How much does Medicare pay for CPT 22515?

Medicare allowed an average of $1212.70 per service and paid $965.91 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $7510.09, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 22515?

Treatment of broken spine bone with stabilizing device, each additional segment. It was billed 2,487 times to 1,710 Medicare beneficiaries by 99 providers in 2024.

Does 22515 pay differently in an office than a hospital?

Yes. The allowed amount averaged $2707.84 in an office setting and $215.60 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 22515 most?

Orthopedic Surgery, with 743 services from 29 clinicians. Next are Diagnostic Radiology, Neurosurgery, Interventional Radiology.

CPT 22515

Treatment of broken spine bone with stabilizing device, each additional segment

$1212.70Medicare-allowed amount per service, averaged across 2,487 services

Providers submitted

$7510.09

Asking price, not received

Medicare allowed

$1212.70

The fee schedule figure

Medicare paid

$965.91

Balance is patient coinsurance

Providers submitted an average of $7510.09 for this code and Medicare allowed $1212.70 — 6.2× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $965.91 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $2707.84
Hospital / facility: $215.60

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 995 services were billed in an office setting and 1,492 in a facility.

Services: 2,487
Beneficiaries: 1,710
Providers billing it: 99
Total allowed: $3,015,985

What Medicare pays for CPT 22515

Across 2,487 services billed by 99 providers to 1,710 beneficiaries, Medicare allowed an average of $1212.70 per service. That is 1.5 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 22515

Specialty	Services	Beneficiaries	Avg allowed	Providers
Orthopedic Surgery	743	535	$1548.33	29
Diagnostic Radiology	686	463	$895.36	25
Neurosurgery	442	285	$738.51	18
Interventional Radiology	235	157	$704.29	10
Interventional Pain Management	190	134	$1932.77	8
Pain Management	116	81	$2299.29	6
Physical Medicine and Rehabilitation	47	42	$2533.13	2
Neurology	28	13	$229.26	1

22515 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Florida	575	$1860.71	$1488.23	22
New York	227	$762.74	$541.95	7
Oklahoma	173	$1603.44	$1489.41	4
California	170	$1455.81	$985.30	6
Ohio	146	$207.43	$167.90	5
North Carolina	128	$1038.62	$880.07	5
Texas	93	$803.95	$615.13	4
Maryland	83	$1282.55	$943.06	4
Virginia	79	$2055.83	$1504.36	5
Washington	77	$1123.55	$814.00	2
Pennsylvania	66	$883.55	$701.46	3
Arkansas	54	$884.58	$780.61	3
Tennessee	51	$1612.81	$1430.48	2
New Jersey	51	$1422.79	$1101.68	2
Mississippi	50	$196.68	$167.89	3
Arizona	49	$2548.76	$2243.60	1
Missouri	42	$205.85	$167.68	2
Illinois	42	$963.50	$808.71	2
Michigan	40	$1366.62	$1256.27	2
Kansas	39	$184.30	$167.84	2
Indiana	38	$195.24	$168.18	2
Wisconsin	37	$190.23	$167.29	2
North Dakota	33	$198.95	$168.16	1
Georgia	33	$1569.03	$1421.58	2
Alabama	21	$196.61	$167.54	1
South Carolina	21	$201.81	$168.07	1
Hawaii	19	$2976.55	$2247.67	1
Idaho	17	$192.88	$168.01	1
Massachusetts	17	$224.21	$168.01	1
Delaware	16	$204.28	$167.47	1

Related codes

22558Fusion of lower spine bone through abdomen$707.92
22551Fusion of upper spine bone$1377.46
22552Fusion of upper spine bone$268.72
22585Fusion of spine bones through front of body$215.15
22514Treatment of broken lower spine bone$2517.60
22513Treatment of broken middle spine bone$2432.63

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.