CPT 22318 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 • GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 22318 |
National average reimbursement for CPT 22318 by major payers:
$2,079.59
$2,198.99
$2,307.16
$2,696.70
| 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 22318 | ||||||
United | 22318 | $1900.00 | 1588029870 - PACIFIC GASTROENTEROLOGY PLLC | 201377401 - (WA) PACIFIC GASTROENTEROLOGY, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22318 | $1118.00 | 1659683662 - PREMIER ENDOSCOPY CENTER, LLC | 272932575 - (AZ) PREMIER ENDOSCOPY CENTER, P.L.L.C. | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22318 | $3888.00 | 1184660151 - INNOVATIVE PROCEDURAL CENTER LLC | 200327828 - (SD) INNOVATIVE PROCEDURE CENTER LLC | SD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22318 | $6588.00 | 1942472931 - SURGCENTER OF GLEN BURNIE, SURGCENTER OF GLEN BURNIE, LLC | 261572774 - (MD) SURGCENTER OF GLEN BURNIE, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22318 | $6588.00 | 1154323988 - CENTRAL VIRGINIA SURGI-CENTER LP, SURGI-CENTER OF CENTRAL VIRGINIA | 752967162 - (VA) CENTRAL VIRGINIA SURGICENTER LP | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22318 | $4268.00 | 1841884731 - EYE MD OF NICEVILLE SURGERY LLC | 862163581 - (FL) EYE MD OF NICEVILLE SURGERY LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22318 | $6588.00 | 1811433410 - OPHTHALMOLOGY SURGERY CENTER OF ORLANDO LLC, ORLANDO OPHTHALMOLOGY SURGERY CENTER | 814378043 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22318 | $3474.00 | 1861449571 - KIRURGS, LLC, SURGEONS' SURGICAL CENTER | 522018568 - (MD) SURGEONS SURGICAL CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22318 | $6365.00 | 1467796730 - WINDSOR MILL SURGERY CENTER, LLC | 461412275 - (MD) WINDSOR MILL SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22318 | $5539.00 | 1346621893 - NORTHERN NEW JERSEY CENTER FOR ADVANCED ENDOSCOPY LLC | 472128570 - (NJ) NORTHERN NEW JERSEY CENTER FOR ADVANCED ENDOSCOPY LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22318 | $4037.00 | 1295973006 - ST. MARY'S OUTPATIENT SURGERY CENTER AT GALENA LLC, SUMMIT SURGERY CENTER AT ST. MARYS GALENA | 264094998 - ST. MARY'S OUTPATIENT SURGERY CENTER AT GALENA LLC D/B/A SUMMIT | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22318 | $2194.00 | 1215939186 - ALL CITY FAMILY HEALTHCARE CENTER, INC. | 113423598 - (NY) ALL CITY FAMILY HEALTH CARE CENTER, INC. | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22318 | $1600.00 | 1245241694 - GAINESVILLE UROLOGY ASC LLC | 30412558 - (GA) GAINESVILLE UROLOGY ASC LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22318 | $3934.00 | 1508005976 - SOUTH SHORE SC, LLC | 341997077 - (NY) SOUTH SHORE SURGERY CENTER, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22318 | $2795.00 | 1538122569 - CENTENNIAL SURGERY CENTER LP | 621624530 - (TN) CENTENNIAL SURGERY CENTER LP | TN | 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 22318 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22318 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 22318 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 |
|---|---|---|
| 22310-CPT | Moderate | Treat Fx/Disloc-Vertebral Body |
| 22315-CPT | High | Closed Treatment Of Vertebral Fracture(S) And/Or Dislocation(S) Requiring Casting Or Bracing With And Including Casting And/Or Bracing With Or Without Anesthesia By Manipulation Or Traction |
| 22318-CPT | High | Open Treatment And/Or Reduction Of Odontoid Fracture(S) And Or Dislocation(S) (Including Os Odontoideum), Anterior Approach, Including Placement Of Internal Fixation; Without Grafting |
| 22319-CPT | High | Open Treatment And/Or Reduction Of Odontoid Fracture(S) And Or Dislocation(S) (Including Os Odontoideum), Anterior Approach, Including Placement Of Internal Fixation; With Grafting |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 22318. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22318 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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