CPT 22210 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 • AS - PA/NP/CNS assistant at surgery • 58 - Staged or related procedure during postoperative period |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 22210 |
National average reimbursement for CPT 22210 by major payers:
$2,095.35
$2,403.63
$2,541.40
$2,949.51
| 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 22210 | ||||||
United | 22210 | $4365.00 | 1053336602 - VIRGINIA EYE INSTITUTE INC, VIRGINIA EYE INSTITUTE SURGERY PAVILION | 541420580 - (VA) VIRGINIA EYE INSTITUTE INC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22210 | $6492.00 | 1548241623 - GASTROENTEROLOGY ASSOCIATES, LLC, GASTROENTEROLOGY ASSOCIATES ENDOSCOPY CENTER | 912104493 - (WA) GASTROENTEROLOGY ASSOCIATES PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22210 | $3000.00 | 1598276404 - BALBOA NEPHROLOGY MEDICAL GROUP,INC., SAN DIEGO ACCESS AND SURGERY CENTER | 952848091 - (CA) BALBOA NEPHROLOGY MEDICAL GROUP, INC. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22210 | $6065.00 | 1497706626 - CHICAGO PROSTATE CANCER SURGERY CENTER, LLC, DUPAGE MEDICAL GROUP SURGERY CENTER, WESTMONT | 204403852 - (IL) CHICAGO PROSTATE CANCER SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22210 | $4000.00 | 1184009326 - AMBULATORY CENTER FOR ENDOSCOPY, LLC, HUDSON BERGEN ENDO-SURGICAL CENTER | 200064962 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22210 | $6492.00 | 1114302353 - POINT OF ROCKS SURGERY CENTER, LLC | 464992977 - (MD) POINT OF ROCKS SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22210 | $5846.00 | 1699144915 - WEST ORANGE ASC LLC, GREGORI SURGERY CENTER | 474739080 - (NJ) WEST ORANGE ASC LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22210 | $3800.00 | 1346243680 - LAWRENCE SURGERY CENTER LLC | 481212136 - (KS) LAWRENCE SURGERY CENTER, LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22210 | $1490.00 | 1477628725 - SURGERY & LASER CENTER AT PROFESSIONAL PARK LLC, SURGERY & LASER CENTER AT PROFESSIONAL PARK LLC | 202435770 - (SC) SURGERY LASER CENTER AT PROFESSIONAL PARK LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22210 | $2853.00 | 1205998648 - REGIONAL EYE ASSOCIATES, INC, SURGICAL EYE CENTER OF MORGANTOWN | 550740986 - REGIONAL EYE ASSOCIATES, INC. | WV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22210 | $6492.00 | 1699284018 - ONYX & PEARL SURGICAL SUITES LLC | 821183739 - (OH) ONYX & PEARL SURGICAL SUITES, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22210 | $1859.00 | 1356654610 - ENDO-SURGICAL CENTER OF FLORIDA | 272047909 - (FL) ENDOSURGICAL CENTER OF FLORIDA | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22210 | $7229.00 | 1528210770 - SOUTH COUNTY OUTPATIENT ENDOSCOPY SERVICES, LP, SCOPES ENDOSCOPY CENTER | 263374547 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22210 | $3402.00 | 1497090740 - OLOL PONTCHARTRAIN SURGERY CENTER, LLC, OUR LADY OF THE LAKE PONTCHARTRAIN SURGERY CENTER | 461379031 - (LA) OLOL PONTCHARTRAIN SURGERY CENTE | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22210 | $2183.00 | 1639566318 - TRIAD SURGERY CENTER, LLC | 473510624 | OK | 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 22210 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22210 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 22210 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 |
|---|---|---|
| 22210-CPT | High | Osteotomy Spine Post Appr-Cervical |
| 22212-CPT | High | Spine Osteotomy,Posterior,Corr.Deform,1 |
| 22214-CPT | High | Osteotomy Spine Post Appr-Lumbar |
| 22216-CPT | Moderate | Osteotomy Of Spine, Posterior Or Posterolateral Approach, 1 Vertebral Segment; Each Additional Vertebral Segment (List Separately In Addition To 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 22210. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22210 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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