CPT 22325 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 • 23 - Emergency Room |
| Common Modifiers | • None • AS - PA/NP/CNS assistant at surgery • 51 - Multiple procedures |
| Complexity Level | High |
National average reimbursement for CPT 22325 by major payers:
$1,770.27
$1,931.57
$2,129.40
$2,404.84
| 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 22325 | ||||||
United | 22325 | $2665.00 | 1679531610 - BOSTON UNIVERSITY EYE ASSOCIATES, INC., BOSTON UNIVERSITY EYE ASSOCIATES SURGERY & LASER CENTER | 43137333 - (MA) BOSTON UNIVERSITY EYE ASSOCIATES INC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22325 | $2991.00 | 1114922192 - GASTROENTEROLOGY ASSOCIATES ENDOSCOPY CENTER, LLC | 680380691 - (CA) GASTROENTEROLOGY ASSOC. ENDOSCOPY CENTER, LLC. DBA REDDING ENDOSCOPY | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22325 | $6087.00 | 1750823886 - LAKE ENDOSCOPY CENTER, LLC | 814225104 - (FL) LAKE ENDOSCOPY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22325 | $2458.90 | 1912431453 - ANDREI TRIPAC | 350593390 - DEACONESS HOSPITAL INC | CT | Anesthesiology Physician (207L00000X) |
United | 22325 | $24368.00 | 1649534843 - SURGERY CENTER OF WASILLA, LLC | 455023852 - (AK) SURGERY CENTER OF WASILLA LLC | AK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22325 | $2023.00 | 1336103001 - PERKINS PLAZA AMBULATORY SURGERY CENTER LLC, LAKE SURGERY CENTER | 481264699 - (LA) LAKE ASC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22325 | $1064.00 | 1093088304 - BARNET DULANEY PERKINS EYE CENTER, PC, BDPEC ASC SEDONA | 562589722 - BARNET DULANEY PERKINS EYE CENTER PLLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22325 | $3374.00 | 1922335900 - PALMETTO LAKES SURGICAL CENTER, LLC | 943459481 - (FL) PALMETTO LAKES SURGICAL CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22325 | $4415.00 | 1942335971 - PALOS SURGICENTER, LLC | 364404305 - (IL) PALOS SURGICENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22325 | $2704.00 | 1730252487 - J C PITTS ENTERPRISES INC, ONTARIO SURGERY CENTER | 930983555 - (OR) J C PITTS ENTERPRISES INC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22325 | $6987.00 | 1447995311 - NEW ENGLAND BAPTIST SURGERY CENTER LLC | 874311329 - (MA) NEW ENGLAND BAPTIST SURGERY CENTER LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22325 | $6343.00 | 1689863771 - CAROLINA SURGERY CENTER LLC, THE SURGERY CENTER AT EDGEWATER | 200707167 - (SC) CAROLINA SURGERY CENTER LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22325 | $2740.00 | 1144200163 - ABILENE ASC LP, ABILENE ENDOSCOPY CENTER | 621562008 - (TX) ABILENE ASC LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22325 | $1832.00 | 1467429233 - WILLOW SPRINGS SURGERY CENTER, LTD, FOREST MED-SURG CENTER | 364391641 - (IL) WILLOW SPRINGS SURGERY CENTER LTD | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22325 | $2500.00 | 1003855594 - OHIO EYE ASSOCIATES, INC., OHIO EYE ASSOCIATES EYE SURGERY & LASER CENTER | 341171920 - (OH) OHIO EYE ASSOCIATES, INC. | OH | 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 22325 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22325 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 22325 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 |
|---|---|---|
| 22325-CPT | High | Open Treatment And/Or Reduction Of Vertebral Fracture(S) And/Or Dislocation(S) Posterior Approach One Fractured Vertebrae Or Dislocated Segment; Lumbar |
| 22326-CPT | High | Open Treatment And/Or Reduction Of Vertebral Fracture(S) And/Or Dislocation(S) Posterior Approach One Fractured Vertebrae Or Dislocated Segment; Cervical |
| 22327-CPT | High | Open Treatment And/Or Reduction Of Vertebral Fracture(S) And/Or Dislocation(S) Posterior Approach One Fractured Vertebrae Or Dislocated Segment; Thoracic |
| 22328-CPT | Moderate | Open Treatment And/Or Reduction Of Vertebral Fracture(S) And/Or Dislocation(S) Posterior Approach One Fractured Vertebrae Or Dislocated Segment; Each Additional Fractured Vertebrae Or Dislocated 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 22325. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22325 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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