How much does Medicare pay for CPT 22842?

Medicare allowed an average of $533.80 per service and paid $426.09 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $3452.66, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 22842?

Placement of stabilizing device to back, 3-6 spine bone segments. It was billed 54,378 times to 53,595 Medicare beneficiaries by 2,721 providers in 2024.

Does 22842 pay differently in an office than a hospital?

Yes. The allowed amount averaged $721.03 in an office setting and $533.76 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 22842 most?

Neurosurgery, with 20,179 services from 1,011 clinicians. Next are Orthopedic Surgery, Physician Assistant, Nurse Practitioner.

CPT 22842

Placement of stabilizing device to back, 3-6 spine bone segments

$533.80Medicare-allowed amount per service, averaged across 54,378 services

Providers submitted

$3452.66

Asking price, not received

Medicare allowed

$533.80

The fee schedule figure

Medicare paid

$426.09

Balance is patient coinsurance

Providers submitted an average of $3452.66 for this code and Medicare allowed $533.80 — 6.5× 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 $426.09 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $721.03
Hospital / facility: $533.76

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. 11 services were billed in an office setting and 54,367 in a facility.

Services: 54,378
Beneficiaries: 53,595
Providers billing it: 2,721
Total allowed: $29,026,976

What Medicare pays for CPT 22842

Across 54,378 services billed by 2,721 providers to 53,595 beneficiaries, Medicare allowed an average of $533.80 per service. 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 22842

Specialty	Services	Beneficiaries	Avg allowed	Providers
Neurosurgery	20,179	19,903	$711.04	1,011
Orthopedic Surgery	18,778	18,462	$689.20	909
Physician Assistant	11,988	11,831	$100.32	622
Nurse Practitioner	3,034	3,004	$97.11	157
Neurology	171	169	$657.86	11
General Surgery	62	62	$430.68	4
Cardiology	53	53	$699.72	1
Osteopathic Manipulative Medicine	46	46	$717.56	2
Undefined Physician type	38	37	$707.87	2
Colorectal Surgery (Proctology)	15	14	$121.60	1
Certified Clinical Nurse Specialist	14	14	$103.34	1

22842 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
California	4,391	$563.62	$445.01	222
Florida	4,202	$560.57	$409.48	195
Texas	4,060	$518.49	$417.57	199
Ohio	2,373	$544.65	$442.20	116
Maryland	2,230	$602.34	$446.11	88
Pennsylvania	1,983	$598.20	$477.14	97
North Carolina	1,932	$485.86	$413.69	96
Virginia	1,872	$545.72	$442.00	91
Illinois	1,826	$597.73	$431.55	98
Tennessee	1,749	$487.99	$441.50	78
Colorado	1,723	$508.15	$413.55	90
Arizona	1,620	$516.29	$429.47	80
Indiana	1,581	$438.91	$402.84	80
Georgia	1,537	$541.19	$434.47	79
New York	1,501	$659.37	$452.83	86
Michigan	1,448	$569.37	$426.85	83
Massachusetts	1,422	$652.72	$502.88	72
Kansas	1,365	$434.64	$387.64	50
Oklahoma	1,290	$474.43	$405.94	62
South Carolina	1,126	$505.77	$427.88	54
Louisiana	1,110	$449.23	$376.87	49
Washington	935	$536.88	$429.87	54
Missouri	911	$521.45	$429.82	52
Iowa	907	$455.88	$414.15	34
New Jersey	840	$501.77	$379.72	51
Alabama	832	$433.15	$392.42	47
Nebraska	735	$400.61	$375.68	37
Minnesota	686	$524.18	$466.85	33
Utah	649	$506.89	$416.41	36
Kentucky	609	$595.66	$492.29	34
Delaware	531	$448.74	$366.83	19
Connecticut	441	$605.35	$444.24	32
Idaho	426	$409.62	$372.46	24
Oregon	417	$508.39	$435.39	28
Arkansas	375	$515.71	$465.66	22
Nevada	331	$561.38	$467.10	20
Wisconsin	322	$599.04	$539.63	22
Montana	312	$581.10	$469.16	16
South Dakota	251	$421.36	$375.40	16
North Dakota	249	$434.82	$382.53	6
Mississippi	216	$467.15	$417.67	12
District of Columbia	202	$760.34	$536.13	8
Alaska	176	$519.68	$347.83	11
Rhode Island	170	$635.58	$505.10	11
West Virginia	143	$606.85	$457.80	8
New Mexico	91	$473.49	$373.66	5
Wyoming	80	$647.43	$528.40	6
Hawaii	75	$460.43	$398.03	4
New Hampshire	63	$446.18	$357.51	4
Vermont	34	$663.25	$578.57	2
Puerto Rico	28	$448.41	$378.97	2

Related codes

22853Insertion of cage or mesh device to spine bone and disc space during s$172.21
22840Placement of stabilizing device to back of 1 spine bone in neck$513.09
22845Placement of stabilizing device to front$497.22
22843Placement of stabilizing device to back$660.26
22848Insertion of instrumentation to pelvic bones$275.32
22830Exploration of spine fusion$310.27
22846Placement of stabilizing device to front$530.39
22854Insertion of cage or mesh device in disc space during spine fusion$220.52

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.