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See a sample rate comparisonCPT 22554 Fee Schedule
Last Verified: September 2026
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.
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.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None AS - PA/NP/CNS assistant at surgery 51 - Multiple procedures |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 22554 |
| Medicaid Fee Schedule | View Medicaid rates for 22554 |
National average reimbursement for CPT 22554 by major payers:
$1,676.53
$1,725.13
$1,839.60
$2,065.03
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CPT 22554
5 of 25 sample ratesHigher to lower in this preview
Monterey Peninsula Surgery Center Capitola, Capitola Surgery Center
Monterey Peninsula Surgery Center, LLC
$19,227.00Published ratePark Central Surgical Center, Ltd, Medical City Surgery Center/Park Central
Park Central Surgical Center Ltd
$7,736.00Published rateOptum Peak Endoscopy Center LLC
$3,760.00Published rateAdvanced Surgery Center Of Central Iowa, LLC
Advanced Surgery Center Of Central Iowa LLC
$2,516.00Published rateGastro Care, LLC
Gastro Care LLC
$898.00Published rate
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See a sample payer proposalCPT 22554 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22554 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 22554 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 |
|---|---|---|
| 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. |
| 22556-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 22554. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22554 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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