No office rate
Use 22222 for the anterior thoracic osteotomy that includes discectomy. Use 22212 when the thoracic osteotomy is performed through a posterior or posterolateral approach.
On this page
CMS RVU26D · Effective 2026-10-01
22222 Spinal osteotomy Medicare reimbursement rates in Illinois
Reports an anterior thoracic spinal osteotomy with discectomy at one vertebral segment, typically performed to release a rigid deformity during reconstruction. Compare 22222 office and facility rates across CMS payment localities in Illinois.
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 22222 in Illinois?
Illinois has 4 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 4 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1891.56–$2193.96
4 of 4 localities have a supported rate.
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.
Where 22222 pays more and less in Illinois
Spine surgery
About 22222: Anterior thoracic spinal osteotomy, one segment
Reports an anterior thoracic spinal osteotomy with discectomy at one vertebral segment, typically performed to release a rigid deformity during reconstruction.
A spine surgeon uses an anterior approach to perform an osteotomy at one thoracic vertebral segment, including the discectomy associated with the release. The procedure may be part of reconstruction for a rigid thoracic deformity, such as scoliosis or kyphosis, when anterior release is needed to help mobilize the spine. It is generally performed in a hospital operating room with an anterior exposure of the thoracic spine.
Select this code when the documented work is an anterior osteotomy at a single thoracic segment. The operative report should establish the spinal region, anterior approach, segment treated, and osteotomy and discectomy performed. This major surgery has a 90-day global period that includes 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 other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this spinal segment service. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 22222
- 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 RVU22.51 · 42%
- Practice expense (office) RVU21.11 · 40%
- Malpractice RVU9.50 · 18%
23
Medicare services in 2024 · #5834 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.
22222 compared with similar codes
Office rates for Illinois, from the same CMS release.
No office rate
The approach and one-segment osteotomy are similar, but 22224 identifies the lumbar region; 22222 identifies the thoracic region.
No office rate
22222 reports the first qualifying thoracic segment. 22226 reports each additional segment and is used as an add-on.
No office rate
22206 describes a thoracic three-column osteotomy. Choose 22222 for the anterior osteotomy with discectomy at one thoracic segment.
Compare 22222 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.
4 of 4 payment localities
Chicago →
Office / nonfacility
Unavailable
Facility
$2193.96
East St. Louis →
Office / nonfacility
Unavailable
Facility
$2039.60
Rest Of Illinois →
Office / nonfacility
Unavailable
Facility
$1891.56
Suburban Chicago →
Office / nonfacility
Unavailable
Facility
$2043.52
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22222 billing questions
How does this differ from 22212?
22222 describes an anterior thoracic osteotomy that includes discectomy. 22212 is a thoracic osteotomy performed through a posterior or posterolateral approach.
Can the discectomy be billed separately?
The discectomy associated with this anterior osteotomy is included in the service. The operative report should document it as part of the osteotomy rather than treating it as a separate service.
When should 22226 be reported with 22222?
22226 is the add-on code for each additional vertebral segment treated with the qualifying anterior osteotomy. Report 22222 for the first thoracic segment and document the additional segment work.
Should modifier 50 be appended for bilateral thoracic work?
No. Modifier 50 is inappropriate because this code identifies a spinal segment, not paired anatomy.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and the service cannot be billed as team surgery.
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.
2,05622214,,Incis 1 vertebral seg lumbar,A,,20.49,16.58,NA,16.58,,6.17,43.24,43.24,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,05722216,,Incis addl spine segment,A,,5.88,1.95,NA,1.95,,1.77,9.60,9.60,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,05822220,,Osteot dsc ant 1 vrt sgm crv,A,,22.37,17.24,NA,17.24,,7.06,46.67,46.67,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,05922222,,Osteot dsc ant 1vrt sgm thrc,A,,22.51,21.11,NA,21.11,,9.50,53.12,53.12,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,06022224,,Osteot dsc ant 1vrt sgm lmbr,A,,22.51,16.07,NA,16.07,,5.74,44.32,44.32,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,06122226,,Osteot dsc ant 1vrt sgm ea,A,,5.88,1.93,NA,1.93,,1.76,9.57,9.57,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,06222310,,Closed tx vert fx w/o manj,A,,3.36,6.07,,4.58,,0.79,10.22,8.73,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00