CPT 22554 Fee Schedule
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.
| 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 |
National average reimbursement for CPT 22554 by major payers:
$1,676.53
$1,725.13
$1,839.60
$2,123.42
| 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 22554 | ||||||
United | 22554 | $5000.00 | 1356718514 - WACO AMBULATORY SURGERY CENTER, LP, WACO CARDIOLOGY CATH LAB & SURGERY CENTER | 473337811 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22554 | $1040.00 | 1366746752 - NEW ENGLAND FERTILITY SURGICAL CENTER | 264741111 - (CT) NEW ENGLAND FERTILITY SURGICAL CENTER | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22554 | $11683.00 | 1174128359 - JEFFERSON ASC, LLC, VOLUNTEER SURGERY CENTER | 364934272 - (TN) JEFFERSON ASC LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22554 | $979.13 | 1811947708 - LEON BROOK | 350593390 - DEACONESS HOSPITAL INC | UT | Certified Registered Nurse Anesthetist (367500000X) |
United | 22554 | $3064.00 | 1184844607 - SPECIALTY CARE AND SURGERY CENTER | 954176904 - (CA) PAULA R. DHANDA, MD | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22554 | $3275.00 | 1831441617 - PLANNED PARENTHOOD OF GREATER TEXAS SURGICAL HEALTH SERVICES | 201121091 - (TX) PLANNED PARENTHOOD OF GREATER TEXAS SURGICAL HEALTH SERVICES | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22554 | $898.00 | 1740424944 - GASTRO CARE, LLC | 263402953 - (OH) GASTRO CARE LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22554 | $3402.00 | 1497090740 - OLOL PONTCHARTRAIN SURGERY CENTER, LLC, OUR LADY OF THE LAKE PONTCHARTRAIN SURGERY CENTER | 461379031 - (LA) OLOL PONTCHARTRAIN SURGERY CENTE | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22554 | $19227.00 | 1407116361 - MONTEREY PENINSULA SURGERY CENTER CAPITOLA, CAPITOLA SURGERY CENTER | 770470910 - (CA) MONTEREY PENINSULA SURGERY CENTER, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22554 | $3760.00 | 1316678311 - OPTUM PEAK ENDOSCOPY CENTER LLC | 880934943 - (CO) OPTUM PEAK ENDOSCOPY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22554 | $2131.05 | 1083772248 - REKHA TUMMALA | 350593390 - DEACONESS HOSPITAL INC | IN | Hospitalist Physician (208M00000X) |
United | 22554 | $2516.00 | 1174999700 - ADVANCED SURGERY CENTER OF CENTRAL IOWA, LLC | 472673565 - (IA) ADVANCED SURGERY CENTER OF CENTRAL IOWA LLC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22554 | $7319.00 | 1326097981 - FREDERICKSBURG AMBULATORY SURGERY CENTER, LLC | 562322548 - (VA) FREDERICKSBURG AMBULATORY SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22554 | $8087.00 | 1083644124 - MEMORIAL HERMANN SURGERY CENTER SOUTHWEST LLP, MEMORIAL HERMANN SURGERY CENTER SOUTHWEST | 202866884 - (TX) MEMORIAL HERMANN SURGERY CENTER SOUTHWEST LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22554 | $2942.00 | 1245340603 - MOUNTAIN EMPIRE CATARACT & EYE SURGERY CENTER | 30408358 - (TN) MOUNTAIN EMPIRE CATARACT EYE SURGERY CENTER | TN | 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 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 | 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 |
| 22556-CPT | High | Arthrodesis, Anterior Interbody Technique, Including Minimal Discectomy To Prepare Interspace (Other Than For Decompression); Thoracic |
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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