No office rate
Use 22840 for posterior nonsegmental fixation; 22842 describes segmental posterior instrumentation across 3 to 6 vertebral segments.
On this page
CMS RVU26D · Effective 2026-10-01
22840 Spinal fixation Medicare reimbursement rates in Indiana
Reports posterior spinal fixation using a nonsegmental construct, typically as an add-on to a primary spinal procedure such as fusion. Compare 22840 office and facility rates across CMS payment localities in Indiana.
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 22840 in Indiana?
Indiana 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
$593.95
1 of 1 localities have a supported rate.
Payment area: Indiana
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 instrumentation
About 22840: Posterior nonsegmental spinal fixation
Reports posterior spinal fixation using a nonsegmental construct, typically as an add-on to a primary spinal procedure such as fusion.
This add-on represents posterior fixation that stabilizes the spine without segmental attachment at each vertebral level, such as a construct spanning one interspace. It may be used during instrumented spinal fusion or another primary spine operation when posterior stabilization is performed. Orthopedic spine surgeons and neurosurgeons commonly place this hardware in an operating room, including for cases involving spinal instability or deformity.
Report 22840 with the primary procedure performed in the same operative session; it is not a standalone service. The operative report should identify the posterior fixation method, the vertebral levels or interspace spanned, and how the construct differs from segmental fixation. CMS treats this as an add-on code: payment is made within the primary procedure’s global period. The segmental extent and fixation pattern help distinguish it from codes for longer posterior segmental constructs.
CMS billing rules for 22840
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU12.21 · 61%
- Practice expense (office) RVU4.04 · 20%
- Malpractice RVU3.76 · 19%
59.7K
Medicare services in 2024 · #716 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.
22840 compared with similar codes
Office rates for Indiana, from the same CMS release.
22841
No office rateInsert spine fixation device
22841 describes internal fixation by wiring spinous processes, while 22840 covers a nonsegmental posterior fixation construct.
No office rate
22845 describes anterior instrumentation across 2 to 3 vertebral segments. Choose based on the approach and instrumentation performed, not simply the number of levels fused.
No office rate
22853 covers placement of an interbody biomechanical device; 22840 covers posterior spinal fixation. Both may be relevant when both services are performed.
Compare 22840 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
Indiana →
Office / nonfacility
Unavailable
Facility
$593.95
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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 22840 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
2,112
- Code
- 22840
- Physician work
- 12.21
- Practice expense
- 4.04
- Malpractice
- 3.76
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 12.21 | × 1.000 | 12.2100 |
| Practice expense | 4.04 | × 0.927 | 3.7451 |
| Malpractice | 3.76 | × 0.486 | 1.8274 |
| Total RVUs | 17.7824 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Indiana$593.95
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 12.21 | 1 |
| Practice expense | 4.04 | 0.927 |
| Malpractice | 3.76 | 0.486 |
(12.21 × 1 + 4.04 × 0.927 + 3.76 × 0.486) × $33.4009 = $593.95
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.
22840 billing questions
How is 22840 distinguished from 22842?
22840 describes posterior nonsegmental fixation, such as a construct spanning one interspace. 22842 is for posterior segmental instrumentation across 3 to 6 vertebral segments.
Can 22840 be billed by itself?
No. It is an add-on code and must be reported with a primary procedure performed in the operative session.
Does 22840 include an interbody cage?
No. Posterior fixation and an interbody biomechanical device are different services. Code 22853 may be relevant when an interbody device is also placed.
What should the operative report document?
Document the posterior fixation method, the vertebral levels or interspace spanned, and whether fixation is nonsegmental rather than attached segmentally across multiple levels.
How does the add-on status affect Medicare payment?
CMS pays 22840 within the global period of the primary procedure. Report it only with that primary procedure.
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.
2,10922836,,Ant thrc vrt body tethrg <7,A,,31.20,16.33,NA,16.33,,6.64,54.17,54.17,0,090,0.10,0.69,0.21,2,0,0,2,1,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11022837,,Ant thrc vrt body tethrg 8+,A,,34.61,11.46,NA,11.46,,3.69,49.76,49.76,0,090,0.10,0.69,0.21,2,0,0,2,1,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11122838,,Rev rplc/rmv thrc vrt tethrg,A,,35.10,11.57,NA,11.57,,3.75,50.42,50.42,0,090,0.10,0.69,0.21,2,0,0,2,1,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11222840,,Insert spine fixation device,A,,12.21,4.04,NA,4.04,,3.76,20.01,20.01,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11322841,,Insert spine fixation device,B,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11422842,,Insert spine fixation device,A,,12.25,4.10,NA,4.10,,4.01,20.36,20.36,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11522843,,Insert spine fixation device,A,,13.10,4.40,NA,4.40,,4.31,21.81,21.81,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915