No office rate
Both report anterior thoracic vertebral body tethering, including thoracoscopy when performed. Choose 22836 for two to seven segments and 22837 for eight or more.
On this page
CMS RVU26D · Effective 2026-10-01
22837 Vertebral tethering Medicare reimbursement rates in Oregon
Reports anterior thoracic vertebral body tethering across eight or more vertebral segments, a growth-modulating operation commonly used for scoliosis in skeletally immature patients. Compare 22837 office and facility rates across CMS payment localities in Oregon.
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 22837 in Oregon?
Oregon 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
$1623.89–$1691.46
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 22837: Anterior thoracic vertebral body tethering, eight or more segments
Reports anterior thoracic vertebral body tethering across eight or more vertebral segments, a growth-modulating operation commonly used for scoliosis in skeletally immature patients.
The surgeon places a flexible tether along the front of the thoracic spine, securing it to vertebral bodies to guide spinal growth and address scoliosis. The operation is generally considered for skeletally immature patients with progressive scoliosis; it may be performed through an open approach or with thoracoscopy. The code includes thoracoscopy when performed and represents a construct spanning eight or more vertebral segments.
Select this code from the documented extent of the tethered construct, not from the number of incisions or the diagnosis alone. The operative report should identify the vertebral levels and support the segment count. The related lower-extent code, 22836, is used for two to seven segments. This is major surgery with a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons are permitted, and team surgery requires supporting documentation.
CMS billing rules for 22837
- 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons permitted.
- Team surgery
- Team surgery paid only with supporting documentation.
Where the value comes from
- Work RVU34.61 · 70%
- Practice expense (office) RVU11.46 · 23%
- Malpractice RVU3.69 · 7%
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.
22837 compared with similar codes
Office rates for Oregon, from the same CMS release.
No office rate
22837 reports the initial tethering construct across eight or more segments. Use 22838 for revision, replacement, or removal of thoracic vertebral body tethering.
No office rate
22840 describes insertion of a nonsegmental spinal fixation device, not the anterior thoracic vertebral body tethering construct reported by 22837.
Compare 22837 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
Portland →
Office / nonfacility
Unavailable
Facility
$1691.46
Rest Of Oregon →
Office / nonfacility
Unavailable
Facility
$1623.89
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22837 billing questions
When should 22837 be selected instead of 22836?
Use 22837 when the anterior thoracic tether construct spans eight or more vertebral segments. Code 22836 is for two to seven segments; use the operative report’s documented levels to establish the count.
Does 22837 include thoracoscopy?
Yes. The code includes thoracoscopy when performed as part of the anterior thoracic vertebral body tethering procedure.
What documentation supports the segment level?
The operative report should identify the vertebral levels included in the tether construct and show that the construct spans at least eight segments.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or another surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons are permitted, while team surgery requires supporting documentation.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures performed in the same session are subject to the standard multiple-procedure reduction.
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.
2,10722819,,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
2,11222840,,Insert spine fixation device,A,,12.21,4.04,NA,4.04,,3.76,20.01,20.01,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11322841,,Insert spine fixation device,B,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00