Billing code 22207: Spinal osteotomyMedicare rate & RVUs in Oregon
Reports a surgeon’s three-column osteotomy at one lumbar vertebral segment, commonly used to correct fixed spinal deformity through a posterior or posterolateral approach.
CMS doesn’t publish an office rate for 22207 in Oregon.
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 22207 covers
This code represents a major corrective bone-cutting procedure through the lumbar spine that changes alignment by releasing or removing bone across all three spinal columns at one vertebral segment. A lumbar pedicle subtraction osteotomy is a familiar example, often performed for rigid sagittal imbalance or another fixed deformity that cannot be adequately corrected with a less extensive release. A spine surgeon performs it in the operating room, often as part of a reconstruction that may also include instrumentation or fusion.
Select the code when the operative report identifies a lumbar level and documents work spanning three columns; a posterior osteotomy that does not span all three columns belongs in a different code. Document the approach, vertebral level, extent of bone removal, and corrective objective. CMS assigns a 90-day global period, including the day-before preoperative visit and related care through 90 days after surgery. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. CMS permits assistant-at-surgery payment; 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.
Where 22207 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $2,212.84 |
| Rest Of Oregon | Unavailable | $2,103.43 |
How the 22207 rate is calculated
Each of 22207’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 · 22207
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 35.76Practice expense 19.61Malpractice 10.93
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 22207
22207 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 22207
Spinal osteotomy
| 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 · 22207
Spinal osteotomy
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
22207 without 51 · national facility
$2,214.48
Spinal osteotomy
22207-51 · Second procedure: 50%
$1,107.24
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%).
22207 compared with similar codes
Compare codes
22207 vs 22206 vs 22208 vs 22214 vs 22224: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 22206Spinal osteotomy
- 22206 is the thoracic counterpart; 22207 is for a lumbar vertebral segment.
- 22208Spinal osteotomy
- 22208 reports each additional segment after the first three-column osteotomy, rather than the initial lumbar segment.
- 22214Spine osteotomy
- 22214 is for a lumbar posterior or posterolateral osteotomy without the three-column extent specified for 22207.
- 22224Spinal osteotomy
- 22224 describes a lumbar osteotomy through an anterior approach, rather than the posterior or posterolateral approach for 22207.
22207 billing questions
How does 22207 differ from 22214?
22207 describes a lumbar osteotomy spanning all three spinal columns at one vertebral segment. Use 22214 for a posterior or posterolateral lumbar osteotomy that does not have that three-column extent.
How is another three-column segment reported?
Code 22208 is the add-on code for each additional vertebral segment treated with a three-column osteotomy. Document each additional level and the work performed there.
Can modifier 50 be used for bilateral work?
No. CMS identifies modifier 50 as inappropriate for this code’s anatomy and descriptor.
What happens when other procedures are performed in the same session?
The highest-valued procedure is paid in full, and other procedures are paid at 50% under the standard multiple procedure reduction.
What documentation supports reporting 22207?
The operative report should identify the lumbar vertebral segment, posterior or posterolateral approach, and bone work spanning all three columns. It should also describe the deformity-correction objective and any additional levels treated.
Can an assistant or co-surgeon be reported?
CMS permits assistant-at-surgery payment. Co-surgeon payment requires supporting documentation, while 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
Fee sheets
Put 22207 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →