CPT 22512 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 • 59 - Distinct Procedural Service • GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 22512 |
National average reimbursement for CPT 22512 by major payers:
$887.50
$1,228.93
$1,199.16
$1,304.63
| 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 22512 | ||||||
United | 22512 | $65.00 | 1972147239 - CHILDREN'S SURGERY CENTER OF PHILADELPHIA LLC, CHILDREN'S DENTAL SURGERY OF PHILADELPHIA | 842886610 - (PA) CHILDRENS SURGERY CENTER OF PHILADELPHIA LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22512 | $100.00 | 1679025449 - DIGESTIVE HEALTH COMPLEX | 262808532 | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22512 | $344.00 | 1255604534 - BARNET DULANEY PERKINS EYE CENTER, PC, BDPEC TUCSON | 562589722 - BARNET DULANEY PERKINS EYE CENTER PLLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22512 | $79.00 | 1144216847 - RIVER PARK ASC LLC | 721510504 - (LA) RIVER PARK ASC LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22512 | $555.00 | 1194351833 - DELRAY BEACH ASC, LLC, DELRAY BEACH SURGERY CENTER | 843067076 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22512 | $54.00 | 1548655053 - MISSISSIPPI UROLOGY OUTPATIENT SURGERY CENTER, LLC | 463162562 - (MS) MISSISSIPPI UROLOGY OUTPATIENT SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22512 | $125.00 | 1376501064 - SOUTH CENTRAL SURGICAL CENTER, LLC, CENTER FOR SPECIALTY CARE | 411952256 - (MN) SOUTH CENTRAL SURGICAL CENTER LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22512 | $1029.00 | 1396700407 - ARLINGTON SURGERY CENTER, LLC, ARLINGTON SURGERY CENTER ASSOCIATES, LP | 752055800 - (TX) ARLINGTON SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22512 | $5000.00 | 1316009194 - ADVOCATE SOUTHWEST AMBULATORY SURGERY CENTER LLC, TINLEY WOODS SURGERY CENTER | 364437931 - (IL) ADVOCATE SOUTHWEST AMBULATORY SURGE | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22512 | $1050.00 | 1043297872 - CENTRAL JERSEY AMBULATORY SURGICAL CENTER, LLC | 223669777 - (NJ) CENTRAL JERSEY AMBULATORY SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22512 | $300.00 | 1548837503 - HOUSTON IVF MANAGEMENT | 841602243 - (TX) HOUSTON IVF MANAGEMENT CO., LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22512 | $240.00 | 1255809620 - PRAIRIE ORTHOPAEDIC & PLASTIC SURGERY, P.C. | 208397360 - (NE) PRAIRIE ORTHOPAEDIC & PLASTIC SURGERY, P.C. | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22512 | $555.00 | 1295060069 - TIMONIUM SURGERY CENTER, LLC | 270399689 - (MD) TIMONIUM SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22512 | $212.00 | 1871007880 - SOUTHWEST ENDOSCOPY PARTNERS LLC | 822948062 - (CO) SOUTHWEST ENDOSCOPY PARTNERS LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22512 | $86.00 | 1306214705 - GSI ASC, LLC | 474883816 - (OK) GSI ASC LLC | OK | 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 22512 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22512 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 22512 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 |
|---|---|---|
| 22510-CPT | High | Percutaneous Vertebral Augmentation Including Imaging Guidance If Applicable; 1 Vertebral Body. Unilateral Or Bilateral Injection Including Imaging Guidance- Cervicothoracic |
| 22511-CPT | High | Percutaneous Vertebral Augmentation Including Imaging Guidance If Applicable; 1 Vertebral Body. Unilateral Or Bilateral Injection Including Imaging Guidance- Lumbosacral |
| 22512-CPT | Moderate | Percutaneous Vertebroplasty (Bone Biopsy Included When Performed), 1 Vertebral Body, Unilateral Or Bilateral Injection, Inclusive Of All Imaging Guidance; Each Additional Cervicothoracic Or Lumbosacral Vertebral Body (List Separately In Addition To Code For Primary |
| 22513-CPT | High | Percutaneous Vertebral Augmentation Including Cavity Creation (Fracture Reduction And Bone Biopsy Included When Performed) Using Mechanical Device (Eg Kyphoplasty) 1 Vertebral Body Unilateral Or Bilateral Cannulation Inclusive Of All Imaging Guidance; Thoracic |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 22512. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22512 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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