CPT 22206 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 • 11 - Office |
| Common Modifiers | • None • AS - PA/NP/CNS assistant at surgery • 62 - Co-Surgeons |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 22206 |
National average reimbursement for CPT 22206 by major payers:
$3,099.23
$3,258.87
$3,471.77
$4,015.45
| 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 22206 | ||||||
United | 22206 | $1692.00 | 1124443809 - POOLE ENDOSCOPY CENTER, LLC | 521831316 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22206 | $1024.00 | 1902958226 - AMBULATORY SURGERY CENTER OF TUCSON, INC. | 262420656 - (AZ) AMBULATORY SURGERY CENTER OF TUCSON INC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22206 | $2245.00 | 1124664198 - ADVANCED SURGICAL CARE EAST LLC | 833657018 - (AZ) ADVANCED SURGICAL CARE EAST LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22206 | $2884.00 | 1720129893 - PACIFIC GASTROENTEROLOGY ENDOSCOPY CENTER | 330898866 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22206 | $6492.00 | 1184687386 - DIGESTIVECARE, LLC, DIGESTIVECARE ENDOSCOPY UNIT | 311108485 - (OH) DIGESTIVE CARE, INC. | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22206 | $1000.00 | 1730249327 - AMBULATORY SURGERY CENTER OF WNY | 161554732 - (NY) AMBULATORY SURGERY CENTER OF WNY | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22206 | $5125.00 | 1154805646 - ANNE ARUNDEL-SCA SURGICENTER, LLC, AAMC SURGERY CENTER - ANNAPOLIS | 824763728 - (MD) ANNE ARUNDELSCA SURGICENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22206 | $7351.00 | 1306905815 - UAS MANAGEMENT, INC., UNIVERSITY SURGERY CENTER | 611845381 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22206 | $4865.00 | 1538608138 - THE REGENTS OF THE UNIVERSITY OF CALIFORNIA, UCLA DEPT OF MEDICINE | 954373071 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22206 | $4970.00 | 1700966710 - SURGERY CENTER OF KALAMAZOO LLC | 61694249 - (MI) SURGERY CENTER OF KALAMAZOO LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22206 | $822.00 | 1629133442 - ARIZONA SURGICAL ARTS, INC. | 860607769 - (AZ) ARIZONA SURGICAL ARTS INC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22206 | $1933.00 | 1295817435 - WILLS SURGERY CENTER OF CHERRY HILL, SURGERY CENTER OF CHERY HILL | 223335953 - (NJ) WILLS SURGERY CENTER OF CHERRY HILL | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22206 | $6342.00 | 1083785398 - OLYMPIA ORTHOPAEDIC ASSOCIATES PLLC, OLYMPIA SURGERY CENTER LLC | 911674528 - OLYMPIA ORTHOPAEDIC ASSOCIATES, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22206 | $8087.00 | 1033586136 - PHYSICIANS WEST HOUSTON SURGICAL CENTER, LLC, MEMORIAL HERMANN SURGERY CENTER PARK TEN | 371789833 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22206 | $6492.00 | 1760491385 - ENDOSCOPY CENTER OF NORTHERN OHIO, LLC | 341966846 - (OH) ENDOSCOPY CENTER OF NORTHERN OHIO LLC | OH | 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 22206 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22206 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 22206 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 |
|---|---|---|
| 22206-CPT | High | Osteotomy Of Spine Posterior Or Posterolateral Approach Three Columns One Vertebral Segment (Eg Pedicle/Vertebral Body Subtraction); Thoracic |
| 22207-CPT | High | Osteotomy Of Spine Posterior Or Posterolateral Approach Three Columns One Vertebral Segment (Eg Pedicle/Vertebral Body Subtraction); Lumbar |
| 22208-CPT | Moderate | Osteotomy Of Spine Posterior Or Posterolateral Approach Three Columns One Vertebral Segment (Eg Pedicle/Vertebral Body Subtraction); Each Additional Verebral Segment (List Separately In Addition To Code For Primary Procedure) |
| 22210-CPT | High | Osteotomy Spine Post Appr-Cervical |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 22206. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22206 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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