No office rate
Both describe posterior segmental fixation. Use 22844 for 13 or more instrumented vertebral segments; 22843 covers 7 through 12.
On this page
CMS RVU26D · Effective 2026-10-01
22844 Spinal fixation Medicare reimbursement rates in Nebraska
Reports posterior segmental spinal fixation spanning 13 or more vertebral segments, commonly used during long constructs for deformity correction or spinal reconstruction. Compare 22844 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 22844 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
$760.25
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 22844: Long-segment posterior spinal fixation
Reports posterior segmental spinal fixation spanning 13 or more vertebral segments, commonly used during long constructs for deformity correction or spinal reconstruction.
Code 22844 represents a long posterior fixation construct spanning at least 13 vertebral segments. An orthopedic spine surgeon or neurosurgeon may place rods, screws, or other fixation components during surgery for conditions such as major scoliosis or complex spinal deformity. These procedures are typically performed in a hospital operating room, often alongside spinal fusion or another primary spine procedure.
Select this code based on the number of vertebral segments instrumented, not the number of implants. The operative report should establish the posterior approach, the extent of the construct, and the primary procedure performed. Medicare treats 22844 as an add-on code: report it only with a primary procedure, and its payment falls within that procedure’s global period. It is not reported as a standalone service.
CMS billing rules for 22844
- 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 RVU16.01 · 61%
- Practice expense (office) RVU5.32 · 20%
- Malpractice RVU4.87 · 19%
1.6K
Medicare services in 2024 · #2626 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.
22844 compared with similar codes
Office rates for Nebraska, from the same CMS release.
No office rate
22842 applies to a posterior segmental construct spanning 3 through 6 vertebral segments; 22844 is for 13 or more.
No office rate
22840 describes nonsegmental fixation. Use 22844 when the posterior construct is segmental and spans at least 13 vertebral segments.
No office rate
22845 describes anterior instrumentation. Code 22844 is for a long posterior segmental construct.
Compare 22844 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
$760.25
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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 22844 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
2,116
- Code
- 22844
- Physician work
- 16.01
- Practice expense
- 5.32
- Malpractice
- 4.87
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 16.01 | × 1.000 | 16.0100 |
| Practice expense | 5.32 | × 0.923 | 4.9104 |
| Malpractice | 4.87 | × 0.378 | 1.8409 |
| Total RVUs | 22.7612 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nebraska$760.25
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 16.01 | 1 |
| Practice expense | 5.32 | 0.923 |
| Malpractice | 4.87 | 0.378 |
(16.01 × 1 + 5.32 × 0.923 + 4.87 × 0.378) × $33.4009 = $760.25
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.
22844 billing questions
When should 22844 be chosen instead of 22843?
Choose 22844 when the posterior segmental construct spans 13 or more vertebral segments. Code 22843 applies to a shorter construct of 7 through 12 segments.
Can 22844 be reported by itself?
No. It is an add-on code and must be reported with a primary procedure; Medicare payment falls within that procedure’s global period.
Is the code based on the number of screws or rods?
No. Selection depends on the number of vertebral segments instrumented, not the number of screws, rods, or other implants.
What documentation supports reporting 22844?
The operative report should identify the posterior construct and the vertebral segments instrumented, supporting a span of 13 or more segments, as well as the accompanying primary procedure.
How does 22844 differ from 22840?
Code 22844 describes a long posterior segmental construct. Code 22840 is for a nonsegmental fixation method and is not selected by counting 13 or more instrumented segments.
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.
2,11322841,,Insert spine fixation device,B,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11422842,,Insert spine fixation device,A,,12.25,4.10,NA,4.10,,4.01,20.36,20.36,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11522843,,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
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