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See a sample rate comparisonCPT 22551 Fee Schedule
Medicare rates as of October 2026
CPT 22551 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Surgical Service Bundle Includes All Surgery Related Health Services Which Are Incurred In Connection With An Approved Outpatient Surgical Procedure, Billed Via The Agreed Upon Cpt Codes And Reimbursed At A Single Payment Rate Including All Services Such
| 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 | AS - PA/NP/CNS assistant at surgery 59 - Distinct Procedural Service |
| Complexity Level | High |
| Medicare Fee Schedule | $1,604.91 national non-facility rate (2026) · View Medicare rates for 22551 |
| Medicaid Fee Schedule | $1,230.315 median of the 8 states in the free preview · View Medicaid rates for 22551 |
National average reimbursement for CPT 22551 by major payers:
$2,249.06
BCBS / Anthem
$2,412.01
UnitedHealthcare
$2,490.17
Aetna
$2,827.88
Cigna
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CPT 22551
5 of 25 sample ratesHigher to lower in this preview
Surgical Specialty Center Of Mid Atlantic, LLC
Surgical Specialty Center Of Mid-Atlantic, LLC
$15,208.00Published rateJason Harms
$4,325.93Published rateJeremy White
$3,403.61Published rateDavid Lent
$2,432.68Published rateLakeside Orthopedic Institute LLC
$1,658.69Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 22551 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 22551. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 22548-CPT | High | Surgery To Fuse Bones In Spine, Surgery To Join Together Two Or More Back Bones With Bone Grafts Or Device Implants. The Surgery Is Done To Relieve Back Pain By Eliminating Motion Between The Back Bones. |
| 22551-CPT | High | Surgical Service Bundle Includes All Surgery Related Health Services Which Are Incurred In Connection With An Approved Outpatient Surgical Procedure, Billed Via The Agreed Upon Cpt Codes And Reimbursed At A Single Payment Rate Including All Services Such |
| 22552-CPT | Moderate | Arthrd Ant Ntrbd Cervical Ea, Arthrodesis Anterior Interbody Including Disc Space Preparation Discectomy Osteophytectomy And Decompression Of Spinal Cord And Or Nerve Roots Cervical Below C2 Each Additional Interspace List Separately In Addition To Code For Primary Procedure |
| 22554-CPT | High | Surgery To Fuse Bones In Spine, Surgery To Join Together Two Or More Back Bones With Bone Grafts Or Device Implants. The Surgery Is Done To Relieve Back Pain By Eliminating Motion Between The Back Bones. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 22551. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22551 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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Frequently Asked Questions
CPT code 22551 is a surgical service bundle used by healthcare providers to document and receive reimbursement for high-level medical decision-making, often including multiple diagnoses or prescription management. It covers all surgery related health services incurred in connection with an approved outpatient surgical procedure, billed via agreed upon CPT codes and reimbursed at a single payment rate.
The CPT 22551 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal System, representing a moderate-complexity encounter. It is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements. CPT 22551 involves more provider time and moderate medical decision-making compared to lower-level codes, which require less time and simpler assessments. It typically includes managing multiple diagnoses, medication, or interpreting test results, leading to higher reimbursement and more detailed documentation requirements.