Billing code 22632: Lumbar fusionMedicare rate & RVUs in Texas
Reports each additional lumbar interspace fused using a posterior interbody technique during a multilevel lumbar fusion, beyond the first interspace.
CMS doesn’t publish an office rate for 22632 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 22632 covers
This add-on represents fusion at an additional lumbar disc space using a posterior interbody approach, such as a multilevel posterior lumbar interbody fusion or transforaminal lumbar interbody fusion. Spine surgeons, including orthopedic surgeons and neurosurgeons, perform these procedures in the operating room. The additional level must receive the interbody fusion technique; simply extending a posterolateral fusion to another vertebral segment is a different service.
Report one unit for each additional lumbar interspace beyond the first, with the primary posterior interbody fusion code 22630. The operative report should identify the treated interspaces and document posterior interbody arthrodesis at each additional level. CMS classifies 22632 as an add-on code: it is billed only with a primary procedure and paid within that procedure’s global period.
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 22632 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 | $284.46 |
| Beaumont | Unavailable | $278.14 |
| Brazoria | Unavailable | $275.27 |
| Dallas | Unavailable | $280.39 |
| Fort Worth | Unavailable | $280.59 |
| Galveston | Unavailable | $278.25 |
| Houston | Unavailable | $311.02 |
| Rest Of Texas | Unavailable | $278.84 |
How the 22632 rate is calculated
Each of 22632’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 · 22632
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 5.09Practice expense 1.73Malpractice 1.79
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 22632
The CMS indicators that decide how 22632 is paid alongside other services.
CMS payment indicators · 22632
Lumbar fusion
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 2 | Permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 80 · payment effect
With and without the modifier
22632 without 80 · national facility
$287.58
Lumbar fusion
22632-80 · Assistant: 16%
$46.01
A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.
22632 compared with similar codes
Compare codes
22632 vs 22630 vs 22634 vs 22614 vs 22633: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 22630Lumbar fusion
- 22630 reports posterior interbody fusion at the first lumbar interspace. 22632 is the add-on for each additional interspace and is reported with 22630.
- 22634Lumbar fusion
- 22634 reports each additional lumbar interspace treated with the combined technique represented by 22633. 22632 is for additional interspaces with the posterior interbody technique represented by 22630.
- 22614Spinal fusion
- 22614 counts additional vertebral segments for posterior or posterolateral fusion. 22632 counts additional lumbar interspaces fused using a posterior interbody technique.
- 22633Lumbar fusion
- 22633 is the primary code for the combined posterior or posterolateral and interbody technique at the first lumbar interspace. It is not the add-on code for additional posterior interbody-only levels.
22632 billing questions
Which primary code must accompany 22632?
Report 22632 with 22630, which represents the first lumbar interspace fused using the posterior interbody technique. Code 22632 accounts for each additional interspace treated with that technique.
How is 22632 different from 22614?
22632 is for each additional lumbar interspace fused with a posterior interbody technique. 22614 is for each additional vertebral segment fused using a posterior or posterolateral technique.
When is 22634 used instead?
Use 22634 for each additional lumbar interspace when the surgeon performs the combined posterior or posterolateral and interbody fusion technique represented by 22633. Use 22632 for additional interspaces in a posterior interbody fusion reported with 22630.
What documentation supports an additional unit?
The operative report should identify each additional lumbar interspace and describe the posterior interbody fusion performed there. The service must be at an additional interspace, not merely another vertebral segment.
How does the add-on status affect payment?
22632 is billed only with its primary procedure, 22630, and CMS pays it within the primary 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 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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