No office rate
22532 represents the primary thoracic lateral extracavitary fusion segment. Use 22534 for each additional segment, not for the initial segment.
On this page
CMS RVU26D · Effective 2026-10-01
22534 Spinal fusion Medicare reimbursement rates in Nebraska
Reports an additional thoracic or lumbar vertebral segment fused through a lateral extracavitary approach, alongside the applicable primary arthrodesis code. Compare 22534 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 22534 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
$278.98
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.
Spinal surgery
About 22534: Additional-level lateral extracavitary spinal fusion
Reports an additional thoracic or lumbar vertebral segment fused through a lateral extracavitary approach, alongside the applicable primary arthrodesis code.
This add-on represents fusion of an additional vertebral segment using a lateral extracavitary approach to the thoracic or lumbar spine. The surgeon prepares the interspace for fusion, including limited disc removal for that purpose; the code does not describe disc removal performed as decompression. Orthopedic spine surgeons and neurosurgeons typically report it for multilevel fusion performed in an operating room.
Report 22534 for each additional segment beyond the segment represented by the primary procedure. The operative report should identify the spinal levels fused and support the lateral extracavitary technique; select the primary code according to the region of the initial segment. CMS treats 22534 as an add-on: it is billed only with a primary procedure and paid within that procedure’s global period.
CMS billing rules for 22534
- 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 RVU5.84 · 60%
- Practice expense (office) RVU1.94 · 20%
- Malpractice RVU1.91 · 20%
856
Medicare services in 2024 · #3086 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.
22534 compared with similar codes
Office rates for Nebraska, from the same CMS release.
No office rate
22533 represents the primary lumbar lateral extracavitary fusion segment. 22534 reports additional segments rather than the primary lumbar fusion.
No office rate
22585 is an additional-level code for anterior interbody arthrodesis. 22534 is for additional segments fused through the lateral extracavitary approach.
Compare 22534 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
$278.98
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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 22534 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
2,081
- Code
- 22534
- Physician work
- 5.84
- Practice expense
- 1.94
- Malpractice
- 1.91
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.84 | × 1.000 | 5.8400 |
| Practice expense | 1.94 | × 0.923 | 1.7906 |
| Malpractice | 1.91 | × 0.378 | 0.7220 |
| Total RVUs | 8.3526 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nebraska$278.98
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.84 | 1 |
| Practice expense | 1.94 | 0.923 |
| Malpractice | 1.91 | 0.378 |
(5.84 × 1 + 1.94 × 0.923 + 1.91 × 0.378) × $33.4009 = $278.98
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.
22534 billing questions
Which primary code is reported with 22534?
Use 22532 for a thoracic primary segment or 22533 for a lumbar primary segment. 22534 represents an additional segment, not the primary fusion.
Can 22534 be submitted by itself?
No. It is an add-on code and must be billed with its applicable primary arthrodesis procedure.
How many units of 22534 should be reported?
Report a unit for each additional vertebral segment treated beyond the segment represented by the primary code. The operative report should identify the fused levels.
Is disc preparation included?
Limited disc removal to prepare the fusion interspace is part of the service. The code does not represent disc removal performed for decompression.
How does CMS treat payment for 22534?
CMS treats it as an add-on billed with a primary procedure and pays it within that procedure’s global period.
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.
2,07822527,,Idet 1 or more levels,N,+,2.95,44.50,,0.64,,0.33,47.78,3.92,9,ZZZ,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
2,07922532,,Arthrd lat xtrcvtry tq thrc,A,,25.34,17.77,NA,17.77,,8.75,51.86,51.86,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,08022533,,Arthrd lat xtrcvtry tq lmbr,A,,24.17,15.51,NA,15.51,,6.66,46.34,46.34,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,08122534,,Arthrd lat xtrcvtry tq ea ad,A,,5.84,1.94,NA,1.94,,1.91,9.69,9.69,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,08222548,,Arthrd ant toral/xoral c1-c2,A,,26.38,20.66,NA,20.66,,11.15,58.19,58.19,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,08322551,,Arthrd ant ntrbdy cervical,A,,24.38,15.43,NA,15.43,,8.24,48.05,48.05,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,08422552,,Arthrd ant ntrbd cervical ea,A,,6.34,2.13,NA,2.13,,2.10,10.57,10.57,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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