No office rate
Use 22319 when graft is used in open odontoid-fracture treatment. Use 22318 for the corresponding open treatment without graft.
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CMS RVU26D · Effective 2026-10-01
22319 Odontoid fracture surgery Medicare reimbursement rates in Pennsylvania
Open surgical treatment of a C2 odontoid fracture with bone grafting, reported when the operative repair includes graft rather than treatment without graft. Compare 22319 office and facility rates across CMS payment localities in Pennsylvania.
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 22319 in Pennsylvania?
Pennsylvania 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
$1738.32–$1917.83
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 22319: Odontoid fracture treatment with graft
Open surgical treatment of a C2 odontoid fracture with bone grafting, reported when the operative repair includes graft rather than treatment without graft.
This code describes open surgical treatment of an odontoid fracture—the dens portion of the C2 vertebra—with bone grafting. A spine surgeon, commonly an orthopedic spine surgeon or neurosurgeon, performs the operation in a hospital operating room. Reduction and stabilization may be part of the repair; internal fixation is included when performed. The graft distinguishes this service from odontoid-fracture treatment without graft.
Report the code when the operative record supports open treatment of an odontoid fracture and documents graft use. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, Medicare pays the highest-valued procedure in full and reduces others to 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available, co-surgeons are permitted, and team surgery is not permitted.
CMS billing rules for 22319
- 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 may be paid.
- Co-surgeons
- Co-surgeons permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU24.70 · 46%
- Practice expense (office) RVU19.05 · 35%
- Malpractice RVU10.43 · 19%
24
Medicare services in 2024 · #5803 by national volume
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.
22319 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
$323.28–$356.78
22310 describes closed vertebral-fracture treatment without manipulation. 22319 is open treatment of an odontoid fracture with graft.
$951.92–$1,051.56
22315 describes closed vertebral-fracture treatment with manipulation; it is not the open grafted odontoid repair represented by 22319.
No office rate
22326 is for open treatment of a cervical spine fracture, while 22319 specifically identifies open treatment of an odontoid fracture with graft.
Compare 22319 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
Metropolitan Philadelphia →
Office / nonfacility
Unavailable
Facility
$1917.83
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$1738.32
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22319 billing questions
How is this code distinguished from 22318?
Both describe open treatment of an odontoid fracture. Choose 22319 when the operative record documents graft use; 22318 is the corresponding treatment without graft.
What documentation supports reporting 22319?
The operative report should identify the odontoid fracture, describe the open treatment, and document that bone graft was used. It should also describe the repair and any fixation performed.
Is internal fixation separately represented by this code?
Internal fixation, when performed as part of the odontoid-fracture repair, is included in the service. The defining distinction from 22318 is use of graft.
Can modifier 50 be reported?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate for the odontoid-fracture service.
How are assistant and co-surgeon claims handled?
CMS permits payment for an assistant at surgery and permits co-surgeons. Team surgery is not permitted for this code.
What happens when other procedures are performed in the same session?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. Related postoperative care is included in this code's 90-day global period.
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.
2,06222310,,Closed tx vert fx w/o manj,A,,3.36,6.07,,4.58,,0.79,10.22,8.73,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,06322315,,Closed tx vert fx w/manj,A,,9.86,17.69,,10.23,,2.54,30.09,22.63,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,06422318,,Treat odontoid fx w/o graft,A,,22.15,17.52,NA,17.52,,8.97,48.64,48.64,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,06522319,,Treat odontoid fx w/graft,A,,24.70,19.05,NA,19.05,,10.43,54.18,54.18,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,06622325,,Treat spine fracture,A,,19.37,17.07,NA,17.07,,6.80,43.24,43.24,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,06722326,,Treat neck spine fracture,A,,20.32,16.37,NA,16.37,,7.43,44.12,44.12,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,06822327,,Treat thorax spine fracture,A,,20.25,17.55,NA,17.55,,7.21,45.01,45.01,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00