CPT 22505 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 | • 24 - Ambulatory Surgical Center • 19 - Off Campus Outpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 22505 |
National average reimbursement for CPT 22505 by major payers:
$171.38
$175.00
$211.48
$217.27
| 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 22505 | ||||||
United | 22505 | $1134.00 | 1174999700 - ADVANCED SURGERY CENTER OF CENTRAL IOWA, LLC | 472673565 - (IA) ADVANCED SURGERY CENTER OF CENTRAL IOWA LLC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22505 | $1682.00 | 1164017778 - MEDICAL CITY SURGERY CENTER OF ALLIANCE, LLC | 822480225 - (TX) MEDICAL CITY SURGERY CENTER OF ALLIANCE LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22505 | $1077.00 | 1083050603 - CORTLAND ASC, LLC, CORTLAND SURGICAL CENTER | 461344196 - (NY) CORTLAND ASC LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22505 | $1910.00 | 1235321571 - SURGICARE SURGICAL ASSOCIATES OF MAHWAH, LLC | 202811130 - (NJ) SURGICARE SURGICAL ASSOCIATES OF MAHWAH LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22505 | $1528.00 | 1750565594 - PEDIATRIC SURGERY CENTER -ODESSA, LLC | 651274446 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22505 | $775.00 | 1881704237 - WATERFRONT SURGERY CENTER LLC | 251898743 - (PA) WATERFRONT SURGERY CENTER | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22505 | $2030.00 | 1427017987 - BAPTIST SURGERY CENTER LP, BAPTIST AMBULATORY SURGERY CENTER | 621672473 - (TN) BAPTIST SURGERY CENTER LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22505 | $1337.00 | 1659443042 - HALLANDALE OUTPATIENT SURGICAL CENTER,LTD | 200244303 - (FL) HALLANDALE OUTPATIENT SURGICAL CENTERLTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22505 | $1714.00 | 1609803204 - AFFILIATED ENDOSCOPY SERVICES OF CLIFTON LLC, AFFILIATED ENDOSCOPY SERVICES OF CLIFTON | 270064844 - (NJ) AFFILIATED ENDOSCOPY SERVICES OF CLIFTON LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22505 | $1438.00 | 1669176020 - MEDSTAR SURGERY CENTER 1, LLC | 922094391 - (MD) MEDSTAR SURGERY CENTER 1 LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22505 | $489.00 | 1275569121 - SOUTHWESTERN EYE CENTER LTD, SOUTHWESTERN EYE SURGICENTER-CASA GRANDE | 860423068 - SOUTHWESTERN EYE CENTER, LTD. | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22505 | $681.00 | 1457957391 - MIDDLEBROOK ASC, LLC | 843656261 - (TN) MIDDLEBROOK ASC LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22505 | $538.00 | 1013048461 - GASTROENTEROLOGY DIAGNOSTIC CENTER MEDICAL GROUP, A PROFESSIONAL, GASTROENTEROLOGY DIAGNOSTIC CENTER | 953921090 - (CA) GASTROENTEROLOGY DIAGNOSTIC CENTER MEDICAL GROUP A PROFESSIONAL | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22505 | $1044.00 | 1033220751 - ENDOSCOPY CENTER AT ST MARY | 205253494 - (PA) ENDOSCOPY CENTER AT ST MARY | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22505 | $1817.00 | 1568776615 - CEDAR PARK SURGERY CENTER, LLC | 272533497 - (TX) CEDAR PARK SURGERY CENTER LLC | TX | 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 22505 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22505 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 22505 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 |
| 22505-CPT | Low | Manip Of Spine Req Anesth, Any Region Deny Inv/N10>= 1/16/2013: Rn Review<01/16/2013 |
| 22510-CPT | High | Percutaneous Vertebral Augmentation Including Imaging Guidance If Applicable; 1 Vertebral Body. Unilateral Or Bilateral Injection Including Imaging Guidance- Cervicothoracic |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 22505. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22505 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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