Billing code 22220: Spinal osteotomyMedicare rate & RVUs in Utah

Report an anterior cervical osteotomy with disc removal when a surgeon releases one vertebral segment to correct a fixed cervical deformity.

CMS RVU26DEffective Oct 1, 20261 payment locality503 Medicare services in 2024

CMS doesn’t publish an office rate for 22220 in Utah.

—Office (non-facility)
$1,500.22Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 22220 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Utah
  2. What 22220 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 22220 covers

This service involves an anteriorly approached osteotomy at one cervical vertebral segment, with removal of the intervening disc as part of the release. A spine surgeon may perform it to mobilize a fixed deformity, such as cervical kyphosis, when correction requires an osteotomy rather than routine disc decompression. It is performed in the operating room and may be part of a larger reconstruction or fusion procedure.

Report one unit for the cervical segment actually osteotomized. The operative report should identify the treated level, anterior approach, bony release, associated disc removal, and correction performed. Routine cervical discectomy and fusion without an osteotomy is not this service; 22226 describes each additional segment. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. 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.

22220 in Utah

22220 office and facility rates by payment locality
Payment localityOfficeFacility
UtahUnavailable$1,500.22

How the 22220 rate is calculated

Each of 22220’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 · 22220

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 22.37Practice expense 17.24Malpractice 7.06

46.6700 adjusted RVUs×$33.4009 conversion factor=$1,558.82

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 22220

22220 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 22220

Spinal osteotomy

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 22220

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

22220 without 51 · national facility

$1,558.82

Spinal osteotomy

22220-51 · Second procedure: 50%

$779.41

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%).

When to use modifier 51

22220 compared with similar codes

Compare codes

22220 vs 22210 vs 22222 vs 22226 vs 22551: national Medicare rates

Swap in your local Medicare rate.

  • 22220
    Spinal osteotomy · 22.37 wRVU
    —
  • 22210
    Spinal osteotomy · 24.75 wRVU
    —
  • 22222
    Spinal osteotomy · 22.51 wRVU
    —
  • 22226
    Spinal osteotomy · 5.88 wRVU
    —
  • 22551
    ACDF · 24.38 wRVU
    —

How to choose

22210Spinal osteotomy
Both describe a cervical osteotomy with disc removal, but 22210 is the posterior-approach service; 22220 is anterior.
22222Spinal osteotomy
This is the corresponding anterior osteotomy for a thoracic segment. Use 22220 for a cervical segment.
22226Spinal osteotomy
22220 describes the first cervical segment; 22226 describes each additional anterior osteotomy segment.
22551ACDF
22551 describes anterior cervical discectomy and fusion, not an osteotomy for deformity release. Report 22220 only when the operative work includes the osteotomy.

22220 billing questions

How is 22220 different from routine anterior cervical discectomy and fusion?

22220 requires an osteotomy to release a cervical vertebral segment for deformity correction. Routine disc removal and fusion without that osteotomy is not enough to report it.

Does 22220 include removal of the disc?

Yes. Disc removal at the treated segment is part of the osteotomy service; do not separately report that same disc removal as a separate service.

When is 22226 used with 22220?

Use 22220 for the first anterior cervical segment osteotomized and 22226 for each additional segment when documented.

What operative documentation supports 22220?

Document the cervical level, anterior approach, vertebral osteotomy and associated disc removal, and the deformity release or correction performed.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeons are paid only with supporting documentation; team surgery is not permitted.

How does the global period affect postoperative billing?

The 90-day global 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
RVUs for 22220PPRRVU2026_Oct_nonQPP.csv, line 2,058 (RVU26D)
Geographic factors for UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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