CPT 22552 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 | • 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 |
National average reimbursement for CPT 22552 by major payers:
$511.55
$562.54
$585.96
$675.44
| 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 22552 | ||||||
United | 22552 | $13900.00 | 1700431798 - METHODIST AMBULATORY SURGERY CENTER OF BOERNE, LLC | 823532569 - (TX) METHODIST AMBULATORY SURGERY CENTER OF BOERNE LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22552 | $673.78 | 1629237078 - NITIN KHADILKAR | 350593390 - DEACONESS HOSPITAL INC | IN | Psychiatry Physician (2084P0800X) |
United | 22552 | $3167.00 | 1689800666 - BSM SURGERY CENTER LLC | 264349685 - (OR) BSM SURGERY CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22552 | $2800.00 | 1619291192 - DALLAS IVF SURGERY CENTER, LLC, DALLAS IVF SURGERY CENTER | 263473774 - (TX) DALLAS IVF SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22552 | $1283.00 | 1093764045 - GASTROENTEROLOGY OF INDIANAPOLIS PC, DIGESTIVE HEALTH CENTER | 351641181 - (IN) GASTROENTEROLOGY OF INDIANAPOLIS, P . C. | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22552 | $4200.00 | 1013493824 - ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO, LURIE CHILDREN'S SURGERY CENTER IN NORTHBROOK | 362170833 - ANN & ROBERT H LURIE CHILDRENS HOSPITAL OF CHICAGO | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22552 | $1005.00 | 1376513440 - FLORIDA EYE CLINIC AMBULATORY SURGERY CENTER, INC. | 592303141 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22552 | $4080.00 | 1316949415 - NEWPORT BEACH SURGERY CENTER, LLC, NEWPORT BEACH SURGERY CENTER | 330488134 - (CA) NEWPORT BEACH SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22552 | $3914.00 | 1154785848 - PROSPECT CCMC, LLC | 811507712 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22552 | $1362.00 | 1609026533 - EYE SURGICENTER LLC | 651005108 - (FL) EYE SURGICENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22552 | $16974.00 | 1275292229 - SCOTTSDALE ENDOSCOPY ASC LLC | 873952617 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22552 | $1472.00 | 1326097536 - HARRISBURG ENDOSCOPY & SURGERY CENTER, INC. | 251847719 - (PA) HARRISBURG ENDOSCOPY SURGERY CENTER INC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22552 | $1206.00 | 1851317614 - KENDALL POINTE SURGERY CENTER LLC | 364236445 - (IL) KENDALL POINTE SURGERY CENTER LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22552 | $11335.00 | 1720011042 - PREMIER ORTHOPAEDIC SURGERY CENTER, LLC | 352433859 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22552 | $18000.00 | 1780218115 - SURGERY CENTER OF FORT WAYNE | 825163478 - (IN) SURGERY CENTER OF FORT WAYNE LLC | IN | 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 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 | Arthrodesis, Anterior Transoral Or Extraoral Technique, Clivus-C1-C2 (Atlas-Axis), With Or Without Excision Of Odontoid Process |
| 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 | 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 |
| 22554-CPT | High | Arthrodesis, Anterior Interbody Technique, Including Minimal Discectomy To Prepare Interspace (Other Than For Decompression); Cervical Below C2 |
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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