No office rate
22867 covers the initial lumbar interspace treated with stabilization and open decompression. Use 22868 for each qualifying additional interspace.
On this page
CMS RVU26D · Effective 2026-10-01
22868 Lumbar stabilization Medicare reimbursement rates in Rhode Island
Reports each additional lumbar interspace treated with an interlaminar or interspinous stabilization device and open decompression beyond the initial level. Compare 22868 office and facility rates across CMS payment localities in Rhode Island.
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 22868 in Rhode Island?
Rhode Island has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$214.29
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
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 22868: Additional lumbar stabilization with decompression
Reports each additional lumbar interspace treated with an interlaminar or interspinous stabilization device and open decompression beyond the initial level.
This add-on represents placement of a stabilization device at an additional lumbar interspace where the surgeon also performs open decompression. It is used in selected lumbar stenosis operations in which decompression and stabilization are performed without spinal fusion. Orthopedic spine surgeons and neurosurgeons typically perform the work in an operating room; Medicare recorded use in facility settings, not office settings, in 2024.
Report 22868 for each qualifying additional interspace beyond the initial level, together with 22867 for the primary level. The operative report should identify the treated levels and document device placement and open decompression at each additional interspace. Do not use this code for an additional level treated with stabilization without open decompression. Medicare treats 22868 as an add-on: it is billed only with a primary procedure, and payment is within that procedure’s global period.
CMS billing rules for 22868
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU3.90 · 61%
- Practice expense (office) RVU1.31 · 20%
- Malpractice RVU1.22 · 19%
201
Medicare services in 2024 · #4320 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.
22868 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
22869 is for the initial lumbar stabilization level without open decompression; 22868 applies only to an additional level with open decompression.
No office rate
22870 covers an additional stabilization level without open decompression. Choose 22868 when open decompression is performed at the additional interspace.
Compare 22868 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.
1 of 1 payment localities
Rhode Island →
Office / nonfacility
Unavailable
Facility
$214.29
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 22868 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
2,137
- Code
- 22868
- Physician work
- 3.90
- Practice expense
- 1.31
- Malpractice
- 1.22
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.90 | × 1.019 | 3.9741 |
| Practice expense | 1.31 | × 1.033 | 1.3532 |
| Malpractice | 1.22 | × 0.892 | 1.0882 |
| Total RVUs | 6.4156 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$214.29
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.9 | 1.019 |
| Practice expense | 1.31 | 1.033 |
| Malpractice | 1.22 | 0.892 |
(3.9 × 1.019 + 1.31 × 1.033 + 1.22 × 0.892) × $33.4009 = $214.29
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
22868 billing questions
What primary code must accompany 22868?
Report 22868 with 22867 for the initial lumbar interspace. It is not a stand-alone code.
How many units should be reported?
Report one unit for each additional lumbar interspace that receives the stabilization device and open decompression beyond the initial level.
When is 22870 more appropriate?
Use 22870 for each additional level in the corresponding stabilization procedure without open decompression. Code 22868 requires open decompression at the additional interspace.
What documentation supports an additional unit?
The operative report should identify the additional lumbar interspace and describe both device placement and open decompression at that level.
How does Medicare treat payment for 22868?
It is an add-on code that must be billed with a primary procedure, and its payment falls within that procedure’s 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.
2,13422864,,Rmvl tot arthrp 1ntrspc crv,A,,28.67,19.72,NA,19.72,,12.12,60.51,60.51,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,13522865,,Rmvl tot arthrp 1ntrspc lmbr,R,,30.96,22.35,NA,22.35,,13.08,66.39,66.39,0,090,0.10,0.71,0.19,2,0,2,2,2,9,,33.4009,09,0,99,0.00,0.00,0.00
2,13622867,,Insj stablj dev w/dcmprn,A,,14.63,11.34,NA,11.34,,4.33,30.30,30.30,0,090,0.10,0.80,0.10,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,13722868,,Insj stablj dev w/dcmprn,A,,3.90,1.31,NA,1.31,,1.22,6.43,6.43,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,13822869,,Insj stablj dev w/o dcmprn,A,,6.85,4.32,NA,4.32,,0.66,11.83,11.83,0,090,0.10,0.80,0.10,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,13922870,,Insj stablj dev w/o dcmprn,A,,2.28,0.53,NA,0.53,,0.21,3.02,3.02,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,14022899,,Unlisted procedure spine,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,2,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537