CPT 22328 Fee Schedule
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.
| 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 | Moderate |
| Medicare Fee Schedule | View Medicare rates for 22328 |
National average reimbursement for CPT 22328 by major payers:
$359.06
$387.03
$440.04
$463.92
| 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 22328 | ||||||
United | 22328 | $1301.00 | 1316359532 - LONE STAR ENDOSCOPY CENTER, LLC | 273635726 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22328 | $2830.00 | 1295213734 - LOS GATOS SURGICAL CENTER, A CALIFORNIA LIMITED PARTNERSHIP, ENDOSCOPY CENTER OF SILICON VALLEY | 942909203 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22328 | $574.00 | 1023349909 - PICCARD SURGERY CENTER, LLC | 270433723 - (MD) PICCARD SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22328 | $285.00 | 1538117841 - SHELBY BAPTIST AMBULATORY SURGERY CENTER, LLC, SHELBY AMBULATORY SURGERY AT THE PHYSICIANS CENTER | 203150946 - (AL) SHELBY BAPTIST AMBULATORY SURGERY CENTER, LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22328 | $261.00 | 1619149960 - THE VANCOUVER CLINIC INC PS, THE VANCOUVER CLINIC, AMBULATORY SURGERY CENTER | 910851599 - THE VANCOUVER CLINIC, INC., PS | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22328 | $1814.00 | 1043275183 - FOREST AMBULATORY SURGICAL ASSOCIATES LLC, FOREST SURGERY CENTER | 942934248 - (CA) FOREST AMBULATORY SURGICAL ASSOCIATES, LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22328 | $531.00 | 1992423719 - ENDOSCOPY ASC OF MIDDLE GEORGIA LLC | 883065469 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22328 | $81.00 | 1710931134 - NOVAMED SURGERY CENTER OF JONESBORO, LLC, EYE SURGERY CENTER OF ARKANSAS | 204407053 - (AR) NOVAMED SURGERY CENTER OF JONESBORO LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22328 | $168.00 | 1053597161 - 1800 MCDONOUGH ROAD SURGERY CENTER LLC | 261278011 - (IL) 1800 MCDONOUGH ROAD SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22328 | $105.00 | 1821397654 - RENUE SURGERY CENTER OF WAYCROSS, LLC | 273847480 - (GA) RENUE SURGERY CENTER OF WAYCROSS LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22328 | $128.00 | 1164697009 - BOX HILL SURGERY CENTER LLC | 262454678 - (MD) BOX HILL SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22328 | $574.00 | 1134126097 - PHYSICIAN'S SURGERY CENTER OF KNOXVILLE LLC | 621777892 - (TN) PHYSICIANS SURGERY CENTER OF KNOXVILLE LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22328 | $491.00 | 1467010736 - MERCY SURGERY CENTER LLC | 841875159 - (IA) MERCY SURGERY CENTER LLC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22328 | $131.00 | 1801458989 - MILLENNIUM SURGERY CENTERS OF FLORIDA, LLC | 371911799 - (FL) MILLENNIUM SURGERY CENTERS OF FLORIDA LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22328 | $1145.00 | 1003842626 - AMBULATORY CENTER FOR ENDOSCOPY, LLC | 200064962 | NJ | 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 22328 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22328 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 22328 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 22328. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22328 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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