No office rate
Both describe lumbar interspinous stabilization, but 22867 includes open decompression; 22869 is for the procedure without it.
On this page
CMS RVU26D · Effective 2026-10-01
22869 Spinal stabilization Medicare reimbursement rates in Texas
Reports placement of a lumbar interspinous stabilization device at one level when the surgeon does not perform open decompression or discectomy. Compare 22869 office and facility rates across CMS payment localities in Texas.
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 22869 in Texas?
Texas has 8 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 8 payment areas shown below, using the same CMS release.
Office / nonfacility
No 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.
Where 22869 pays more and less in Texas
Spine surgery
About 22869: Lumbar interspinous stabilization without decompression
Reports placement of a lumbar interspinous stabilization device at one level when the surgeon does not perform open decompression or discectomy.
CPT 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.
CMS billing rules for 22869
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU6.85 · 58%
- Practice expense (office) RVU4.32 · 37%
- Malpractice RVU0.66 · 6%
2.8K
Medicare services in 2024 · #2226 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.
22869 compared with similar codes
Office rates for Texas, from the same CMS release.
No office rate
22870 reports each additional lumbar level after the first level treated without open decompression or discectomy; 22869 is the single-level code.
No office rate
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.
Compare 22869 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.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Office Unavailable | Facility $401.45 |
| Beaumont | Office Unavailable | Facility $380.58 |
| Brazoria | Office Unavailable | Facility $390.81 |
| Dallas | Office Unavailable | Facility $393.48 |
| Fort Worth | Office Unavailable | Facility $392.33 |
| Galveston | Office Unavailable | Facility $392.16 |
| Houston | Office Unavailable | Facility $404.24 |
| Rest Of Texas | Office Unavailable | Facility $385.64 |
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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 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.
2,13522865,,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
2,14122900,,Exc abdl tum deep < 5 cm,A,,8.11,6.30,NA,6.30,,1.98,16.39,16.39,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00