Billing code 22551: ACDFMedicare rate & RVUs in Washington
Reports anterior cervical discectomy and fusion at one interspace below C2 when the surgeon also decompresses the spinal cord or nerve roots.
CMS doesn’t publish an office rate for 22551 in Washington.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 22551 covers
This code describes an anterior cervical discectomy and fusion at a single interspace below C2 that includes removal of disc and bone material to decompress the spinal cord or nerve roots. A spine surgeon, commonly an orthopedic surgeon or neurosurgeon, performs the operation in an operating room. The surgeon prepares the disc space and fuses the adjacent vertebrae, often using graft material and an interbody device. Typical indications include cervical disc disease or osteophytes causing radiculopathy or myelopathy when decompression and fusion are performed at that level.
Report 22551 for one treated interspace when the operative documentation supports both decompression and fusion; the documented level and work distinguish it from fusion without decompression. Additional cervical interspaces may be reported with add-on code 22552. Disc removal, osteophyte removal, and decompression at the coded level are included. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In the same session, the highest-valued procedure is paid in full and other procedures receive the standard multiple-procedure reduction. Modifier 50 is inappropriate for this anatomy. Assistant-at-surgery payment may be made, co-surgeons are permitted, 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.
Where 22551 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $1,577.04 |
| Seattle (King Cnty) | Unavailable | $1,712.25 |
How the 22551 rate is calculated
Each of 22551’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 · 22551
RVUs × geographic indexes × conversion factor
Work24.38
24.38 RVUs× 1.000 GPCI
Practice expense15.43
15.43 RVUs× 1.000 GPCI
Malpractice8.24
8.24 RVUs× 1.000 GPCI
Adjusted RVUs
48.0500
Conversion factor
$33.4009
Medicare rate
$1,604.91
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 22551
22551 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 22551
ACDF
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 2 | Permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 22551
ACDF
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
22551 without 51 · national facility
$1,604.91
ACDF
22551-51 · Second procedure: 50%
$802.46
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%).
22551 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 22552Cervical fusion
- 22552 is the add-on for each additional cervical interspace; 22551 reports the primary interspace.
- 22554Cervical fusion
- 22554 is for cervical anterior fusion without decompression. Choose 22551 when the surgeon also decompresses the spinal cord or nerve roots.
- 22558Anterior fusion
- 22558 describes anterior interbody fusion in the lumbar region, rather than the cervical interspace below C2 covered by 22551.
22551 billing questions
When should 22551 be chosen over 22554?
Use 22551 when the surgeon performs cervical decompression along with the fusion at the interspace. Code 22554 describes cervical anterior fusion without that decompression work.
Can 22552 be reported with 22551?
Yes. Report 22552 as the add-on for each additional cervical interspace treated with the qualifying fusion and decompression service.
Is the discectomy separately reported at the 22551 level?
No. Disc removal, osteophyte removal, and neural decompression at the treated level are included in 22551.
What should the operative report document?
Document the cervical level, the decompression performed, the fusion work, and the number of interspaces treated. The record should support that the work at the 22551 level included decompression as well as fusion.
Can an assistant or co-surgeon be reported?
CMS permits payment for an assistant at surgery and permits co-surgeons for this code. Team-surgery billing is not permitted.
Should modifier 50 be used for two-sided cervical work?
No. Modifier 50 is inappropriate for this code's anatomy; report the treated interspace rather than bilateral units.
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
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