Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonHealthcare 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 | 11 - Office 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service GO - Services delivered under an outpatient occupational therapy plan of care |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 22222 |
| Medicaid Fee Schedule | View Medicaid rates for 22222 |
National average reimbursement for CPT 22222 by major payers:

$2,025.79

$2,205.86

$2,343.86

$2,702.56
Choose a payer to see a sample of rates for CPT 22222.
The Surgery Center, LLC
Sacramento Heart Ambulatory Surgery Center Inc
Central Ohio Endoscopy Center LLC
Choose your state and specialty to build a report from payer-published rates.
Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 22222 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22222 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 22222 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 |
|---|---|---|
| 22220-CPT | High | Osteotomy Of Spine Inclu Discectomy Anterio Approa Sngle Ve, Osteotomy Of Spine Including Discectomy Anterior Approach Single Ve |
| 22222-CPT | High | Osteotomy Of Spine Inclu Discectomy Anterio Approa Sngle Ve, Osteotomy Of Spine Including Discectomy Anterior Approach Single Ve |
| 22224-CPT | High | Osteotomy Of Spine Inclu Discectomy Anterio Approa Sngle Ve, Osteotomy Of Spine Including Discectomy Anterior Approach Single Ve |
| 22226-CPT | Moderate | Osteot Dsc Ant 1vrt Sgm Ea, Osteotomy Of Spine Including Discectomy Anterior Approach Single Vertebral Segment Each Additional Vertebral 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 22222. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22222 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.
Bring your top codes (like CPT 22222) and we'll show you how you compare in 15 minutes or less.