Billing code 22327: Fracture treatmentMedicare rate & RVUs in Oklahoma
Reports open posterior surgical treatment of a fractured thoracic vertebral segment, with additional treated segments represented by an add-on code.
CMS doesn’t publish an office rate for 22327 in Oklahoma.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 22327 covers
This service covers open surgical treatment of a fractured thoracic vertebral segment through a posterior approach. A spine surgeon, commonly an orthopedic surgeon or neurosurgeon, performs it in an operating room when the fracture requires operative treatment. The operative work may include reducing the fracture and addressing associated instability as clinically indicated; the code represents one treated vertebral segment.
Report one unit for the primary treated segment and use 22328 for each additional fractured segment treated in the same session. The operative report should identify the thoracic level or levels, posterior approach, and treatment performed. The 90-day global includes the day-before preoperative visit and related postoperative care during the 90 days after surgery. For multiple procedures in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
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.
22327 in Oklahoma
| Payment locality | Office | Facility |
|---|---|---|
| Oklahoma | Unavailable | $1,386.95 |
How the 22327 rate is calculated
Each of 22327’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 · 22327
RVUs × geographic indexes × conversion factor
Work20.25
20.25 RVUs× 1.000 GPCI
Practice expense17.55
17.55 RVUs× 1.000 GPCI
Malpractice7.21
7.21 RVUs× 1.000 GPCI
Adjusted RVUs
45.0100
Conversion factor
$33.4009
Medicare rate
$1,503.37
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 22327
22327 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 22327
Fracture treatment
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 22327
Fracture treatment
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
22327 without 51 · national facility
$1,503.37
Fracture treatment
22327-51 · Second procedure: 50%
$751.69
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%).
22327 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 22325Spine fracture
- Use 22325 for the lumbar region; 22327 represents a thoracic vertebral segment.
- 22326Spine fracture repair
- Use 22326 for the cervical region; 22327 represents a thoracic vertebral segment.
- 22328Spine fracture treatment
- 22328 reports each additional fractured segment treated in the same session; 22327 reports the primary segment.
- 22310Spine fracture care
- 22310 represents closed fracture treatment without manipulation. Choose 22327 when the thoracic fracture receives open posterior surgical treatment.
22327 billing questions
How is 22327 distinguished from 22325 or 22326?
Choose 22327 for a treated thoracic vertebral segment. Code 22326 is for the cervical region, and 22325 is for the lumbar region.
How should additional fractured segments be reported?
Report 22327 for the primary treated segment and 22328 for each additional fractured segment treated during the same operative session.
Can modifier 50 be used for fractures on both sides?
No. The anatomy and descriptor make modifier 50 inappropriate for this service.
What postoperative care is included in the global period?
The 90-day global includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
When may assistant or co-surgeon services be paid?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What documentation supports reporting 22327?
The operative report should establish the thoracic vertebral level, the posterior approach, and open treatment of the fractured segment. It should also identify any additional fractured segments treated.
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
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