CPT 20822 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | • 21 - Inpatient Hospital • 23 - Emergency Room |
| Common Modifiers | • None • F1 - Left hand, second digit • F6 - Right hand, second digit |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 20822 |
National average reimbursement for CPT 20822 by major payers:

$2,574.89

$2,538.88

$2,466.82

$3,062.77
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 20822 | ||||||
United | 20822 | $935.00 | 1265907885 - APEX SURGERY CENTER, LLC | 814252902 - (OK) APEX SURGERY CENTER LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20822 | $935.00 | 1891865077 - REGENCY SURGERY CENTER, LLC | 710973677 - (CA) REGENCY SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20822 | $801.00 | 1629262274 - THE SURGERY CENTER OF THE VILLAGES, LLC, THE SURGERY CENTER OF THE VILLAGES | 208291654 - (FL) THE SURGERY CENTER OF THE VILLAGES LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20822 | $6651.00 | 1114980166 - NEW PORT RICHEY SURGERY CENTER LTD | 592907068 - (FL) NEW PORT RICHEY SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20822 | $908.00 | 1043497019 - PIKESVILLE MD ENDOSCOPY ASC LLC, ENDOCENTRE OF BALTIMORE | 261467040 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20822 | $500.00 | 1942242441 - ADVANCED EYE SURGERY CENTER, LLC | 510567447 - (FL) ADVANCED EYE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20822 | $1331.00 | 1891049441 - ISLAND DIGESTIVE HEALTH CENTER, LLC | 452411095 - (NY) ISLAND DIGESTIVE HEALTH CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20822 | $700.00 | 1407801509 - ATLANTIC SURGERY CENTER,LLC | 223625894 - (NJ) ATLANTIC SURGERY CENTERLLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20822 | $2100.00 | 1124068549 - CROWN VALLEY SURGERY CENTER | 454125214 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20822 | $3993.00 | 1619218096 - SAN MARCOS ASC LLC | 800899088 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20822 | $3500.00 | 1316359532 - LONE STAR ENDOSCOPY CENTER, LLC | 273635726 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20822 | $1134.00 | 1295240133 - BRAINARD SURGERY CENTER LLC | 823600153 - (OH) BRAINARD SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20822 | $2388.00 | 1114196151 - SUMMIT AMBULATORY SURGICAL CENTER LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20822 | $950.00 | 1497206890 - MIDWEST EYE CONSULTANTS OHIO, INC., CATARACT & LASER INSTITUTE ASC - MAUMEE #352 | 300888250 - (OH) MIDWEST EYE CONSULTANTS OHIO INC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 20822 | $3383.00 | 1841234150 - HINSDALE SURGICAL CENTER, LLC | 362276984 - ADVENTIST MIDWEST HEALTH | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 20822 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 20822 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 20822 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 20816-CPT | High | Replantation, Digit, Excluding Thumb (Includes Metacarpophalangeal Joint To Insertion Of Flexor Sublimis Tendon), Complete Amputation |
| 20822-CPT | High | Replant Digit Tip To Flex Sublimis Compl |
| 20824-CPT | High | Replant Thumb Carpo To Mp Complete Amp |
| 20924-CPT | Moderate | Tendon Graft From Distance |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 20822. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20822 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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