Billing code 22210: Spinal osteotomyMedicare rate & RVUs in Texas
Reports one-segment posterior or posterolateral cervical osteotomy, often for fixed deformity correction, with associated discectomy included in the operative service.
CMS doesn’t publish an office rate for 22210 in Texas.
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 22210 covers
This code represents a posterior or posterolateral osteotomy at one cervical vertebral segment; discectomy performed as part of the corrective work is included. The surgeon removes or reshapes bone to mobilize a rigid deformity, such as fixed cervical kyphosis, and improve alignment. Orthopedic spine surgeons and neurosurgeons typically perform the procedure in an operating room as part of cervical deformity reconstruction.
Choose the code when the operative report supports one treated cervical segment and the posterior or posterolateral approach. Document the level, approach, osteotomy work, and number of segments. The service 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, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is not appropriate. An assistant at surgery may be paid; co-surgeons require 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 22210 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $1,719.96 |
| Beaumont | Unavailable | $1,638.80 |
| Brazoria | Unavailable | $1,654.94 |
| Dallas | Unavailable | $1,679.98 |
| Fort Worth | Unavailable | $1,677.34 |
| Galveston | Unavailable | $1,669.18 |
| Houston | Unavailable | $1,817.62 |
| Rest Of Texas | Unavailable | $1,655.78 |
How the 22210 rate is calculated
Each of 22210’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 · 22210
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 24.75Practice expense 18.44Malpractice 8.11
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 22210
22210 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 22210
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 · 22210
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
22210 without 51 · national facility
$1,713.47
Spinal osteotomy
22210-51 · Second procedure: 50%
$856.74
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%).
22210 compared with similar codes
Compare codes
22210 vs 22212 vs 22214 vs 22216 vs 22220: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 22212Spinal osteotomy
- Use 22212 when the one-segment osteotomy is thoracic; 22210 is for a cervical segment.
- 22214Spine osteotomy
- Use 22214 when the one-segment osteotomy is lumbar; 22210 is for a cervical segment.
- 22216Spinal osteotomy
- 22216 reports additional segments and is not the primary code for the first segment. Use 22210 for the cervical primary segment.
- 22220Spinal osteotomy
- Both describe cervical osteotomy work at one segment, but 22220 uses an anterior approach; 22210 uses a posterior or posterolateral approach.
22210 billing questions
How is this code distinguished from 22212 or 22214?
Use 22210 for one cervical segment. Code 22212 is for a thoracic segment, while 22214 is for a lumbar segment.
Can 22216 be reported with this code?
When the surgeon performs osteotomy work at additional vertebral segments, 22216 is the add-on code for those additional segments. The operative report should support the number and location of the treated segments.
Is the associated discectomy separately reported?
Discectomy performed as part of the osteotomy is included in this service. Document the osteotomy and any separately performed procedures distinctly.
Should modifier 50 be appended for bilateral work?
No. The descriptor and anatomy make modifier 50 inappropriate for this code.
What assistant or co-surgeon rules apply?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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
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