No office rate
Use 22819 when the resection involves three or more vertebral segments; 22818 is limited to one or two.
On this page
CMS RVU26D · Effective 2026-10-01
22818 Kyphectomy Medicare reimbursement rates in Vermont
Surgical resection of one or two vertebral segments to correct a focal kyphotic deformity, selected by the number of segments removed. Compare 22818 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 22818 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
$1788.50
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 22818: Kyphectomy, one or two vertebral segments
Surgical resection of one or two vertebral segments to correct a focal kyphotic deformity, selected by the number of segments removed.
Kyphectomy removes one or two vertebral segments at the apex of a kyphotic deformity to correct a sharp spinal angulation. It may be performed for severe congenital kyphosis or a prominent deformity in a patient with myelomeningocele that interferes with sitting or creates pressure over the prominence. An orthopedic spine surgeon or neurosurgeon typically performs the operation in a hospital operating room.
Choose this code by the number of vertebral segments resected, not the number fused or instrumented. The operative report should identify the resection levels and extent; use 22819 when three or more segments are removed. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For other procedures in the same session, the highest-valued procedure is paid in full and others at 50%. Do not use modifier 50 to represent bilateral work. Assistant-at-surgery payment may be available, and co-surgeons and team surgery are permitted.
CMS billing rules for 22818
- 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 permitted.
Where the value comes from
- Work RVU33.47 · 58%
- Practice expense (office) RVU16.63 · 29%
- Malpractice RVU7.14 · 12%
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.
22818 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
22800 describes posterior fusion for spinal deformity, not resection of the kyphotic apex.
No office rate
22802 is posterior arthrodesis for deformity across a longer fusion span; 22818 is selected by the number of segments resected.
Compare 22818 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
$1788.50
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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 22818 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
2,106
- Code
- 22818
- Physician work
- 33.47
- Practice expense
- 16.63
- Malpractice
- 7.14
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 33.47 | × 1.000 | 33.4700 |
| Practice expense | 16.63 | × 0.990 | 16.4637 |
| Malpractice | 7.14 | × 0.506 | 3.6128 |
| Total RVUs | 53.5465 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$1788.50
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 33.47 | 1 |
| Practice expense | 16.63 | 0.99 |
| Malpractice | 7.14 | 0.506 |
(33.47 × 1 + 16.63 × 0.99 + 7.14 × 0.506) × $33.4009 = $1788.50
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.
22818 billing questions
How do I choose between 22818 and 22819?
Count the vertebral segments resected: 22818 is for one or two, while 22819 is for three or more. The count is based on the resection, not the fusion or instrumentation span.
Is this the same as posterior arthrodesis for deformity?
No. Kyphectomy reports resection of vertebral segments at the kyphotic apex; posterior arthrodesis codes describe fusion for spinal deformity.
Can spinal instrumentation be reported with 22818?
Instrumentation may accompany the resection when performed. Document the fixation construct and report the applicable instrumentation service separately when supported by the operative work and coding edits.
Should modifier 50 be appended?
No. This is a midline spinal resection, not a paired-side service, so modifier 50 is not appropriate.
What documentation supports the segment count?
The operative report should identify the vertebral levels and state how many segments were resected. Do not use the number of fused or instrumented segments as a substitute.
How does the 90-day global affect postoperative reporting?
The day-before preoperative visit and 90 days of related postoperative care are included in the 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 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.
2,10322808,,Arthrd ant dfrm 2-3 vrt sgm,A,,26.82,17.22,NA,17.22,,8.49,52.53,52.53,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,10422810,,Arthrd ant dfrm 4-7 vrt sgm,A,,30.71,16.51,NA,16.51,,6.55,53.77,53.77,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,10522812,,Arthrd ant dfrm 8+ vrt sgm,A,,33.39,18.50,NA,18.50,,7.12,59.01,59.01,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,10622818,,Kyphectomy 1-2 segments,A,,33.47,16.63,NA,16.63,,7.14,57.24,57.24,0,090,0.11,0.76,0.13,2,0,2,2,2,9,,33.4009,09,0,99,0.00,0.00,0.00
2,10722819,,Kyphectomy 3 or more,A,,38.40,19.34,NA,19.34,,8.18,65.92,65.92,0,090,0.11,0.76,0.13,2,0,2,2,2,9,,33.4009,09,0,99,0.00,0.00,0.00
2,10822830,,Exploration of spinal fusion,A,,10.94,9.42,NA,9.42,,3.34,23.70,23.70,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,10922836,,Ant thrc vrt body tethrg <7,A,,31.20,16.33,NA,16.33,,6.64,54.17,54.17,0,090,0.10,0.69,0.21,2,0,0,2,1,9,,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