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CMS RVU26D · Effective 2026-10-01

22800 Spinal fusion Medicare reimbursement rates in Wisconsin

Reports posterior spinal fusion performed to correct a deformity when the fusion spans no more than six vertebral segments. Compare 22800 office and facility rates across CMS payment localities in Wisconsin.

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 22800 in Wisconsin?

Wisconsin 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

$1159.46

1 of 1 localities have a supported rate.

Payment area: Wisconsin

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.

Find 22800 in your payment locality →

Spinal surgery

About 22800: Posterior spinal deformity fusion, up to six segments

Reports posterior spinal fusion performed to correct a deformity when the fusion spans no more than six vertebral segments.

This code describes a posterior approach arthrodesis performed to correct a spinal deformity, such as scoliosis or kyphosis, across up to six vertebral segments. Orthopedic or neurosurgical spine surgeons commonly perform it in a hospital operating room. The procedure may be done with or without a cast; the defining features are the deformity indication, posterior approach, and extent of the fusion.

Select the code by counting the vertebral segments fused for deformity correction, not by the number of incisions or implants. The operative report should identify the deformity, posterior approach, and fused levels. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

CMS billing rules for 22800

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 RVU19.01 · 48%
  • Practice expense (office) RVU14.54 · 37%
  • Malpractice RVU5.76 · 15%

581

Medicare services in 2024 · #3425 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.

22800 compared with similar codes

Office rates for Wisconsin, from the same CMS release.

22802

Spinal fusion

Posterior deformity, 7-12 segments

No office rate

Both describe posterior deformity arthrodesis; choose 22802 when the fusion spans seven to twelve vertebral segments rather than up to six.

22804

Spinal deformity fusion

Posterior, 13 or more segments

No office rate

This is the posterior deformity arthrodesis level for thirteen or more vertebral segments; 22800 is limited to six.

22808

Anterior fusion

Deformity, 2–3 segments

No office rate

22808 describes anterior deformity arthrodesis across two to three segments. The approach, not just the number of levels, distinguishes it from this posterior fusion code.

22842

Spinal fixation

Posterior, three to six segments

No office rate

22842 describes posterior segmental instrumentation across three to six vertebral segments, not the deformity arthrodesis itself; it may be reported for instrumentation placed during the fusion.

Compare 22800 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

Office and facility base rates · shared scale starting at $0

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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 22800 in Wisconsin.

PPRRVU2026_Oct_nonQPP.csv

2,100

Code
22800
Physician work
19.01
Practice expense
14.54
Malpractice
5.76

GPCI2026.csv

111

Locality
Wisconsin
Physician work
1.000
Practice expense
0.958
Malpractice
0.308
Facility calculation for 22800 in Wisconsin
ComponentRVULocality factorAdjusted
Physician work19.01× 1.00019.0100
Practice expense14.54× 0.95813.9293
Malpractice5.76× 0.3081.7741
Total RVUs34.7134
Conversion factor× 33.4009

Facility rate, Wisconsin$1159.46

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.
Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work19.011
Practice expense14.540.958
Malpractice5.760.308

(19.01 × 1 + 14.54 × 0.958 + 5.76 × 0.308) × $33.4009 = $1159.46

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.

22800 billing questions

How many segments can be reported with this code?

Use it when posterior deformity fusion spans up to six vertebral segments. For a longer fusion, select the corresponding higher-level posterior deformity code.

How does this differ from anterior deformity fusion?

This code describes a posterior approach. Anterior deformity arthrodesis is reported from the anterior code series, with the level determined by the number of segments.

Can spinal instrumentation be reported with the fusion?

Instrumentation may be separately reported when performed and documented. For example, posterior segmental instrumentation across three to six vertebral segments is described by 22842.

Should modifier 50 be appended?

No. Modifier 50 is inappropriate because the descriptor and anatomy do not define a bilateral service.

What documentation supports the segment level?

The operative report should establish deformity correction, the posterior approach, and the vertebral segments fused. The count determines whether this code or a higher-level sibling is appropriate.

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 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.

RVUs for 22800PPRRVU2026_Oct_nonQPP.csv, line 2,100 (RVU26D)
Geographic factors for WisconsinGPCI2026.csv, line 111 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet