No office rate
Use 22326 for the cervical region. This code describes posterior open treatment at a lumbar level.
On this page
CMS RVU26D · Effective 2026-10-01
22325 Spine fracture Medicare reimbursement rates in Virginia
Open posterior surgery to reduce a lumbar vertebral fracture or dislocation is reported for operative treatment of one affected vertebral segment. Compare 22325 office and facility rates across CMS payment localities in Virginia.
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 22325 in Virginia?
Virginia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1367.79–$1606.34
2 of 2 localities have a 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.
Spine surgery
About 22325: Posterior open lumbar fracture treatment
Open posterior surgery to reduce a lumbar vertebral fracture or dislocation is reported for operative treatment of one affected vertebral segment.
This code describes open operative treatment of a fracture or dislocation involving one lumbar vertebra or segment through a posterior approach. The surgeon exposes the affected level and treats the injury directly; these procedures are commonly performed by orthopedic spine surgeons or neurosurgeons in a hospital operating room after traumatic spinal injury. The code is specific to the lumbar region, not cervical or thoracic levels.
Select the code based on the documented spinal region, operative approach, and number of treated segments. The operative report should identify the injured level or levels, the posterior approach, and the treatment performed. An additional treated vertebral segment may be reported with 22328 when supported. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and others at 50%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 22325
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU19.37 · 45%
- Practice expense (office) RVU17.07 · 39%
- Malpractice RVU6.80 · 16%
2.6K
Medicare services in 2024 · #2279 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.
22325 compared with similar codes
Office rates for Virginia, from the same CMS release.
No office rate
Use 22327 for the thoracic region. This code describes posterior open treatment at a lumbar level.
No office rate
22328 reports each additional treated vertebral segment; this code reports the initial lumbar segment.
$970.05–$1,137.58
22315 is for closed treatment with manipulation. This code describes open posterior operative treatment.
Compare 22325 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.
2 of 2 payment localities
Dc + Md/Va Suburbs →
Office / nonfacility
Unavailable
Facility
$1606.34
Virginia →
Office / nonfacility
Unavailable
Facility
$1367.79
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22325 billing questions
How is this code distinguished from 22326 or 22327?
This code is for a lumbar vertebral fracture or dislocation treated through a posterior approach. Codes 22326 and 22327 describe the corresponding treatment in the cervical and thoracic regions.
When is 22328 reported with this procedure?
Report 22328 for each additional treated vertebral segment when the operative documentation supports treatment beyond the first segment.
Can this code be used for closed fracture treatment?
No. It describes open posterior operative treatment. Codes 22310 and 22315 are closed-treatment alternatives when their respective treatment circumstances are met.
What documentation supports reporting this code?
The operative report should establish the lumbar level, the fracture or dislocation treated, the posterior approach, and the number of treated segments.
How does Medicare handle multiple procedures in the same session?
The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple procedure reduction.
May an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; 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.
2,06322315,,Closed tx vert fx w/manj,A,,9.86,17.69,,10.23,,2.54,30.09,22.63,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,06422318,,Treat odontoid fx w/o graft,A,,22.15,17.52,NA,17.52,,8.97,48.64,48.64,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,06522319,,Treat odontoid fx w/graft,A,,24.70,19.05,NA,19.05,,10.43,54.18,54.18,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,06622325,,Treat spine fracture,A,,19.37,17.07,NA,17.07,,6.80,43.24,43.24,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,06722326,,Treat neck spine fracture,A,,20.32,16.37,NA,16.37,,7.43,44.12,44.12,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,06822327,,Treat thorax spine fracture,A,,20.25,17.55,NA,17.55,,7.21,45.01,45.01,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,06922328,,Treat each add spine fx,A,,4.49,1.51,NA,1.51,,1.56,7.56,7.56,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00