A CPT (Current Procedural Terminology) code is a five-digit number assigned to every task and service a medical practitioner may provide to a patient, including medical, surgical, and diagnostic services. They are used by health insurance companies and government payers to determine the amount of reimbursement that a practitioner will receive for services.

How can I find out the cost of a medical procedure before I have it?

Understanding the cost of a medical procedure beforehand can be challenging due to variations in pricing based on location, provider, and insurance plan. You should first contact your insurance company for an estimate of your out-of-pocket costs, including deductibles, co-pays, and co-insurance. For more specific information on what providers are charging for certain CPT codes in your specific location, you can utilize tools like Payerprice, which provides a fee schedule lookup based on CPT code and geographic area.

Why do medical costs vary so much?

Medical costs can vary significantly due to several factors, including the specific provider's negotiated rates with insurance companies, the geographical location (urban vs. rural), the type of facility (hospital vs. outpatient clinic), the complexity of the procedure, and whether the provider is in-network or out-of-network for your insurance plan. The lack of price transparency in the healthcare system also contributes to this variability.

What's the difference between my insurance's "negotiated rate" and the "chargemaster" price?

The "chargemaster" price (or list price) is the maximum amount a hospital charges for a service, which is often much higher than what most patients or insurers actually pay. The "negotiated rate" is the discounted price that an insurance company has pre-arranged with a healthcare provider for a specific service. If you have insurance, you will typically pay a portion of the negotiated rate, not the chargemaster price. If you are uninsured, you might be billed the chargemaster price, though you can often negotiate a lower self-pay rate.

Where can I find specific fee schedule information for CPT codes in my area?

To find specific fee schedule information for CPT codes in your area, it's best to use tools designed for price transparency. While your insurance company can provide estimates for services under your plan, for a broader view of provider pricing based on specific CPT codes and your location, you can use Payerprice's fee schedule lookup tool. This tool allows you to search with CPT codes and your specific geographic location to get an idea of what different payers are reimbursing.

CPT 22552 Fee Schedule

Last Verified: September 2026

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.

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

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 AS - PA/NP/CNS assistant at surgery 59 - Distinct Procedural Service
Complexity Level	Moderate
Medicare Fee Schedule	View Medicare rates for 22552
Medicaid Fee Schedule	View Medicaid rates for 22552

National average reimbursement for CPT 22552 by major payers:

$511.55

$562.54

$585.96

$663.62

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CPT 22552

5 of 25 sample ratesHigher to lower in this preview

Surgery Center Of Fort Wayne
Surgery Center Of Fort Wayne LLC
INAmbulatory Surgical Clinic/CenterNPI 1780218115Tax ID 82-5163478
$18,000.00Published rate
Mercy Health Boardman Surgery
Bsmh Ambulatory Ventures II LLC
OHAmbulatory Surgical Clinic/CenterNPI 1700492170Tax ID 86-3462441
$7,500.00Published rate
Bsm Surgery Center LLC
ORAmbulatory Surgical Clinic/CenterNPI 1689800666Tax ID 26-4349685
$3,167.00Published rate
Gastroenterology Of Indianapolis PC, Digestive Health Center
Gastroenterology Of Indianapolis, P . C.
INAmbulatory Surgical Clinic/CenterNPI 1093764045Tax ID 35-1641181
$1,283.00Published rate
The Eye Surgical Center Of Fort Wayne, LLC
The Eye Surgical Center Of Fort Wayne LLC
INAmbulatory Surgical Clinic/CenterNPI 1588991228Tax ID 27-1316595
$635.00Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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CPT 22552 vs. Other Surgical Procedures on the Musculoskeletal System Codes

The CPT 22552 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 22552 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
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 22552. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 22552 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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CPT 22552 Fee Schedule

Compare published rates across providers.

Surgery Center Of Fort Wayne

Mercy Health Boardman Surgery

Bsm Surgery Center LLC

Gastroenterology Of Indianapolis PC, Digestive Health Center

The Eye Surgical Center Of Fort Wayne, LLC