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See a sample rate comparisonCPT 22226 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
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
| 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 80 - Assistant surgeon |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 22226 |
| Medicaid Fee Schedule | View Medicaid rates for 22226 |
National average reimbursement for CPT 22226 by major payers:
$443.38
$501.54
$560.74
$588.74
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CPT 22226
5 of 25 sample ratesHigher to lower in this preview
Metropolitan Surgical Institute, LLC
Metropolitan Surgical Institute
$1,135.00Published rateLafayette Surgery Center Limited Partnership
$527.00Published rateEye Surgery Centers Of New Mexico, LLC, Surgery Center Of Santa Fe
Eye Surgery Centers Of New Mexico LLC
$220.00Published rateUrology Surgical Partners, LLC
$132.00Published rateLincoln Digestive Health Center LLC
$73.00Published rate
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See a sample payer proposalCPT 22226 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22226 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 22226 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 22226. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22226 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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