Billing code 22556: Thoracic fusionMedicare rate & RVUs in Ohio

Reports anterior interbody fusion at a thoracic spinal level, including the limited disc removal needed to prepare the space for fusion.

CMS RVU26DEffective Oct 1, 20261 payment locality485 Medicare services in 2024

CMS doesn’t publish an office rate for 22556 in Ohio.

—Office (non-facility)
$1,554.23Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 22556 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Ohio
  2. What 22556 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 22556 covers

This code describes fusion of a thoracic spinal level through an anterior approach, with limited disc removal to prepare the interspace for fusion. Spine surgeons, including orthopedic spine surgeons and neurosurgeons, typically perform it in a hospital operating room for conditions such as thoracic instability, deformity, or disc disease requiring fusion. The code includes the disc preparation inherent to the fusion, rather than a separate extensive decompression service.

Report it for the thoracic region; cervical and lumbar interbody fusions use different codes. Documentation should identify the spinal level, anterior approach, fusion work, and any additional levels or separately performed services. Code 22585 may be reported for each additional interspace when its requirements are met. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral adjustment is inappropriate. Assistant-at-surgery and co-surgeon payment are permitted; team surgery is not.

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.

22556 in Ohio

22556 office and facility rates by payment locality
Payment localityOfficeFacility
OhioUnavailable$1,554.23

How the 22556 rate is calculated

Each of 22556’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 22556

RVUs × geographic indexes × conversion factor

Work24.08

24.08 RVUs× 1.000 GPCI

Practice expense16.08

16.08 RVUs× 1.000 GPCI

Malpractice7.71

7.71 RVUs× 1.000 GPCI

Adjusted RVUs

47.8700

Conversion factor

$33.4009

Medicare rate

$1,598.90

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 22556

22556 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 22556

Thoracic fusion

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)2Permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 22556

Thoracic fusion

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

22556 without 51 · national facility

$1,598.90

Thoracic fusion

22556-51 · Second procedure: 50%

$799.45

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

22556 compared with similar codes

Compare codes · National

5 codes, side by side

  • 22556

    Thoracic fusion24.08 wRVU

    Not priced

  • 22554

    Cervical fusion17.25 wRVU

    Not priced

  • 22558

    Anterior fusion22.94 wRVU

    Not priced

  • 22532

    Spinal fusion25.34 wRVU

    Not priced

  • 22585

    Anterior fusion5.38 wRVU

    Not priced

How to choose

22554Cervical fusion
Both describe anterior interbody fusion with limited disc preparation, but 22554 applies to the cervical region and 22556 to the thoracic region.
22558Anterior fusion
22558 is the lumbar-region anterior interbody fusion code; use 22556 for the thoracic region.
22532Spinal fusion
22532 describes thoracic fusion through a lateral extracavitary approach. Code 22556 is for an anterior approach.
22585Anterior fusion
22556 reports the primary thoracic interspace fusion. Code 22585 is an add-on for each additional interspace, not a substitute for the primary code.

22556 billing questions

How does this differ from 22554 or 22558?

22556 is for anterior interbody fusion in the thoracic region. Code 22554 is the cervical counterpart, and 22558 is for the lumbar region.

Can 22585 be reported with 22556?

Yes. When the surgeon fuses an additional interspace, 22585 may be reported as the add-on code for that additional level.

Is disc removal separately reported?

The limited disc removal used to prepare the interspace for fusion is included in 22556. A separately performed decompression is distinct work and should be documented as such.

Can instrumentation or graft services be reported separately?

Instrumentation or bone graft services may be separately reportable when performed and supported by the operative documentation. The fusion code itself includes the limited disc preparation, not every separately performed service.

How does the 90-day global period affect billing?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period. Same-session procedures are subject to the standard multiple-procedure reduction when applicable.

Can the claim include an assistant or co-surgeon?

CMS permits payment for an assistant at surgery and for co-surgeons for this code. Team surgery is not permitted.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 22556PPRRVU2026_Oct_nonQPP.csv, line 2,086 (RVU26D)
Geographic factors for OhioGPCI2026.csv, line 85 (RVU26D)

Open CMS sourceHow we calculate rates

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