No office rate
Both describe anterior fixation, but 22845 is for two to three vertebral segments; 22846 is for four to seven.
On this page
CMS RVU26D · Effective 2026-10-01
22846 Spinal fixation Medicare reimbursement rates in Missouri
Reports anterior spinal fixation spanning four to seven vertebral segments, typically added to a qualifying fusion or other primary spinal procedure. Compare 22846 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 22846 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
$651.17–$667.12
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 22846 pays more and less in Missouri
Spinal instrumentation
About 22846: Anterior spinal fixation, four to seven segments
Reports anterior spinal fixation spanning four to seven vertebral segments, typically added to a qualifying fusion or other primary spinal procedure.
This code represents an anteriorly placed fixation construct spanning four to seven vertebral segments. A spine surgeon may use a plate-and-screw construct to stabilize the spine during an anterior fusion, such as multilevel cervical fusion, or another qualifying spinal operation. The construct’s approach and span distinguish this service from posterior fixation and from a device placed within an interspace.
Select the code by counting the vertebral segments instrumented, not the number of screws or the number of disc spaces treated. The operative report should identify the anterior approach and the segments spanned by the fixation construct. This is an add-on code: report it only with a qualifying primary procedure, not by itself. CMS payment is tied to the primary procedure’s global period.
CMS billing rules for 22846
- 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 RVU12.09 · 60%
- Practice expense (office) RVU4.06 · 20%
- Malpractice RVU4.01 · 20%
13.3K
Medicare services in 2024 · #1324 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.
22846 compared with similar codes
Office rates for Missouri, from the same CMS release.
No office rate
Both describe anterior fixation, but 22847 is for eight or more vertebral segments; 22846 is for four to seven.
No office rate
22842 describes posterior fixation across three to six vertebral segments. Use the approach documented in the operative report to distinguish it from anterior fixation.
No office rate
22853 describes placement of an interbody biomechanical device within an interspace. It is distinct from the anterior fixation construct represented by 22846.
Compare 22846 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
$662.01
Metropolitan St. Louis →
Office / nonfacility
Unavailable
Facility
$667.12
Rest Of Missouri →
Office / nonfacility
Unavailable
Facility
$651.17
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22846 billing questions
How is 22846 distinguished from 22845 and 22847?
Choose by the number of vertebral segments spanned by the anterior construct: 22846 covers four to seven. Codes 22845 and 22847 cover smaller and larger spans, respectively.
Do I count treated disc spaces or fixation hardware?
Base selection on the vertebral segments instrumented. The number of screws and the number of disc spaces treated do not set the code level.
Can 22846 be billed by itself?
No. It is an add-on code and must be reported with a qualifying primary procedure.
What should the operative report document?
Document the anterior approach and the vertebral segments spanned by the fixation construct. This supports both the instrumentation type and the four-to-seven-segment selection.
Is an interbody device the same service as 22846?
No. 22846 represents anterior fixation spanning vertebral segments; an interbody device is placed within a disc space. The operative report should support each service reported.
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.
2,11522843,,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
2,11622844,,Insert spine fixation device,A,,16.01,5.32,NA,5.32,,4.87,26.20,26.20,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11722845,,Insert spine fixation device,A,,11.64,3.90,NA,3.90,,3.85,19.39,19.39,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11822846,,Insert spine fixation device,A,,12.09,4.06,NA,4.06,,4.01,20.16,20.16,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11922847,,Insert spine fixation device,A,,13.44,4.28,NA,4.28,,2.86,20.58,20.58,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,12022848,,Insert pelv fixation device,A,,5.84,1.93,NA,1.93,,1.74,9.51,9.51,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,12122849,,Reinsert spinal fixation,A,,18.69,12.26,NA,12.26,,5.78,36.73,36.73,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00