No office rate
22612 represents posterior or posterolateral lumbar fusion without an interbody fusion technique. Choose 22630 when the surgeon also fuses through the prepared disc space.
On this page
CMS RVU26D · Effective 2026-10-01
22630 Lumbar fusion Medicare reimbursement rates in Missouri
Report 22630 for a single-level lumbar posterior interbody fusion, joining adjacent vertebrae after posterior disc-space preparation and graft placement. Compare 22630 office and facility rates across CMS payment localities in Missouri.
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 22630 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1431.01–$1485.90
3 of 3 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 22630 pays more and less in Missouri
Spinal surgery
About 22630: Lumbar posterior interbody fusion, single level
Report 22630 for a single-level lumbar posterior interbody fusion, joining adjacent vertebrae after posterior disc-space preparation and graft placement.
A spine surgeon performs a posterior approach to fuse one lumbar interspace by preparing the disc space and placing bone graft between adjacent vertebral bodies. The work includes the laminectomy and/or discectomy needed to prepare the interspace for fusion, but not when performed solely as a separate decompression. This procedure is typically performed in a hospital operating room for conditions such as lumbar instability or degenerative disc disease.
Report 22630 for one interspace treated with the posterior interbody technique. Use 22632 for each additional interspace fused using that technique; a posterolateral fusion alone or a combined posterolateral and interbody fusion follows a different code path. The operative report should identify the lumbar level, fusion technique, and interspace preparation. The day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures at 50%. Assistant-at-surgery payment and co-surgeon billing are permitted; team-surgery billing is not permitted.
CMS billing rules for 22630
- 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 RVU21.54 · 48%
- Practice expense (office) RVU15.81 · 35%
- Malpractice RVU7.88 · 17%
6K
Medicare services in 2024 · #1756 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.
22630 compared with similar codes
Office rates for Missouri, from the same CMS release.
No office rate
22630 reports the first lumbar interspace fused with the posterior interbody technique. 22632 is the add-on code for each additional interspace.
No office rate
22633 describes a lumbar interspace fused with both interbody and posterolateral techniques. 22630 describes the posterior interbody technique without that combined approach.
No office rate
22634 is the add-on for each additional interspace treated with the combined technique represented by 22633; it is not the additional-level code for 22630.
Compare 22630 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
Unavailable
Facility
$1472.46
Metropolitan St. Louis →
Office / nonfacility
Unavailable
Facility
$1485.90
Rest Of Missouri →
Office / nonfacility
Unavailable
Facility
$1431.01
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22630 billing questions
When should 22630 be chosen instead of 22612?
Use 22630 for a posterior interbody fusion at a lumbar interspace. Code 22612 describes a posterior or posterolateral fusion without the interbody technique.
How is another interspace reported?
Report 22632 for each additional lumbar interspace fused with the posterior interbody technique. The operative documentation should distinguish each treated level.
Can 22630 be reported with 22633?
They represent different fusion approaches at a level: 22630 is posterior interbody fusion, while 22633 combines interbody and posterolateral fusion. Select the code matching the technique documented for that interspace.
Is the disc-space preparation included?
Preparation of the interspace, including the laminectomy and/or discectomy needed to prepare it for fusion, is part of 22630. The operative note should make clear that this work prepares the fusion site.
Can an assistant or co-surgeon be reported?
CMS permits assistant-at-surgery payment and co-surgeon billing for 22630. Team-surgery billing is not permitted for this service.
What postoperative care is included?
The major-surgery 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.
2,09322610,,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
2,09422612,,Arthrd pst tq 1ntrspc lumbar,A,,22.94,14.38,NA,14.38,,6.62,43.94,43.94,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,09522614,,Arthrd pst tq 1ntrspc ea add,A,,6.27,2.11,NA,2.11,,2.08,10.46,10.46,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,09622630,,Arthrd pst tq 1ntrspc lum,A,,21.54,15.81,NA,15.81,,7.88,45.23,45.23,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,09722632,,Arthrd pst tq 1ntrspc lm ea,A,,5.09,1.73,NA,1.73,,1.79,8.61,8.61,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,09822633,,Arthrd cmbn 1ntrspc lumbar,A,,26.13,16.31,NA,16.31,,8.46,50.90,50.90,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,09922634,,Arthrd cmbn 1ntrspc ea addl,A,,7.76,2.61,NA,2.61,,2.58,12.95,12.95,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00