CPT 22534 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 • 24 - Ambulatory Surgical Center • 11 - Office |
| Common Modifiers | • None • AS - PA/NP/CNS assistant at surgery • 82 - Assistant surgeon - no qualified resident |
| Complexity Level | Moderate |
National average reimbursement for CPT 22534 by major payers:
$481.83
$497.23
$550.12
$596.71
| 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 22534 | ||||||
United | 22534 | $116.00 | 1033162631 - EYE SURGERY CENTER-NORTHLAND LLC | 201938574 - (MO) EYE SURGERY CENTERNORTHLAND LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22534 | $351.00 | 1417217183 - PAULSEN STREET SUGERY CENTER LLC | 824075002 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22534 | $803.00 | 1225275688 - MAIN STREET SPECIALTY SURGERY CENTER, LLC | 954813223 - (CA) MAIN STREET SPECIALTY SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22534 | $94.00 | 1144983990 - MOUNTAIN WEST SURGICAL CENTER, LLC | 844185465 - (NV) MOUNTAIN WEST SURGICAL CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22534 | $100.00 | 1205998648 - REGIONAL EYE ASSOCIATES, INC, SURGICAL EYE CENTER OF MORGANTOWN | 550740986 - REGIONAL EYE ASSOCIATES, INC. | WV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22534 | $150.00 | 1700282852 - LAKE JACKSON ENDOSCOPY CENTER, LP. | 800513571 - (TX) LAKE JACKSON ENDOSCOPY CENTER LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22534 | $202.00 | 1275951196 - TEMECULA CA UNITED SURGERY CENTER, LP | 464144489 - (CA) TEMECULA CA UNITED SURGERY CEN | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22534 | $129.00 | 1295841666 - SURGERY CENTER OF SANDUSKY LLC, SURGERY CENTER OF SANDUSKY | 204913215 - (OH) SURGERY CENTER OF SANDUSKY LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22534 | $574.00 | 1376779561 - SURGICARE OF MIRAMAR LLC | 208552194 - (FL) SURGICARE OF MIRAMAR LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22534 | $142.00 | 1730112178 - SAN JOAQUIN LASER SURGERY CENTER | 943308994 - (CA) SAN JOAQUIN LASER SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22534 | $1180.00 | 1225064876 - ROCK HILL SURGERY CENTER, LLC, CAROLINA SURGICAL CENTER | 752562111 - (SC) ROCK HILL SURGERY CENTER LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22534 | $400.00 | 1619971470 - ARIZONA ADVANCED SURGERY CENTER, LLC | 202770438 - (AZ) ARIZONA ADVANCED SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22534 | $249.00 | 1306435086 - PHOENIX SPINE AND JOINT GILBERT ASC, LLC | 853605981 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22534 | $100.00 | 1609968478 - IOWA ENDOSCOPY CENTER, INC. | 421407285 - (IA) IOWA ENDOSCOPY CENTER INC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22534 | $257.00 | 1003168907 - CANDESCENT EYE HEALTH SURGICENTER, LLC | 460608742 | MA | 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 22534 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22534 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 22534 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 |
|---|---|---|
| 22532-CPT | High | Arthrodesis Lateral Extracavitary Technique Including Minimal Diskectomy To Prepare Interspace (Other Than For Decompression); Thoracic |
| 22533-CPT | High | Arthrodesis Lateral Extracavitary Technique Including Minimal Diskectomy To Prepare Interspace (Other Than For Decompression); Lumbar |
| 22534-CPT | Moderate | Arthrodesis, Lateral Extracavitary Technique, Including Minimal Discectomy To Prepare Interspace (Other Than For Decompression); Thoracic Or Lumbar, Each Additional Vertebral Segment (List Separately In Addition To Code For Primary Procedure) |
| 22548-CPT | High | Arthrodesis, Anterior Transoral Or Extraoral Technique, Clivus-C1-C2 (Atlas-Axis), With Or Without Excision Of Odontoid Process |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 22534. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22534 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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