Medicare Reimbursement for CPT 22534

This page covers a CPT procedure code used in spine-related surgical services; the exact clinical description is licensed by the AMA and not reproduced here. It shows the Medicare Physician Fee Schedule (PFS) allowed amount at the national level and by locality, broken out for non-facility and facility settings.

Medicare allowed amount (2026)

Locality	Non-facility	Facility
National (unadjusted)	$323.65	$323.65
ALASKA* (AK)	$396.75	$396.75
ALABAMA (AL)	$287.87	$287.87
ARKANSAS (AR)	$283.58	$283.58
ARIZONA (AZ)	$312.46	$312.46
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$332.07	$332.07
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$335.28	$335.28
OXNARD-THOUSAND OAKS-VENTURA (CA)	$316.86	$316.86
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$322.07	$322.07
NAPA (CA)	$325.16	$325.16
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$334.24	$334.24
VALLEJO (CA)	$322.04	$322.04
BAKERSFIELD (CA)	$308.64	$308.64
CHICO (CA)	$303.59	$303.59
FRESNO (CA)	$303.59	$303.59
HANFORD-CORCORAN (CA)	$303.59	$303.59
MADERA (CA)	$303.59	$303.59
MERCED (CA)	$303.59	$303.59
MODESTO (CA)	$303.59	$303.59
REDDING (CA)	$303.59	$303.59
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$324.01	$324.01
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$311.64	$311.64
SALINAS (CA)	$310.40	$310.40
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$344.15	$344.15
SANTA CRUZ-WATSONVILLE (CA)	$312.08	$312.08
SANTA ROSA-PETALUMA (CA)	$314.68	$314.68
STOCKTON (CA)	$303.59	$303.59
VISALIA (CA)	$303.59	$303.59
YUBA CITY (CA)	$303.59	$303.59
EL CENTRO (CA)	$303.91	$303.91
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$312.99	$312.99
SAN LUIS OBISPO-PASO ROBLES (CA)	$306.38	$306.38
SANTA MARIA-SANTA BARBARA (CA)	$310.27	$310.27
REST OF CALIFORNIA (CA)	$303.59	$303.59
COLORADO (CO)	$316.17	$316.17
CONNECTICUT (CT)	$345.94	$345.94
DC + MD/VA SUBURBS (DC)	$352.93	$352.93
DELAWARE (DE)	$317.41	$317.41
FORT LAUDERDALE (FL)	$376.04	$376.04
MIAMI (FL)	$423.86	$423.86
REST OF FLORIDA (FL)	$352.89	$352.89
ATLANTA (GA)	$338.10	$338.10
REST OF GEORGIA (GA)	$328.91	$328.91
HAWAII, GUAM (HI)	$305.67	$305.67
IOWA (IA)	$279.68	$279.68
IDAHO (ID)	$284.85	$284.85
EAST ST. LOUIS (IL)	$383.16	$383.16
SUBURBAN CHICAGO (IL)	$376.02	$376.02
CHICAGO (IL)	$407.96	$407.96
REST OF ILLINOIS (IL)	$353.93	$353.93
INDIANA (IN)	$286.13	$286.13
KANSAS (KS)	$285.79	$285.79
KENTUCKY (KY)	$311.04	$311.04
NEW ORLEANS (LA)	$328.51	$328.51
REST OF LOUISIANA (LA)	$313.52	$313.52
METROPOLITAN BOSTON (MA)	$337.21	$337.21
REST OF MASSACHUSETTS (MA)	$317.26	$317.26
BALTIMORE/SURR. CNTYS (MD)	$346.63	$346.63
REST OF MARYLAND (MD)	$321.15	$321.15
SOUTHERN MAINE (ME)	$299.53	$299.53
REST OF MAINE (ME)	$294.36	$294.36
DETROIT (MI)	$365.15	$365.15
REST OF MICHIGAN (MI)	$326.25	$326.25
MINNESOTA (MN)	$280.62	$280.62
METROPOLITAN ST. LOUIS (MO)	$320.67	$320.67
METROPOLITAN KANSAS CITY (MO)	$318.23	$318.23
REST OF MISSOURI (MO)	$313.05	$313.05
MISSISSIPPI (MS)	$298.00	$298.00
MONTANA** (MT)	$323.53	$323.53
NORTH CAROLINA (NC)	$296.28	$296.28
NORTH DAKOTA** (ND)	$285.76	$285.76
NEBRASKA (NE)	$278.98	$278.98
NEW HAMPSHIRE (NH)	$318.34	$318.34
NORTHERN NJ (NJ)	$350.65	$350.65
REST OF NEW JERSEY (NJ)	$343.61	$343.61
NEW MEXICO (NM)	$331.10	$331.10
NEVADA** (NV)	$313.07	$313.07
MANHATTAN (NY)	$384.02	$384.02
NYC SUBURBS/LONG ISLAND (NY)	$403.06	$403.06
POUGHKPSIE/N NYC SUBURBS (NY)	$351.99	$351.99
QUEENS (NY)	$376.13	$376.13
REST OF NEW YORK (NY)	$301.47	$301.47
OHIO (OH)	$318.53	$318.53
OKLAHOMA (OK)	$302.49	$302.49
PORTLAND (OR)	$317.64	$317.64
REST OF OREGON (OR)	$304.45	$304.45
METROPOLITAN PHILADELPHIA (PA)	$342.14	$342.14
REST OF PENNSYLVANIA (PA)	$314.83	$314.83
PUERTO RICO (PR)	$323.41	$323.41
RHODE ISLAND (RI)	$322.61	$322.61
SOUTH CAROLINA (SC)	$309.16	$309.16
SOUTH DAKOTA** (SD)	$281.29	$281.29
TENNESSEE (TN)	$288.22	$288.22
BRAZORIA (TX)	$310.60	$310.60
DALLAS (TX)	$316.09	$316.09
GALVESTON (TX)	$313.79	$313.79
HOUSTON (TX)	$348.75	$348.75
BEAUMONT (TX)	$313.29	$313.29
FORT WORTH (TX)	$316.27	$316.27
AUSTIN (TX)	$320.53	$320.53
REST OF TEXAS (TX)	$314.16	$314.16
UTAH (UT)	$313.26	$313.26
VIRGINIA (VA)	$303.80	$303.80
VIRGIN ISLANDS (VI)	$323.41	$323.41
VERMONT (VT)	$291.49	$291.49
SEATTLE (KING CNTY) (WA)	$336.44	$336.44
REST OF WASHINGTON (WA)	$314.38	$314.38
WISCONSIN (WI)	$276.79	$276.79
WEST VIRGINIA (WV)	$342.66	$342.66
WYOMING** (WY)	$307.07	$307.07

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 3 units per patient per day — Date of Service Edit: Clinical. Units above the MUE are denied; some MUEs can be exceeded only with appropriate documentation and modifiers where policy allows.

How the amount is calculated

Medicare's PFS amount is built from three Relative Value Units (RVUs) — physician work, practice expense, and malpractice — each adjusted by the Geographic Practice Cost Indices (GPCIs) for the specific locality where the service is furnished. The locality-adjusted RVUs are summed and then multiplied by the annual Medicare conversion factor to produce the allowed amount. Non-facility and facility settings can have different practice-expense RVUs, reflecting whether overhead costs (like supplies and staff time) are borne by the physician's office or by a facility such as a hospital. The conversion factor and RVUs are updated annually and can shift due to legislative or regulatory changes.

RVUs — work 5.84, practice expense 1.94 (non-facility) / 1.94 (facility), malpractice 1.91 — × the locality GPCIs × the 2026 conversion factor of $33.40.

Good to know

This is an estimate only, not a guarantee of payment.
Medicare typically pays 80% of the allowed amount after the annual Part B deductible is met; the patient or secondary payer is generally responsible for the remainder.
Modifiers, multiple-procedure reductions, sequestration, and annual budget-neutrality adjustments can change the actual paid amount.
Local Medicare Administrative Contractor (MAC) policies and edits may affect coverage or payment; always verify with your MAC before billing.

Frequently asked

Why does the facility amount differ from the non-facility amount?

The two settings often use different practice-expense RVUs because overhead costs are allocated differently depending on whether the service is performed in a physician's office versus a hospital or ambulatory surgical center.

Does this amount include anesthesia or assistant-surgeon fees?

No. The PFS amount shown reflects only the primary procedure code; anesthesia, assistant-at-surgery, and any add-on codes are billed and paid separately.

Why might my locality's payment differ from the national rate?

Medicare adjusts RVUs using GPCIs that reflect local differences in wages, rents, and malpractice costs, so the same code can pay more or less depending on where the service is furnished.

Will this rate change next year?

Yes — RVUs and the conversion factor are reviewed and typically updated annually, and budget-neutrality adjustments can shift the final payment even if RVUs stay the same.

More free billing tools: all Medicare fees · fee calculator · denial code decoder

Estimated Medicare Physician Fee Schedule amount. Medicare generally pays 80% after the deductible; actual amounts vary by locality, modifiers, sequestration, and annual updates. Verify with your MAC.