No office rate
22633 represents the initial lumbar interspace treated with the combined technique. Use 22634 for each additional interspace treated that way.
On this page
CMS RVU26D · Effective 2026-10-01
22634 Lumbar fusion Medicare reimbursement rates in Nebraska
Reports each additional lumbar interspace fused using combined posterior or posterolateral and posterior interbody techniques during a multilevel fusion. Compare 22634 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 22634 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
$372.23
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 22634: Additional combined lumbar interspace fusion
Reports each additional lumbar interspace fused using combined posterior or posterolateral and posterior interbody techniques during a multilevel fusion.
This code captures each additional lumbar disc space fused after the first when the surgeon combines a posterior or posterolateral fusion with an interbody fusion performed from the back. The surgeon prepares the disc space and performs interbody fusion while also creating a posterior or posterolateral fusion at that level. Laminectomy or discectomy performed to prepare the interspace is part of the service. Spine surgeons typically report it for multilevel lumbar fusion operations in hospital or ambulatory surgical settings.
Report 22634 for each additional interspace treated with the combined technique beyond the initial level represented by 22633. It is an add-on code and must be billed with that primary procedure; it is paid within the primary procedure's global period. The operative report should identify each fused interspace and document both fusion techniques at each additional level. Count interspaces, not vertebrae or implants.
CMS billing rules for 22634
- 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 RVU7.76 · 60%
- Practice expense (office) RVU2.61 · 20%
- Malpractice RVU2.58 · 20%
23.3K
Medicare services in 2024 · #1081 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.
22634 compared with similar codes
Office rates for Nebraska, from the same CMS release.
No office rate
22632 applies to each additional level of posterior interbody lumbar fusion alone. 22634 is for an additional level where the posterior or posterolateral fusion technique is combined with interbody fusion.
No office rate
22614 is an additional-level code for posterior or posterolateral fusion without the combined interbody technique. Use 22634 when the additional lumbar interspace also receives posterior interbody fusion.
No office rate
22630 represents the initial level of posterior interbody lumbar fusion without the combined posterior or posterolateral technique; 22634 is an add-on for additional levels using the combined technique.
Compare 22634 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
$372.23
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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 22634 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
2,099
- Code
- 22634
- Physician work
- 7.76
- Practice expense
- 2.61
- Malpractice
- 2.58
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.76 | × 1.000 | 7.7600 |
| Practice expense | 2.61 | × 0.923 | 2.4090 |
| Malpractice | 2.58 | × 0.378 | 0.9752 |
| Total RVUs | 11.1443 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nebraska$372.23
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.76 | 1 |
| Practice expense | 2.61 | 0.923 |
| Malpractice | 2.58 | 0.378 |
(7.76 × 1 + 2.61 × 0.923 + 2.58 × 0.378) × $33.4009 = $372.23
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.
22634 billing questions
Which primary code must accompany 22634?
Report 22634 with 22633, which represents the initial lumbar interspace treated with the combined posterior or posterolateral and posterior interbody techniques.
How many units should be reported?
Report one unit for each additional lumbar interspace treated with the combined technique beyond the initial level. Count fused interspaces, not vertebrae.
How does 22634 differ from 22632?
22634 represents an additional interspace treated with combined posterior or posterolateral and posterior interbody fusion. 22632 is the additional-level code for posterior interbody fusion without the combined technique.
What operative documentation supports 22634?
Document the specific additional lumbar interspace and the posterior or posterolateral fusion and posterior interbody fusion performed there.
Is interspace preparation separately described by 22634?
The code includes laminectomy or discectomy performed to prepare the interspace for the interbody fusion. Document the work and its purpose in the operative report.
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.
2,09622630,,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
2,10022800,,Arthrd pst dfrm<6 vrt sgm,A,,19.01,14.54,NA,14.54,,5.76,39.31,39.31,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,10122802,,Arthrd pst dfrm 7-12 vrt sgm,A,,31.31,17.86,NA,17.86,,8.80,57.97,57.97,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,10222804,,Arthrd pst dfrm 13+ vrt sgm,A,,36.56,19.62,NA,19.62,,10.36,66.54,66.54,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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