CPT 22212 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 • 51 - Multiple procedures • 59 - Distinct Procedural Service |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 22212 |
National average reimbursement for CPT 22212 by major payers:
$1,776.58
$2,001.67
$2,256.91
$2,489.10
| 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 22212 | ||||||
United | 22212 | $6492.00 | 1336246099 - VALLEY BAPTIST AMBULATORY SURGERY CENTER, LLC, PLATINUM SURGERY CENTER | 871904768 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22212 | $2986.00 | 1396782553 - SSM ST. JOSEPH SURGERY CENTER, LLC, THE SURGERY CENTER AT ST. JOSEPH MEDICAL PARK | 431822767 - (MO) SSM ST JOSEPH SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22212 | $3109.00 | 1154867562 - UROLOGIC AMBULATORY SURGERY CENTER, LLC | 814904405 - (MS) UROLOGIC AMBULATORY SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22212 | $4234.00 | 1386882587 - BAYLOR SURGICARE AT GRANBURY LLC, BAYLOR SCOTT & WHITE SURGICARE-GRANBURY | 263896477 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22212 | $4480.00 | 1942230024 - LUTHERVILLE ENDOSCOPY CENTER LLC | 823193901 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22212 | $1800.00 | 1144213547 - DERMATOLOGY & COSMETIC SURGERY CENTER PC | 251820229 - (PA) DERMATOLOGY COSMETIC SURGERY CENTER PC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22212 | $2911.00 | 1023036688 - BAYSIDE AMBULATORY CENTER, LLC | 510438152 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22212 | $3058.00 | 1790936847 - RSC SURGERY CENTER, LLC | 352345966 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22212 | $1144.00 | 1457320962 - FOOT AND ANKLE CENTER AT THE BURKLAND MEDICAL CENTER INC. | 522160415 - (MD) FOOT AND ANKLE CENTER AT THE BURKLAND MEDICAL CENTER INC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22212 | $4589.00 | 1912909144 - THE UROLOGY CENTER, PC, UROLOGY CENTER ASC | 470593275 - (NE) THE UROLOGY CENTER, P.C. | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22212 | $1241.00 | 1003168907 - CANDESCENT EYE HEALTH SURGICENTER, LLC | 460608742 | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22212 | $4814.00 | 1316939556 - SEQUOIA SURGICAL CENTER LP, SEQUOIA SURGICAL PAVILION | 364408212 - (CA) SEQUOIA SURGICAL CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22212 | $6087.00 | 1366444929 - EAST WEST SURGERY CENTER LP | 621797897 - (GA) EAST WEST SURGERY CENTER LP | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22212 | $6588.00 | 1912434697 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22212 | $4953.00 | 1922301712 - THE SURGERY CENTER AT WILLIAMSON LLC | 270929515 - (TX) THE SURGERY CENTER AT WILLIAMSON LLC | TX | 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 22212 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22212 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 22212 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 22212. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22212 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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