2. Use 22595 when the fused level is C1-C2.
Compare 22595 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
Idaho →
Office / nonfacility
Unavailable
Facility
$1318.36
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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 22595 in Idaho.
PPRRVU2026_Oct_nonQPP.csv
2,091
- Code
- 22595
- Physician work
- 20.12
- Practice expense
- 17.09
- Malpractice
- 7.67
GPCI2026.csv
47
- Locality
- Idaho
- Physician work
- 1.000
- Practice expense
- 0.920
- Malpractice
- 0.473
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 20.12 | × 1.000 | 20.1200 |
| Practice expense | 17.09 | × 0.920 | 15.7228 |
| Malpractice | 7.67 | × 0.473 | 3.6279 |
| Total RVUs | 39.4707 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Idaho$1318.36
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 20.12 | 1 |
| Practice expense | 17.09 | 0.92 |
| Malpractice | 7.67 | 0.473 |
(20.12 × 1 + 17.09 × 0.92 + 7.67 × 0.473) × $33.4009 = $1318.36
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.
22595 billing questions
How does this differ from 22590?
22595 is for posterior fusion at C1-C2. Code 22590 applies to posterior fusion at the craniocervical junction, rather than the atlas-axis level.
Can modifier 50 be used?
No. This is a single midline C1-C2 fusion service, and the CMS bilateral adjustment does not apply.
Is spinal instrumentation included?
The fusion code identifies the arthrodesis, not the instrumentation. When fixation is performed, report the applicable instrumentation code separately when supported by the operative record.
What documentation supports 22595?
Document the posterior approach, C1-C2 as the fused levels, the clinical indication, and the fusion work performed. Identify graft and instrumentation details when used.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. Medicare applies this period to the C1-C2 fusion service.
Can an assistant or co-surgeon be reported?
CMS permits payment for an assistant at surgery and permits co-surgeons for this service. Team surgery is not permitted.
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.
2,08822585,,Arthrd ant ntrbd min dsc ea,A,,5.38,1.62,NA,1.62,,1.61,8.61,8.61,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,08922586,,Arthrd pre-sac ntrbdy l5-s1,A,,27.42,21.11,NA,21.11,,11.59,60.12,60.12,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,09022590,,Arthrd pst tq craniocervical,A,,21.22,17.41,NA,17.41,,8.05,46.68,46.68,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,09122595,,Arthrd pst tq atlas-axis,A,,20.12,17.09,NA,17.09,,7.67,44.88,44.88,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,09222600,,Arthrd pst tq 1ntrspc crv,A,,16.97,15.37,NA,15.37,,6.07,38.41,38.41,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,09322610,,Arthrd pst tq 1ntrspc thrc,A,,16.85,14.96,NA,14.96,,5.78,37.59,37.59,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,09422612,,Arthrd pst tq 1ntrspc lumbar,A,,22.94,14.38,NA,14.38,,6.62,43.94,43.94,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772