CPT 22100 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 • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 22100 |
National average reimbursement for CPT 22100 by major payers:
$1,134.04
$1,153.54
$1,248.70
$1,483.84
| 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 22100 | ||||||
United | 22100 | $4384.00 | 1891759569 - ST JOSEPH CENTER FOR OUTPATIENT SURGERY, LLC | 680510220 - (MO) ST JOSEPH CENTER FOR OUTPATIENT SURGERY LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22100 | $3772.00 | 1467195057 - BONE AND JOINT SURGICAL SUITES, LLC | 872413013 - (FL) BONE AND JOINT SURGICAL SUITES LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22100 | $2460.00 | 1720606932 - PHYSICIANS CLINIC INC | 470687317 - PHYSICIANS CLINIC INC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22100 | $1369.00 | 1073516795 - SPRING PARK SURGERY CENTER L L C | 421483989 - (IA) SPRING PARK SURGERY CENTER, LLC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22100 | $3836.00 | 1083912745 - RED ROCKS SURGERY CENTERS, LLC | 271095323 - (CO) RED ROCKS SURGERY CENTERS LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22100 | $951.00 | 1457331274 - MONTGOMERY EYE SURGERY CENTER LLC, THE MONTGOMERY EYE SURGERY CENTER | 621607284 - (AL) MONTGOMERY EYE SURGERY CENTER LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22100 | $1400.00 | 1437512993 - UNITED SKIN SPECIALISTS MISSOURI LTD, PC, CHESTERFIELD ASC | 811166184 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22100 | $3474.00 | 1942458062 - ASC DEVELOPMENT COMPANY, LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22100 | $2400.00 | 1962695122 - NORTH ORANGE COUNTY SURGERY CENTER | 260625103 - (CA) NORTH ORANGE COUNTY SURGERY CENTER, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22100 | $3871.00 | 1366013914 - THE LASER SURGERY CENTER, LLC | 861190282 - (TX) THE LASER SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22100 | $950.00 | 1467582437 - NORTH FLORIDA SURGERY CENTER INC, NORTH FLORIDA SURGERY CENTER | 593377918 - (FL) NORTH FLORIDA SURGERY CENTER INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22100 | $3391.00 | 1023199601 - ANNE ARUNDEL UROLOGICAL SURGERY CENTER LLC | 522012685 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22100 | $900.00 | 1104880723 - WNC EYE SURGERY CENTERS INC | 200067898 - (NC) WNC EYE SURGERY CENTERS INC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22100 | $1829.00 | 1114952686 - NORTH RICHLAND HILLS ENDOSCOPY CENTER LLC, DIGESTIVE HEALTH CENTER OF NORTH RICHLAND HILLS | 203711547 - (TX) NORTH RICHLAND HILLS ENDOSCOPY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22100 | $1800.00 | 1831636752 - RIVER VIEW SURGERY CENTER, LLC | 814790945 - (ID) RIVER VIEW SURGERY CENTER, LLC | ID | 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 22100 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22100 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 22100 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 |
|---|---|---|
| 22100-CPT | High | Partial Excision Of Posterior Vertebral Component (Eg, Spinous Process, Lamina Or Facet) For Intrinsic Bony Lesion, Single Vertebral Segment; Cervical |
| 22101-CPT | High | Partial Excision Of Posterior Vertebral Component (Eg, Spinous Process, Lamina Or Facet) For Intrinsic Bony Lesion, Single Vertebral Segment; Thoracic |
| 22102-CPT | Moderate | Partial Excision Of Posterior Vertebral Component (Eg, Spinous Process, Lamina Or Facet) For Intrinsic Bony Lesion, Single Vertebral Segment; Lumbar |
| 22103-CPT | Low | Partial Excision Of Posterior Vertebral Component (Eg, Spinous Process, Lamina Or Facet) For Intrinsic Bony Lesion, Single Vertebral Segment; Each Additional Segment (List Separately In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 22100. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22100 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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