Billing code 22326: Spine fracture repairMedicare rate & RVUs in Indiana
Open posterior operative treatment of a cervical vertebral fracture or dislocation, reported when the surgeon reduces or treats the injured cervical segment or segments.
CMS doesn’t publish an office rate for 22326 in Indiana.
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 22326 covers
Code 22326 represents operative treatment or reduction of a cervical vertebral fracture or dislocation through a posterior approach. An orthopedic spine surgeon or neurosurgeon typically performs it in a hospital operating room for an injury requiring open surgical management. It is distinct from closed treatment using manipulation and external immobilization alone.
Report the operation with documentation identifying the cervical injury level or levels, posterior approach, and treatment or reduction performed. Use 22328 for each additional vertebral segment treated. The 90-day global includes the day-before preoperative visit and related postoperative care during the 90 days after surgery. For multiple procedures in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team-surgery payment 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.
22326 in Indiana
| Payment locality | Office | Facility |
|---|---|---|
| Indiana | Unavailable | $1,306.17 |
How the 22326 rate is calculated
Each of 22326’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 · 22326
RVUs × geographic indexes × conversion factor
Work20.32
20.32 RVUs× 1.000 GPCI
Practice expense16.37
16.37 RVUs× 1.000 GPCI
Malpractice7.43
7.43 RVUs× 1.000 GPCI
Adjusted RVUs
44.1200
Conversion factor
$33.4009
Medicare rate
$1,473.65
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 22326
22326 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 22326
Spine fracture repair
| 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) | 1 | Permitted with supporting documentation. |
| 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 · 22326
Spine fracture repair
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
22326 without 51 · national facility
$1,473.65
Spine fracture repair
22326-51 · Second procedure: 50%
$736.83
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%).
22326 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 22325Spine fracture
- Both describe posterior operative treatment of vertebral fracture or dislocation; 22325 is for lumbar levels, while 22326 is for cervical levels.
- 22327Fracture treatment
- 22327 applies to thoracic levels. Use 22326 for cervical injuries treated through a posterior approach.
- 22328Spine fracture treatment
- 22328 is an add-on for each additional vertebral segment treated; it is reported with the applicable primary-level code rather than instead of 22326.
- 22318Odontoid fixation
- 22318 is for open treatment of an odontoid fracture without graft. Code 22326 describes posterior operative treatment of cervical vertebral fracture or dislocation more broadly.
22326 billing questions
How is 22326 different from 22325 or 22327?
22326 applies to posterior operative treatment of cervical vertebral injuries. Use 22325 for lumbar injuries and 22327 for thoracic injuries.
When should 22328 be reported with 22326?
Report 22328 for each additional vertebral segment treated beyond the segment represented by the primary procedure. Document the levels treated.
Is 22326 appropriate for closed treatment?
No. It represents open posterior operative treatment. Codes 22310 and 22315 describe closed vertebral fracture treatment, with the distinction based on whether manipulation is performed.
Does the 90-day global include postoperative visits?
Yes. Related postoperative care during the 90 days after surgery is included, along with the day-before preoperative visit.
Can modifier 50 be used for bilateral cervical treatment?
No. The anatomy and service descriptor make modifier 50 inappropriate for 22326.
What documentation supports 22326?
The operative report should identify the cervical fracture or dislocation, the treated level or levels, the posterior approach, and the operative treatment or reduction performed.
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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