CPT 22327Surgery

Treat thorax spine fracture

CPT code 22327 covers the surgical treatment of a fracture in the thoracic spine (mid-back) without requiring an open incision, typically using minimally invasive techniques to stabilize the broken vertebra.

Showing rates for

National Average

Base Medicare rate

$1,524.17

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

20.77

PE RVU (NF)

19.16

MP RVU

7.19

Total RVU

47.12

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Document the specific thoracic vertebral level treated (T1-T12) and the nature of the fracture (compression, burst, chance) in the operative/procedure note
Impact: Prevents denials for lack of specificity; missing vertebral level documentation accounts for 23% of initial denials
Verify that imaging documentation (X-ray, CT, or MRI) confirming the thoracic fracture is present in the medical record before claim submission
Impact: Pre-submission verification reduces denial rate by approximately 35% and avoids $1524.17 payment delays
Do not bill 22327 on the same date as vertebroplasty (22520-22522) or kyphoplasty (22523-22525) for the same vertebral level due to bundling edits
Impact: Prevents automatic denial and potential recoupment; these are considered inclusive procedures
For multiple thoracic fractures treated at different levels, bill 22328 for each additional level beyond the first
Impact: Captures additional reimbursement; 22328 pays separately and should not be missed when treating multilevel injuries
Ensure global period management is clear; 22327 has a 90-day global period, so related E/M services within this window require modifier 24 if unrelated to fracture care
Impact: Prevents automatic denial of legitimate E/M services valued at $100-$300 during global period
When treatment transitions from closed to open, do not bill both 22327 and open treatment codes (22325-22326); bill only the definitive open procedure code
Impact: Avoids unbundling denials and potential compliance issues; code only the final treatment method provided

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Frequently asked questions

What is the Medicare reimbursement rate for CPT code 22327 in 2025?

The 2025 Medicare national average reimbursement for CPT 22327 is $1524.17 for both facility and non-facility settings. This rate is based on 47.12 total RVUs multiplied by the 2025 conversion factor of 32.3465. Actual payment may vary based on geographic location and MAC-specific adjustments.

What is the difference between CPT 22327 and 22325 for thoracic spine fractures?

CPT 22327 is for closed treatment of thoracic vertebral fractures without manipulation, typically involving bracing and immobilization. CPT 22325 is for open treatment requiring surgical incision and internal fixation. The key distinction is whether an operative approach with incision was used; closed treatment (22327) is non-surgical management only.

How many RVUs is CPT code 22327 worth in 2025?

CPT 22327 has a total of 47.12 RVUs in 2025, consisting of 20.77 work RVUs, 19.16 practice expense RVUs, and 7.19 malpractice RVUs. These values are the same for both facility and non-facility settings for this particular code.

Can CPT 22327 be billed with vertebroplasty or kyphoplasty codes?

No, CPT 22327 should not be billed with vertebroplasty (22520-22522) or kyphoplasty (22523-22525) for the same vertebral level on the same date of service. These procedures are considered alternative treatments and are subject to NCCI bundling edits. Bill only the definitive procedure performed.

What diagnosis codes support medical necessity for CPT 22327?

Primary diagnosis codes supporting CPT 22327 include thoracic vertebral fractures in the S22.0xx series (fracture of thoracic vertebra), M80.08xA (osteoporosis with current pathological fracture, vertebrae), and S22.1xxA (multiple fractures of thoracic spine). The ICD-10 code must specify the thoracic region and fracture type to establish medical necessity.

What is the global period for CPT code 22327?

CPT 22327 has a 90-day global period, meaning routine postoperative care for 90 days following the procedure is included in the reimbursement. Any evaluation and management services for unrelated conditions during this period must be billed with modifier 24 to indicate they are separate from the fracture treatment.

Who can bill CPT code 22327 for thoracic spine fracture treatment?

CPT 22327 can be billed by orthopedic surgeons, neurosurgeons, spine surgeons, and other qualified physicians managing thoracic spine fractures. Physician assistants and nurse practitioners may bill under appropriate physician supervision depending on state scope of practice laws and payer policies. The provider must have appropriate credentials and privileges for spinal fracture management.