Closed treatment of one or more vertebral fractures or dislocations requiring manipulation or traction, with application of casting or bracing included in the service.

Verified May 8, 2026 · 7 sources ↓

Medicare: $1,005.03
Total RVUs: 30.09
Global, days: 90
Region: Spine

Drawn from CMSAAPCManagedresourcesincNIHMdclarity

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 7 cited references ↓

Specify the exact vertebral level(s) treated — do not use generic language like 'thoracic fracture'
Describe the manipulation or traction technique performed, including force and duration if applicable
Confirm the fracture was managed closed with no open surgical exposure
Document the type of immobilization applied (cast vs. brace, region covered)
State the imaging used to confirm fracture reduction pre- and post-manipulation
Record the clinical rationale for non-operative management, especially if neurologic deficits are present or absent

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 24 Unrelated E/M during global 25 Significant separate E/M 57 Decision for surgery 58 Staged or related 76 Repeat, same physician 77 Repeat, another physician 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon

What this code covers

Source · Editorial summary grounded in 7 cited references ↓

CPT 22315 covers closed (non-surgical) management of a vertebral body fracture or dislocation when the physician performs manual realignment or applies traction to reduce the injury, then immobilizes the spine with a cast or brace. Casting and bracing are bundled into this code — do not bill them separately. The code spans the full range of closed vertebral fracture work in this setting: compression fractures, burst-pattern injuries, and dislocations managed without open surgical exposure.

The 90-day global period is the dominant billing reality for this code. All routine follow-up visits, cast changes, and brace checks through day 90 are included. Any E/M visit unrelated to the fracture during that window requires modifier 24. If the decision for surgery is made at the same encounter, append modifier 57 to the E/M, not modifier 25.

Decompression procedures are bundled with fracture codes per NCCI policy — do not bill a decompression separately when performed in the same encounter. If multiple vertebral levels are treated, document each level explicitly; the code covers fractures plural, but payers will scrutinize operative notes that don't name levels. Open posterior treatment maps to 22325–22328; open anterior fractures with corpectomy map to 63081–63091. If you're at the wrong code, it's not a modifier fix — it's the wrong code.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	9.86
Practice expense RVU	17.69
Malpractice RVU	2.54
Total RVU	30.09
Medicare national rate	$1,005.03
Global period	90 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$1,005.03
HOPD (APC 5113) Hospital outpatient department	$3,342.87
ASC (PI A2) Ambulatory surgical center (freestanding)	$1,644.87

Common denial reasons

The recurring reasons claims for CPT 22315 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Missing level specificity — operative or clinical note does not name the treated vertebral segment(s)
Decompression billed separately on the same date; it is bundled per NCCI policy
Casting or bracing billed as a separate line item when it is already included in 22315
Wrong fracture code family — open posterior treatment should be 22325–22328, not 22315
E/M billed same-day without modifier 25 (or modifier 57 when decision for surgery was made at that visit)
Global period violation — routine post-op visit billed without modifier 24 during the 90-day global

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 7 cited references ↓

01Is casting or bracing separately billable when I use 22315?

No. Casting and bracing are explicitly included in 22315. Billing a separate HCPCS code for the cast or brace supply on the same date is an NCCI bundling violation.

02Can I bill a decompression code alongside 22315 if I decompress at the same session?

No. Per NCCI policy, decompression is bundled with vertebral fracture codes. Billing a separate decompression CPT at the same encounter is incorrect coding regardless of modifier use.

03Which modifier do I use when I decide at the office visit to perform 22315?

Append modifier 57 to the E/M code, not modifier 25. Modifier 57 signals that the E/M was the visit at which the decision for a major procedure was made. The 90-day global starts the day after that visit.

04What is the global period for 22315 and what does it include?

The global period is 90 days. It includes the day before surgery, the procedure day, and all routine follow-up through day 90 — including cast changes, brace adjustments, and standard post-fracture visits. Unrelated E/M services in that window need modifier 24.

05When does 22315 become the wrong code — what are the open alternatives?

If the treatment requires open posterior surgical exposure, use 22325–22328 instead. If the fracture is managed via open anterior corpectomy approach, use 63081–63091. 22315 is strictly for closed management with no open incision.

06Can 22315 be billed for multiple vertebral levels, and how?

The code descriptor covers fractures plural, so multiple levels at the same session are captured under one unit of 22315. However, each treated level must be named in the documentation. Payers routinely query notes that treat multiple levels but only reference a spinal region.

07What ICD-10 codes pair with 22315 for a typical thoracic compression fracture?

A wedge compression fracture of T7-T8 at initial encounter maps to S22.060A. Use the appropriate S-code for the specific vertebral level and encounter type (initial = A, subsequent = D, sequela = S). Diagnosis-code specificity must match the level documented in the operative note.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures the treated vertebral level(s) by name, the specific reduction technique (manipulation vs. traction), the type of immobilization applied, and the imaging confirmation of fracture alignment — directly from dictation. That prevents the two most common audit flags for 22315: vague level documentation and missing reduction technique, both of which trigger downcoding or outright denial.

See how Mira captures CPT 22315 documentation