No office rate
Choose 22590 for posterior fusion spanning the craniocervical junction, generally occiput through C2; choose 22595 when the fusion is limited to C1-C2.
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CMS RVU26D · Effective 2026-10-01
22590 Posterior fusion Medicare reimbursement rates in Michigan
Reports posterior fusion across the craniocervical junction, typically stabilizing the occiput and upper cervical spine through C2. Compare 22590 office and facility rates across CMS payment localities in Michigan.
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 22590 in Michigan?
Michigan has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1543.25–$1723.25
2 of 2 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.
Spine surgery
About 22590: Posterior craniocervical fusion
Reports posterior fusion across the craniocervical junction, typically stabilizing the occiput and upper cervical spine through C2.
This service fuses the junction between the skull base and upper cervical spine using a posterior surgical approach, generally spanning the occiput through C2. Neurosurgeons and orthopedic spine surgeons perform it in an operating room to stabilize craniocervical instability or deformity, including cases related to trauma or congenital conditions. The operative report should make the posterior approach and fused levels clear; it should also describe graft and fixation work performed.
CMS 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 at 50%. Modifier 50 is inappropriate for this anatomy. Assistant-at-surgery and co-surgeon services may be paid; team surgery is not permitted. Report graft and instrumentation services separately when supported by the applicable coding requirements.
CMS billing rules for 22590
- 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 RVU21.22 · 45%
- Practice expense (office) RVU17.41 · 37%
- Malpractice RVU8.05 · 17%
1.1K
Medicare services in 2024 · #2896 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.
22590 compared with similar codes
Office rates for Michigan, from the same CMS release.
No office rate
22548 describes an anterior transoral or extraoral approach for C1-C2 fusion. This code is for posterior craniocervical fusion.
No office rate
22551 is an anterior cervical interbody fusion code for subaxial cervical levels, not a posterior fusion across the skull base and upper cervical spine.
Compare 22590 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.
2 of 2 payment localities
Detroit →
Office / nonfacility
Unavailable
Facility
$1723.25
Rest Of Michigan →
Office / nonfacility
Unavailable
Facility
$1543.25
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22590 billing questions
How is this code distinguished from 22595?
22590 describes posterior fusion across the craniocervical junction, generally occiput through C2. 22595 is for posterior fusion limited to the atlas and axis, C1-C2.
Can modifier 50 be used?
No. CMS identifies bilateral adjustment as inapplicable because the descriptor and anatomy make modifier 50 inappropriate.
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?
CMS permits payment for assistant-at-surgery and co-surgeon services for this code. Team surgery is not permitted.
How does the multiple-procedure rule affect payment?
For procedures performed in the same session, the highest-valued procedure is paid in full and other procedures are paid at 50%.
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.
2,08722558,,Arthrd ant ntrbd min dsc lum,A,,22.94,13.20,NA,13.20,,6.49,42.63,42.63,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,08822585,,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