No office rate
Both codes describe anterior thoracic vertebral body tethering. Select 22836 for fewer than seven segments and 22837 for the larger extent.
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CMS RVU26D · Effective 2026-10-01
22836 Vertebral tethering Medicare reimbursement rates in Kansas
Reports anterior thoracic vertebral body tethering across fewer than seven vertebral segments, a growth-modulating operation most often used for selected scoliosis patients. Compare 22836 office and facility rates across CMS payment localities in Kansas.
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 22836 in Kansas?
Kansas 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
$1646.96
1 of 1 localities have a supported rate.
Payment area: Kansas
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 22836: Anterior thoracic vertebral body tethering
Reports anterior thoracic vertebral body tethering across fewer than seven vertebral segments, a growth-modulating operation most often used for selected scoliosis patients.
An orthopedic spine surgeon places anchors in thoracic vertebral bodies and connects them with a flexible tether to guide spinal growth and address scoliosis. The operation is generally considered for skeletally immature patients when continued growth can help correct the curve. Thoracoscopic access may be used, but the code includes that work when performed. The service is distinct from rigid spinal fixation or fusion instrumentation.
Select this code by the documented extent of tethering: it describes fewer than seven vertebral segments. The operative report should identify the thoracic levels treated and the tethering performed; do not select it solely from the diagnosis or approach. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in one 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 midline spinal procedure. Assistant-at-surgery payment requires documented medical necessity; co-surgeons are permitted, and team-surgery payment requires supporting documentation.
CMS billing rules for 22836
- 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons permitted.
- Team surgery
- Team surgery paid only with supporting documentation.
Where the value comes from
- Work RVU31.20 · 58%
- Practice expense (office) RVU16.33 · 30%
- Malpractice RVU6.64 · 12%
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.
22836 compared with similar codes
Office rates for Kansas, from the same CMS release.
No office rate
22838 addresses revision, replacement, or removal of thoracic vertebral tethering; 22836 reports the tethering operation itself.
No office rate
22845 describes anterior spinal instrumentation, a rigid fixation construct. Code 22836 describes flexible anterior thoracic tethering intended to guide growth.
Compare 22836 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
Kansas →
Office / nonfacility
Unavailable
Facility
$1646.96
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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 22836 in Kansas.
PPRRVU2026_Oct_nonQPP.csv
2,109
- Code
- 22836
- Physician work
- 31.20
- Practice expense
- 16.33
- Malpractice
- 6.64
GPCI2026.csv
54
- Locality
- Kansas
- Physician work
- 1.000
- Practice expense
- 0.904
- Malpractice
- 0.504
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 31.20 | × 1.000 | 31.2000 |
| Practice expense | 16.33 | × 0.904 | 14.7623 |
| Malpractice | 6.64 | × 0.504 | 3.3466 |
| Total RVUs | 49.3089 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kansas$1646.96
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 31.2 | 1 |
| Practice expense | 16.33 | 0.904 |
| Malpractice | 6.64 | 0.504 |
(31.2 × 1 + 16.33 × 0.904 + 6.64 × 0.504) × $33.4009 = $1646.96
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.
22836 billing questions
How do I distinguish this code from 22837?
Choose based on the documented number of vertebral segments tethered. Code 22836 is for fewer than seven segments; 22837 describes the larger extent.
Does this code include thoracoscopy?
Yes. Thoracoscopic access, when performed for the tethering procedure, is included in the service.
Can modifier 50 be reported?
No. Modifier 50 is inappropriate for this midline spinal procedure.
What documentation supports the segment selection?
The operative report should identify the thoracic vertebral levels treated and document the tethering performed, supporting the segment count reported.
When is assistant-at-surgery payment supported?
Payment for an assistant at surgery requires documentation of medical necessity. Co-surgeons are permitted, while team-surgery payment requires supporting documentation.
How does the 90-day global period affect postoperative visits?
The global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
2,10622818,,Kyphectomy 1-2 segments,A,,33.47,16.63,NA,16.63,,7.14,57.24,57.24,0,090,0.11,0.76,0.13,2,0,2,2,2,9,,33.4009,09,0,99,0.00,0.00,0.00
2,10722819,,Kyphectomy 3 or more,A,,38.40,19.34,NA,19.34,,8.18,65.92,65.92,0,090,0.11,0.76,0.13,2,0,2,2,2,9,,33.4009,09,0,99,0.00,0.00,0.00
2,10822830,,Exploration of spinal fusion,A,,10.94,9.42,NA,9.42,,3.34,23.70,23.70,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,10922836,,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
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
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958