Medicare Reimbursement for CPT 22845

CPT 22845 is a surgical procedure code reported for certain spinal instrumentation services; the exact clinical description is licensed by the AMA and not reproduced here. This page shows the Medicare Physician Fee Schedule (PFS) estimated 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)	$647.64	$647.64
ALASKA* (AK)	$792.77	$792.77
ALABAMA (AL)	$575.55	$575.55
ARKANSAS (AR)	$566.91	$566.91
ARIZONA (AZ)	$625.09	$625.09
SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)	$664.04	$664.04
SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) (CA)	$670.44	$670.44
OXNARD-THOUSAND OAKS-VENTURA (CA)	$633.76	$633.76
LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) (CA)	$644.21	$644.21
NAPA (CA)	$650.29	$650.29
SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) (CA)	$668.42	$668.42
VALLEJO (CA)	$643.99	$643.99
BAKERSFIELD (CA)	$617.26	$617.26
CHICO (CA)	$607.09	$607.09
FRESNO (CA)	$607.09	$607.09
HANFORD-CORCORAN (CA)	$607.09	$607.09
MADERA (CA)	$607.09	$607.09
MERCED (CA)	$607.09	$607.09
MODESTO (CA)	$607.09	$607.09
REDDING (CA)	$607.09	$607.09
RIVERSIDE-SAN BERNARDINO-ONTARIO (CA)	$648.24	$648.24
SACRAMENTO-ROSEVILLE-FOLSOM (CA)	$623.21	$623.21
SALINAS (CA)	$620.74	$620.74
SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) (CA)	$688.32	$688.32
SANTA CRUZ-WATSONVILLE (CA)	$624.15	$624.15
SANTA ROSA-PETALUMA (CA)	$629.34	$629.34
STOCKTON (CA)	$607.09	$607.09
VISALIA (CA)	$607.09	$607.09
YUBA CITY (CA)	$607.09	$607.09
EL CENTRO (CA)	$607.73	$607.73
SAN DIEGO-CHULA VISTA-CARLSBAD (CA)	$625.94	$625.94
SAN LUIS OBISPO-PASO ROBLES (CA)	$612.69	$612.69
SANTA MARIA-SANTA BARBARA (CA)	$620.49	$620.49
REST OF CALIFORNIA (CA)	$607.09	$607.09
COLORADO (CO)	$632.48	$632.48
CONNECTICUT (CT)	$692.45	$692.45
DC + MD/VA SUBURBS (DC)	$706.36	$706.36
DELAWARE (DE)	$635.04	$635.04
FORT LAUDERDALE (FL)	$753.24	$753.24
MIAMI (FL)	$849.60	$849.60
REST OF FLORIDA (FL)	$706.59	$706.59
ATLANTA (GA)	$676.74	$676.74
REST OF GEORGIA (GA)	$658.26	$658.26
HAWAII, GUAM (HI)	$611.35	$611.35
IOWA (IA)	$559.03	$559.03
IDAHO (ID)	$569.45	$569.45
EAST ST. LOUIS (IL)	$767.62	$767.62
SUBURBAN CHICAGO (IL)	$753.16	$753.16
CHICAGO (IL)	$817.54	$817.54
REST OF ILLINOIS (IL)	$708.71	$708.71
INDIANA (IN)	$572.04	$572.04
KANSAS (KS)	$571.36	$571.36
KENTUCKY (KY)	$622.25	$622.25
NEW ORLEANS (LA)	$657.45	$657.45
REST OF LOUISIANA (LA)	$627.26	$627.26
METROPOLITAN BOSTON (MA)	$674.71	$674.71
REST OF MASSACHUSETTS (MA)	$634.66	$634.66
BALTIMORE/SURR. CNTYS (MD)	$693.85	$693.85
REST OF MARYLAND (MD)	$642.55	$642.55
SOUTHERN MAINE (ME)	$599.02	$599.02
REST OF MAINE (ME)	$588.61	$588.61
DETROIT (MI)	$731.30	$731.30
REST OF MICHIGAN (MI)	$652.90	$652.90
MINNESOTA (MN)	$560.89	$560.89
METROPOLITAN ST. LOUIS (MO)	$641.65	$641.65
METROPOLITAN KANSAS CITY (MO)	$636.74	$636.74
REST OF MISSOURI (MO)	$626.32	$626.32
MISSISSIPPI (MS)	$595.97	$595.97
MONTANA** (MT)	$647.39	$647.39
NORTH CAROLINA (NC)	$592.49	$592.49
NORTH DAKOTA** (ND)	$571.26	$571.26
NEBRASKA (NE)	$557.63	$557.63
NEW HAMPSHIRE (NH)	$636.91	$636.91
NORTHERN NJ (NJ)	$701.72	$701.72
REST OF NEW JERSEY (NJ)	$687.65	$687.65
NEW MEXICO (NM)	$662.68	$662.68
NEVADA** (NV)	$626.30	$626.30
MANHATTAN (NY)	$768.98	$768.98
NYC SUBURBS/LONG ISLAND (NY)	$807.35	$807.35
POUGHKPSIE/N NYC SUBURBS (NY)	$704.52	$704.52
QUEENS (NY)	$753.07	$753.07
REST OF NEW YORK (NY)	$602.94	$602.94
OHIO (OH)	$637.34	$637.34
OKLAHOMA (OK)	$605.03	$605.03
PORTLAND (OR)	$635.40	$635.40
REST OF OREGON (OR)	$608.93	$608.93
METROPOLITAN PHILADELPHIA (PA)	$684.80	$684.80
REST OF PENNSYLVANIA (PA)	$629.89	$629.89
PUERTO RICO (PR)	$647.15	$647.15
RHODE ISLAND (RI)	$645.44	$645.44
SOUTH CAROLINA (SC)	$618.45	$618.45
SOUTH DAKOTA** (SD)	$562.26	$562.26
TENNESSEE (TN)	$576.25	$576.25
BRAZORIA (TX)	$621.29	$621.29
DALLAS (TX)	$632.36	$632.36
GALVESTON (TX)	$627.72	$627.72
HOUSTON (TX)	$698.19	$698.19
BEAUMONT (TX)	$626.79	$626.79
FORT WORTH (TX)	$632.73	$632.73
AUSTIN (TX)	$641.32	$641.32
REST OF TEXAS (TX)	$628.53	$628.53
UTAH (UT)	$626.71	$626.71
VIRGINIA (VA)	$607.62	$607.62
VIRGIN ISLANDS (VI)	$647.15	$647.15
VERMONT (VT)	$582.82	$582.82
SEATTLE (KING CNTY) (WA)	$673.12	$673.12
REST OF WASHINGTON (WA)	$628.87	$628.87
WISCONSIN (WI)	$553.19	$553.19
WEST VIRGINIA (WV)	$686.00	$686.00
WYOMING** (WY)	$614.21	$614.21

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Maximum units per day (MUE)

Medicare’s Medically Unlikely Edit caps this code at 1 unit 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 PFS amounts are built from three Relative Value Units (RVUs) assigned to a code: physician work, practice expense, and malpractice. Each RVU component is adjusted by Geographic Practice Cost Indices (GPCIs) specific to the locality where the service is performed, then the adjusted RVUs are summed and multiplied by the annual national conversion factor to produce a dollar amount. Because practice expense RVUs can differ between non-facility (e.g., office) and facility (e.g., hospital) settings, the resulting allowed amount may also differ between the two. For this code, the facility and non-facility practice expense RVUs are the same, so the calculated amounts align nationally, though locality-specific GPCIs can still cause variation by region.

RVUs — work 11.64, practice expense 3.9 (non-facility) / 3.9 (facility), malpractice 3.85 — × 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 patient meets the annual Part B deductible; the beneficiary or secondary payer is responsible for the remainder.
Modifiers, multiple-procedure reductions, bilateral rules, and other claim-specific adjustments can change the actual payment.
Annual conversion factor updates and budget-neutrality adjustments change these figures each year.
Sequestration and other federal payment adjustments may reduce the amount actually disbursed.
Always verify current, locality-specific rates with your Medicare Administrative Contractor (MAC) before billing or appealing a claim.

Frequently asked

Why does the allowed amount for CPT 22845 vary by locality even though the RVUs are the same?

The RVUs (work, practice expense, malpractice) are fixed nationally, but each locality has its own GPCI values that adjust for local cost differences, so the final payment amount differs by location even with identical RVUs.

Why are the facility and non-facility amounts the same for this code?

When the practice expense RVU is identical for both facility and non-facility settings, as it is here, the calculated PFS amount comes out the same regardless of place of service.

Does this amount reflect what Medicare will actually pay?

No. This is a calculated estimate based on standard PFS inputs. Actual payment can differ due to modifiers, sequestration, secondary payer rules, and annual adjustments.

Where can I find the official CPT descriptor for 22845?

The full CPT code descriptor is copyrighted by the American Medical Association and must be obtained through a licensed CPT reference, such as the AMA's CPT codebook or an authorized coding software vendor.

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.