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 |
| Medicare Fee Schedule | View Medicare rates for 22325 |
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 | $2458.90 | 1912431453 - ANDREI TRIPAC | 350593390 - DEACONESS HOSPITAL INC | CT | Anesthesiology Physician (207L00000X) |
United | 22325 | $2346.00 | 1477645711 - PROGRESSIVE SURGERY CENTER LLC | 20685569 - (NY) PROGRESSIVE SURGERY CENTER, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22325 | $2669.00 | 1912196494 - VALDOSTA FOOT & ANKLE SURGERY CENTER, P.C. | 582556232 - (GA) VALDOSTA FOOT ANKLE SURGERY CENTER PC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22325 | $3592.00 | 1073816690 - PENN STATE HERSHEY ENDOSCOPY CENTER LLC | 274000022 - (PA) PENN STATE HERSHEY ENDOSCOPY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22325 | $6492.00 | 1720085277 - ROSWELL SURGERY CENTER LLC, ROSWELL SURGERY CENTER | 582577112 - (GA) ROSWELL SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22325 | $2458.90 | 1811301666 - HEMAPRIYA GOPAL REDDY | 350593390 - DEACONESS HOSPITAL INC | IN | Hospitalist Physician (208M00000X) |
United | 22325 | $4580.00 | 1649682014 - ENTI SURGERY CENTER LLC | 462334845 - (GA) ENTI SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22325 | $6492.00 | 1215091087 - CORPUS CHRISTI SURGICARE LTD, CHRISTUS SPOHN TEXAS ORTHOPEDIC CENTER OF EXCELLENCE | 753049514 - (TX) CORPUS CHRISTI SURGICARE LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22325 | $4865.00 | 1740634369 - THE REGENTS OF THE UNIVERSITY OF CALIFORNIA, UCLA DEPT OF MEDICINE | 954373071 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22325 | $1472.00 | 1164414447 - EAST VALLEY ENDOSCOPY LLC | 870667809 - (AZ) EAST VALLEY ENDOSCOPY, PLLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22325 | $9347.00 | 1215930078 - MARIN HEALTH VENTURES, LLC, MARIN SPECIALTY SURGERY CENTER | 943377073 - (CA) MARIN HEALTH VENTURES, INC. DBA MARIN SPECIALTY SURGERY CENTER | CA | 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 | $3937.00 | 1710961800 - NORTH COUNTRY ORTHOPAEDIC AMBULATORY SURGERY CENTER LLC | 731653922 - (NY) NORTH COUNTRY ORTHOPAEDIC AMBULATORY SURGERY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22325 | $4090.00 | 1356616064 - CORONA SURGICAL LLC, CORONA SUMMIT SURGICAL CENTER | 900722404 - (CA) CORONA SURGICAL LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22325 | $979.00 | 1891049441 - ISLAND DIGESTIVE HEALTH CENTER, LLC | 452411095 - (NY) ISLAND DIGESTIVE HEALTH CENTER LLC | NY | 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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