No office rate
Both describe anterior interbody fusion with limited disc preparation, but 22554 applies to the cervical region and 22556 to the thoracic region.
On this page
CMS RVU26D · Effective 2026-10-01
22556 Thoracic fusion Medicare reimbursement rates in Vermont
Reports anterior interbody fusion at a thoracic spinal level, including the limited disc removal needed to prepare the space for fusion. Compare 22556 office and facility rates across CMS payment localities in Vermont.
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 22556 in Vermont?
Vermont 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
$1466.31
1 of 1 localities have a supported rate.
Payment area: Vermont
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.
Spinal surgery
About 22556: Anterior interbody thoracic fusion
Reports anterior interbody fusion at a thoracic spinal level, including the limited disc removal needed to prepare the space for fusion.
This code describes fusion of a thoracic spinal level through an anterior approach, with limited disc removal to prepare the interspace for fusion. Spine surgeons, including orthopedic spine surgeons and neurosurgeons, typically perform it in a hospital operating room for conditions such as thoracic instability, deformity, or disc disease requiring fusion. The code includes the disc preparation inherent to the fusion, rather than a separate extensive decompression service.
Report it for the thoracic region; cervical and lumbar interbody fusions use different codes. Documentation should identify the spinal level, anterior approach, fusion work, and any additional levels or separately performed services. Code 22585 may be reported for each additional interspace when its requirements are met. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral adjustment is inappropriate. Assistant-at-surgery and co-surgeon payment are permitted; team surgery is not.
CMS billing rules for 22556
- 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 permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU24.08 · 50%
- Practice expense (office) RVU16.08 · 34%
- Malpractice RVU7.71 · 16%
485
Medicare services in 2024 · #3592 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.
22556 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
22558 is the lumbar-region anterior interbody fusion code; use 22556 for the thoracic region.
No office rate
22532 describes thoracic fusion through a lateral extracavitary approach. Code 22556 is for an anterior approach.
No office rate
22556 reports the primary thoracic interspace fusion. Code 22585 is an add-on for each additional interspace, not a substitute for the primary code.
Compare 22556 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
Vermont →
Office / nonfacility
Unavailable
Facility
$1466.31
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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 22556 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
2,086
- Code
- 22556
- Physician work
- 24.08
- Practice expense
- 16.08
- Malpractice
- 7.71
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 24.08 | × 1.000 | 24.0800 |
| Practice expense | 16.08 | × 0.990 | 15.9192 |
| Malpractice | 7.71 | × 0.506 | 3.9013 |
| Total RVUs | 43.9005 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$1466.31
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 24.08 | 1 |
| Practice expense | 16.08 | 0.99 |
| Malpractice | 7.71 | 0.506 |
(24.08 × 1 + 16.08 × 0.99 + 7.71 × 0.506) × $33.4009 = $1466.31
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.
22556 billing questions
How does this differ from 22554 or 22558?
22556 is for anterior interbody fusion in the thoracic region. Code 22554 is the cervical counterpart, and 22558 is for the lumbar region.
Can 22585 be reported with 22556?
Yes. When the surgeon fuses an additional interspace, 22585 may be reported as the add-on code for that additional level.
Is disc removal separately reported?
The limited disc removal used to prepare the interspace for fusion is included in 22556. A separately performed decompression is distinct work and should be documented as such.
Can instrumentation or graft services be reported separately?
Instrumentation or bone graft services may be separately reportable when performed and supported by the operative documentation. The fusion code itself includes the limited disc preparation, not every separately performed service.
How does the 90-day global period affect billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period. Same-session procedures are subject to the standard multiple-procedure reduction when applicable.
Can the claim include an assistant or co-surgeon?
CMS permits payment for an assistant at surgery and for co-surgeons for this code. Team surgery is not permitted.
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.
2,08322551,,Arthrd ant ntrbdy cervical,A,,24.38,15.43,NA,15.43,,8.24,48.05,48.05,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,08422552,,Arthrd ant ntrbd cervical ea,A,,6.34,2.13,NA,2.13,,2.10,10.57,10.57,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,08522554,,Arthrd ant ntrbd min dsc crv,A,,17.25,13.35,NA,13.35,,5.80,36.40,36.40,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,08622556,,Arthrd ant ntrbd min dsc thc,A,,24.08,16.08,NA,16.08,,7.71,47.87,47.87,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,08722558,,Arthrd ant ntrbd min dsc lum,A,,22.94,13.20,NA,13.20,,6.49,42.63,42.63,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,08822585,,Arthrd ant ntrbd min dsc ea,A,,5.38,1.62,NA,1.62,,1.61,8.61,8.61,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,08922586,,Arthrd pre-sac ntrbdy l5-s1,A,,27.42,21.11,NA,21.11,,11.59,60.12,60.12,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817