No office rate
22840 reports nonsegmental spinal fixation. Add 22848 when the caudal end of an eligible construct is also anchored to pelvic bone other than the sacrum.
On this page
CMS RVU26D · Effective 2026-10-01
22848 Pelvic fixation Medicare reimbursement rates in Nevada
Reports pelvic anchoring of spinal instrumentation to pelvic bone other than the sacrum, as an add-on to an eligible primary instrumentation procedure. Compare 22848 office and facility rates across CMS payment localities in Nevada.
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 22848 in Nevada?
Nevada 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
$308.00
1 of 1 localities have a supported rate.
Payment area: Nevada**
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 instrumentation
About 22848: Pelvic fixation for spinal instrumentation
Reports pelvic anchoring of spinal instrumentation to pelvic bone other than the sacrum, as an add-on to an eligible primary instrumentation procedure.
Code 22848 captures the pelvic anchor at the lower end of spinal instrumentation when fixation is attached to pelvic bone other than the sacrum, commonly through iliac fixation. Orthopedic spine surgeons and neurosurgeons report it during instrumented lumbosacral fusion or long constructs for spinal deformity when the construct is extended into the pelvis. It represents the pelvic fixation service, not a count of individual screws.
Report 22848 only with an eligible primary spinal instrumentation procedure, such as 22840 or 22842–22844; it is not a stand-alone line. Select the primary instrumentation code by its own construct and segment criteria, then report 22848 when operative documentation shows attachment of the caudal construct to pelvic bone. The operative report should identify the pelvic anchor site and its connection to the spinal construct. CMS pays this add-on within the primary procedure’s global period.
CMS billing rules for 22848
- 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 · 61%
- Practice expense (office) RVU1.93 · 20%
- Malpractice RVU1.74 · 18%
10.5K
Medicare services in 2024 · #1446 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.
22848 compared with similar codes
Office rates for Nevada, from the same CMS release.
No office rate
22842 is the primary segmental instrumentation code for a 3–6 vertebral-segment construct; 22848 separately reports its pelvic anchoring when performed.
No office rate
22843 is the primary segmental instrumentation code for a 7–12 vertebral-segment construct; 22848 identifies the additional pelvic fixation.
No office rate
22844 is the primary segmental instrumentation code for a construct of 13 or more vertebral segments; 22848 reports pelvic anchoring separately.
Compare 22848 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
Nevada** →
Office / nonfacility
Unavailable
Facility
$308.00
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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 22848 in Nevada**.
PPRRVU2026_Oct_nonQPP.csv
2,120
- Code
- 22848
- Physician work
- 5.84
- Practice expense
- 1.93
- Malpractice
- 1.74
GPCI2026.csv
73
- Locality
- Nevada**
- Physician work
- 1.000
- Practice expense
- 1.001
- Malpractice
- 0.833
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.84 | × 1.000 | 5.8400 |
| Practice expense | 1.93 | × 1.001 | 1.9319 |
| Malpractice | 1.74 | × 0.833 | 1.4494 |
| Total RVUs | 9.2213 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nevada**$308.00
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.84 | 1 |
| Practice expense | 1.93 | 1.001 |
| Malpractice | 1.74 | 0.833 |
(5.84 × 1 + 1.93 × 1.001 + 1.74 × 0.833) × $33.4009 = $308.00
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.
22848 billing questions
What distinguishes 22848 from 22842–22844?
Those codes describe the spinal instrumentation construct by vertebral segment range. Code 22848 reports the additional pelvic anchoring of that construct.
Which primary codes can be reported with 22848?
Report it with an eligible primary instrumentation code, including 22840 or 22842–22844. It cannot be billed as a stand-alone procedure.
Does 22848 describe fixation to the sacrum?
It describes attachment to pelvic bone other than the sacrum, such as iliac fixation. Sacral-only fixation does not meet that distinction.
Is 22848 reported per screw or per side?
The code represents the pelvic fixation service, not each individual screw. Do not derive claim units from the number of implanted screws.
How does the global-period payment work?
CMS treats 22848 as an add-on and pays it within the global period of the primary procedure. The claim must include an eligible primary procedure.
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.
2,11722845,,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
2,12222850,,Remove spine fixation device,A,,9.57,8.88,NA,8.88,,3.01,21.46,21.46,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,12322852,,Remove spine fixation device,A,,9.14,8.73,NA,8.73,,2.85,20.72,20.72,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
7612402,NJ,99,REST OF NEW JERSEY,1.040,1.092,1.097