No office rate
Use 22325 for the lumbar region; 22327 represents a thoracic vertebral segment.
On this page
CMS RVU26D · Effective 2026-10-01
22327 Fracture treatment Medicare reimbursement rates in Nebraska
Reports open posterior surgical treatment of a fractured thoracic vertebral segment, with additional treated segments represented by an add-on code. Compare 22327 office and facility rates across CMS payment localities in Nebraska.
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 22327 in Nebraska?
Nebraska 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
$1308.45
1 of 1 localities have a supported rate.
Payment area: Nebraska
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 22327: Open thoracic vertebral fracture treatment
Reports open posterior surgical treatment of a fractured thoracic vertebral segment, with additional treated segments represented by an add-on code.
This service covers open surgical treatment of a fractured thoracic vertebral segment through a posterior approach. A spine surgeon, commonly an orthopedic surgeon or neurosurgeon, performs it in an operating room when the fracture requires operative treatment. The operative work may include reducing the fracture and addressing associated instability as clinically indicated; the code represents one treated vertebral segment.
Report one unit for the primary treated segment and use 22328 for each additional fractured segment treated in the same session. The operative report should identify the thoracic level or levels, posterior approach, and treatment performed. The 90-day global includes the day-before preoperative visit and related postoperative care during the 90 days after surgery. For multiple procedures in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 22327
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU20.25 · 45%
- Practice expense (office) RVU17.55 · 39%
- Malpractice RVU7.21 · 16%
2.6K
Medicare services in 2024 · #2283 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.
22327 compared with similar codes
Office rates for Nebraska, from the same CMS release.
No office rate
Use 22326 for the cervical region; 22327 represents a thoracic vertebral segment.
No office rate
22328 reports each additional fractured segment treated in the same session; 22327 reports the primary segment.
$309.33
22310 represents closed fracture treatment without manipulation. Choose 22327 when the thoracic fracture receives open posterior surgical treatment.
Compare 22327 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
Nebraska →
Office / nonfacility
Unavailable
Facility
$1308.45
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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 22327 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
2,068
- Code
- 22327
- Physician work
- 20.25
- Practice expense
- 17.55
- Malpractice
- 7.21
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 20.25 | × 1.000 | 20.2500 |
| Practice expense | 17.55 | × 0.923 | 16.1987 |
| Malpractice | 7.21 | × 0.378 | 2.7254 |
| Total RVUs | 39.1740 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nebraska$1308.45
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 20.25 | 1 |
| Practice expense | 17.55 | 0.923 |
| Malpractice | 7.21 | 0.378 |
(20.25 × 1 + 17.55 × 0.923 + 7.21 × 0.378) × $33.4009 = $1308.45
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.
22327 billing questions
How is 22327 distinguished from 22325 or 22326?
Choose 22327 for a treated thoracic vertebral segment. Code 22326 is for the cervical region, and 22325 is for the lumbar region.
How should additional fractured segments be reported?
Report 22327 for the primary treated segment and 22328 for each additional fractured segment treated during the same operative session.
Can modifier 50 be used for fractures on both sides?
No. The anatomy and descriptor make modifier 50 inappropriate for this service.
What postoperative care is included in the global period?
The 90-day global includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
When may assistant or co-surgeon services be paid?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What documentation supports reporting 22327?
The operative report should establish the thoracic vertebral level, the posterior approach, and open treatment of the fractured segment. It should also identify any additional fractured segments treated.
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.
2,06522319,,Treat odontoid fx w/graft,A,,24.70,19.05,NA,19.05,,10.43,54.18,54.18,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,06622325,,Treat spine fracture,A,,19.37,17.07,NA,17.07,,6.80,43.24,43.24,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,06722326,,Treat neck spine fracture,A,,20.32,16.37,NA,16.37,,7.43,44.12,44.12,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,06822327,,Treat thorax spine fracture,A,,20.25,17.55,NA,17.55,,7.21,45.01,45.01,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,06922328,,Treat each add spine fx,A,,4.49,1.51,NA,1.51,,1.56,7.56,7.56,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,07022505,,Manipulation of spine,A,,1.82,2.00,NA,2.00,,0.78,4.60,4.60,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,07122510,,Perq cervicothoracic inject,A,,7.70,43.93,,2.61,,1.16,52.79,11.47,0,010,0.10,0.80,0.10,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068