Billing code 22869: Spinal stabilizationMedicare rate & RVUs in Oregon
Reports placement of a lumbar interspinous stabilization device at one level when the surgeon does not perform open decompression or discectomy.
CMS doesn’t publish an office rate for 22869 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 22869 covers
billing code 22869 covers placement of a device between lumbar spinous processes to stabilize or distract one spinal level, without open decompression or discectomy. A spine surgeon typically performs the procedure in an operating room for a patient whose lumbar condition is treated with this interspinous implant approach. The operative report should identify the lumbar level, the implanted device, and whether decompression or discectomy was performed.
Report one unit for the single treated level. For an additional level treated with the same no-decompression approach, 22870 is the add-on code. 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 occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeons and team surgery are 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 22869 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $409.17 |
| Rest Of Oregon | Unavailable | $388.01 |
How the 22869 rate is calculated
Each of 22869’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 · 22869
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 6.85Practice expense 4.32Malpractice 0.66
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 22869
22869 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 22869
Spinal stabilization
| 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) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.80/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 22869
Spinal stabilization
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
22869 without 51 · national facility
$395.13
Spinal stabilization
22869-51 · Second procedure: 50%
$197.57
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%).
22869 compared with similar codes
Compare codes
22869 vs 22867 vs 22870 vs 22853: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 22867Spinal stabilization
- Both describe lumbar interspinous stabilization, but 22867 includes open decompression; 22869 is for the procedure without it.
- 22870Spinal stabilization
- 22870 reports each additional lumbar level after the first level treated without open decompression or discectomy; 22869 is the single-level code.
- 22853Interbody device
- 22853 concerns a biomechanical device placed in an intervertebral space, typically in a fusion procedure. 22869 describes a stabilizing device placed between lumbar spinous processes.
22869 billing questions
How does 22869 differ from 22867?
22869 describes lumbar interspinous stabilization without open decompression or discectomy. Use 22867 when the procedure includes open decompression.
How should an additional treated level be reported?
Report 22870 for each additional lumbar level treated with the no-decompression approach. The operative report should support the levels treated.
Can modifier 50 be used when both sides are treated?
No. The code's anatomy and descriptor make a bilateral adjustment inappropriate.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or another surgeon be reported?
An assistant at surgery may be paid. Co-surgeons and team surgery are not permitted for this code.
What happens when this procedure is performed with another procedure in the same session?
The highest-valued procedure is paid in full; other procedures 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 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 22869 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 →