No office rate
Use 22840 for posterior nonsegmental fixation, such as fixation across one motion segment. Use 22842 when posterior segmental instrumentation spans three to six vertebral segments.
On this page
CMS RVU26D · Effective 2026-10-01
22842 Spinal fixation Medicare reimbursement rates in Wyoming
Reports posterior segmental spinal fixation spanning three to six vertebral segments, commonly added to a fusion procedure requiring multilevel stabilization. Compare 22842 office and facility rates across CMS payment localities in Wyoming.
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 22842 in Wyoming?
Wyoming 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
$645.22
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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 instrumentation
About 22842: Posterior segmental spinal fixation, three to six segments
Reports posterior segmental spinal fixation spanning three to six vertebral segments, commonly added to a fusion procedure requiring multilevel stabilization.
This code describes posterior segmental fixation spanning three to six vertebral segments, using connected hardware such as rods with pedicle screws, hooks, or wires. Spine surgeons commonly place this instrumentation during surgery for spinal fusion when multilevel stabilization is needed, including for deformity or instability. The code identifies the fixation construct, not the spinal fusion itself or an interbody device.
Select the code by the number of vertebral segments spanned by the posterior segmental construct, not by the number of screws or other individual implants. The operative report should establish the posterior approach, segmental fixation method, and levels instrumented. This is an add-on code: report it with an eligible primary procedure, not by itself. CMS pays it within the primary procedure’s global period.
CMS billing rules for 22842
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU12.25 · 60%
- Practice expense (office) RVU4.10 · 20%
- Malpractice RVU4.01 · 20%
84.4K
Medicare services in 2024 · #612 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.
22842 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
Both describe posterior segmental instrumentation; 22843 is for a construct spanning more vertebral segments than 22842.
No office rate
22845 describes anterior instrumentation across a limited span. Choose based on the approach and construct, rather than treating anterior and posterior fixation as interchangeable.
No office rate
22853 concerns insertion of an interbody biomechanical device. It does not describe the posterior segmental fixation reported with 22842.
Compare 22842 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
Wyoming** →
Office / nonfacility
Unavailable
Facility
$645.22
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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 22842 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
2,114
- Code
- 22842
- Physician work
- 12.25
- Practice expense
- 4.10
- Malpractice
- 4.01
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 12.25 | × 1.000 | 12.2500 |
| Practice expense | 4.10 | × 1.000 | 4.1000 |
| Malpractice | 4.01 | × 0.740 | 2.9674 |
| Total RVUs | 19.3174 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$645.22
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 12.25 | 1 |
| Practice expense | 4.1 | 1 |
| Malpractice | 4.01 | 0.74 |
(12.25 × 1 + 4.1 × 1 + 4.01 × 0.74) × $33.4009 = $645.22
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.
22842 billing questions
How do I distinguish this code from 22840?
This code is for posterior segmental fixation spanning three to six vertebral segments. Code 22840 describes posterior nonsegmental fixation, typically spanning one motion segment or using a nonsegmental technique.
How are the segments counted?
Count the vertebral segments spanned by the fixation construct, rather than the number of screws, hooks, or rods. The operative report should identify the instrumented levels and the construct.
Can 22842 be reported by itself?
No. It is an add-on code and must be reported with an eligible primary procedure. For example, posterior lumbar fusion code 22612 may be a primary procedure when performed with the instrumentation.
Is an interbody device included in this service?
This code describes posterior fixation, not insertion of an interbody biomechanical device. When an interbody device is placed, determine separately whether the applicable device code is supported.
What documentation supports reporting 22842?
Document the posterior approach, fixation method, and vertebral levels spanned. The record should support a segmental construct across three to six vertebral segments.
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.
2,11122838,,Rev rplc/rmv thrc vrt tethrg,A,,35.10,11.57,NA,11.57,,3.75,50.42,50.42,0,090,0.10,0.69,0.21,2,0,0,2,1,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11222840,,Insert spine fixation device,A,,12.21,4.04,NA,4.04,,3.76,20.01,20.01,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11322841,,Insert spine fixation device,B,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11422842,,Insert spine fixation device,A,,12.25,4.10,NA,4.10,,4.01,20.36,20.36,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11522843,,Insert spine fixation device,A,,13.10,4.40,NA,4.40,,4.31,21.81,21.81,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11622844,,Insert spine fixation device,A,,16.01,5.32,NA,5.32,,4.87,26.20,26.20,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,11722845,,Insert spine fixation device,A,,11.64,3.90,NA,3.90,,3.85,19.39,19.39,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,