CPT 22515 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • XS - Separate Structure |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 22515 |
National average reimbursement for CPT 22515 by major payers:
$3,753.75
$5,403.85
$5,059.47
$5,406.88
| 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 22515 | ||||||
United | 22515 | $170.00 | 1366868572 - PREMIER SURGERY CENTER, LLC | 463321793 - (NC) PREMIER SURGERY CENTER LLC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22515 | $480.00 | 1023551413 - MID-BRONX ENDOSCOPY CENTER LLC | 471156630 - (NY) MIDBRONX ENDOSCOPY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22515 | $108.00 | 1740254572 - THE NORTHERN NV ENDOSCOPY ASC LLC, DIGESTIVE HEALTH CENTER | 200470103 - THE NORTHERN NV ENDOSCOPY ASC LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22515 | $793.00 | 1851491013 - NEW ENGLAND AMBULATORY SURGICENTER, LLC | 205110715 - (MA) NEW ENGLAND AMBULATORY SURGICENTER LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22515 | $150.00 | 1922542745 - NORTH TEXAS SURGERY CENTER, LLC | 813775233 - (TX) NORTH TEXAS SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22515 | $531.00 | 1043303894 - DOCTORS OUTPATIENT SURGERY CENTER OF JUPITER, LLC, LASER & SURGERY CENTER OF THE PALM BEACHES | 650953183 - (FL) DRS. OUTPATIENT SURGERY CENTER OF JUPITER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22515 | $100.00 | 1386604908 - MATTAX NEU PRATER SURGERY CENTER, LLC | 431842771 - (MO) MATTAX NEU PRATER SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22515 | $555.00 | 1730175159 - CHARLOTTE ENDOSCOPIC SURGERY CENTER LLC, CHARLOTTE SURGERY CENTER | 651071112 - (FL) CHARLOTTE ENDOSCOPIC SURGERY CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22515 | $171.00 | 1083851497 - GEORGIA UROLOGY, PA, GEORGIA UROLOGY ASC GWINNETT | 550846177 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22515 | $574.00 | 1184680225 - CAPITAL CITY SURGICAL CENTER LLC, CAPITAL CITY SURGICAL CENTER LLC | 471211202 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22515 | $728.00 | 1023218500 - SAN MARTIN SURGERY CENTER LLC | 202999408 - (NV) SAN MARTIN SURGERY CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22515 | $301.00 | 1063019586 - GREENWAY SURGICAL SUITES, LLC | 853346468 - (MN) GREENWAY SURGICAL SUITES LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22515 | $410.00 | 1164414447 - EAST VALLEY ENDOSCOPY LLC | 870667809 - (AZ) EAST VALLEY ENDOSCOPY, PLLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22515 | $688.00 | 1699284018 - ONYX & PEARL SURGICAL SUITES LLC | 821183739 - (OH) ONYX & PEARL SURGICAL SUITES, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22515 | $220.00 | 1871538694 - SOUTHWEST ENDOSCOPY LTD | 850452091 - (NM) SOUTHWEST ENDOSCOPY LTD | NM | 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 22515 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22515 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 22515 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 |
| 22515-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; (List Separately In Additionto 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 22515. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22515 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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