No office rate
22612 reports posterior or posterolateral lumbar fusion work. Code 22830 reports assessment of an existing fusion, not creation of a new fusion.
On this page
CMS RVU26D · Effective 2026-10-01
22830 Fusion exploration Medicare reimbursement rates in New Jersey
An operative inspection of a previously fused spinal segment, reported when the surgeon assesses whether the fusion is solid or has failed. Compare 22830 office and facility rates across CMS payment localities in New Jersey.
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 22830 in New Jersey?
New Jersey has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$845.99–$872.55
2 of 2 localities have a supported rate.
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 22830: Exploration of prior spinal fusion
An operative inspection of a previously fused spinal segment, reported when the surgeon assesses whether the fusion is solid or has failed.
A spine surgeon—typically an orthopedic surgeon or neurosurgeon—operatively exposes and assesses a prior fusion to determine whether the bone has united or whether a nonunion or other failure is present. This is an intraoperative assessment, often encountered during surgery planned for persistent symptoms or revision of a prior spinal procedure; it is not an imaging study or a routine office examination. The operative report should identify the fusion site explored and describe the findings that support the assessment.
Report 22830 for the exploration itself, distinguishing it in the record from any revision fusion, fixation-device work, or other procedure performed during the same operation. It has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and others at 50%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this code.
CMS billing rules for 22830
- 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 RVU10.94 · 46%
- Practice expense (office) RVU9.42 · 40%
- Malpractice RVU3.34 · 14%
8.6K
Medicare services in 2024 · #1557 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.
22830 compared with similar codes
Office rates for New Jersey, from the same CMS release.
No office rate
22852 describes removal of segmental spinal instrumentation. Use 22830 for exploration of the fusion itself, not simply for taking out hardware.
No office rate
22849 describes reinsertion of a spinal fixation device. It concerns fixation hardware, whereas 22830 concerns assessment of the prior bone fusion.
Compare 22830 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.
2 of 2 payment localities
Northern Nj →
Office / nonfacility
Unavailable
Facility
$872.55
Rest Of New Jersey →
Office / nonfacility
Unavailable
Facility
$845.99
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22830 billing questions
How is exploration different from revision fusion?
Exploration assesses whether the prior fusion has united; revision fusion treats or extends the fusion. The operative note should distinguish the assessment from any repair performed.
Does 22830 include removal of spinal hardware?
No. Exploration concerns the prior fusion, while hardware removal is a separate service, such as removal of segmental instrumentation reported with 22852. Document each service performed and follow applicable coding edits.
Can 22830 be reported with a fusion procedure?
It may occur during an operation that also revises or extends a fusion. Documentation should show the distinct exploration and its findings; whether both services are separately reportable depends on applicable coding edits.
Should modifier 50 be used when the surgeon explores both sides?
No. CMS identifies bilateral adjustment as inappropriate for 22830; modifier 50 should not be used for this code.
What documentation supports 22830?
Record the previously fused site that was explored and the surgeon's intraoperative findings about fusion integrity, including evidence supporting a solid union or suspected failure.
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.
2,10522812,,Arthrd ant dfrm 8+ vrt sgm,A,,33.39,18.50,NA,18.50,,7.12,59.01,59.01,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,10622818,,Kyphectomy 1-2 segments,A,,33.47,16.63,NA,16.63,,7.14,57.24,57.24,0,090,0.11,0.76,0.13,2,0,2,2,2,9,,33.4009,09,0,99,0.00,0.00,0.00
2,10722819,,Kyphectomy 3 or more,A,,38.40,19.34,NA,19.34,,8.18,65.92,65.92,0,090,0.11,0.76,0.13,2,0,2,2,2,9,,33.4009,09,0,99,0.00,0.00,0.00
2,10822830,,Exploration of spinal fusion,A,,10.94,9.42,NA,9.42,,3.34,23.70,23.70,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,10922836,,Ant thrc vrt body tethrg <7,A,,31.20,16.33,NA,16.33,,6.64,54.17,54.17,0,090,0.10,0.69,0.21,2,0,0,2,1,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11022837,,Ant thrc vrt body tethrg 8+,A,,34.61,11.46,NA,11.46,,3.69,49.76,49.76,0,090,0.10,0.69,0.21,2,0,0,2,1,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11122838,,Rev rplc/rmv thrc vrt tethrg,A,,35.10,11.57,NA,11.57,,3.75,50.42,50.42,0,090,0.10,0.69,0.21,2,0,0,2,1,9,,33.4009,09,0,99,0.00,0.00,0.00