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 |
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 | $898.00 | 1740424944 - GASTRO CARE, LLC | 263402953 - (OH) GASTRO CARE LLC | OH | 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 | $2872.00 | 1801110275 - GA PAIN MANAGEMENT CENTER, LLC | 271069156 - (GA) GA PAIN MANAGEMENT CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22554 | $2347.00 | 1265486849 - FEATHERSTONE PARTNERSHIP LP, ROCKFORD AMBULATORY SURGERY CENTER | 363861021 - (IL) THE FEATHERSTONE PARTNERSHIP L. P. | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22554 | $2131.05 | 1346209798 - VERNON TAYLOR | 350593390 - DEACONESS HOSPITAL INC | IN | Emergency Medicine Physician (207P00000X) |
United | 22554 | $1610.00 | 1346270428 - BALTIMORE AMBULATORY CENTER FOR ENDOSCOPY | 521913193 - (MD) BALTIMORE AMBULATORY CENTER FO | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22554 | $18571.00 | 1992058325 - SOUTH BEND SPECIALTY SURGERY CENTER, LLC | 460571418 - (IN) SOUTH BEND SPECIALTY SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22554 | $1575.00 | 1548655053 - MISSISSIPPI UROLOGY OUTPATIENT SURGERY CENTER, LLC | 463162562 - (MS) MISSISSIPPI UROLOGY OUTPATIENT SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
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 | $2762.00 | 1073026639 - MID CITY SPECIALTY CENTER, LLC | 822996794 - (LA) MID CITY SPECIALTY CENTER LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22554 | $8200.00 | 1437110293 - ST. VINCENT-ARKANSAS ORTHOPAEDIC SURGERY CENTER LLC | 710813827 - (AR) ST VINCENTARKANSAS ORTHOPAEDIC SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22554 | $4704.00 | 1902218456 - TEXAS ENDOSCOPY CENTERS, LLC, TEXAS ENDOSCOPY AT INDEPENDENCE MEDICAL VILLAGE | 470985876 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22554 | $2190.00 | 1316253438 - TREASURE COAST UROLOGY CENTER, LLC | 273328667 - (FL) TREASURE COAST UROLOGY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22554 | $300.00 | 1730355595 - FORT MYERS ENDOSCOPY CENTER LLC | 800149158 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22554 | $6492.00 | 1245263292 - CHATTANOOGA PAIN MANAGEMENT CENTER LLC, CHATTANOOGA PAIN SURGERY CENTER | 320121593 - (TN) CHATTANOOGA PAIN MANAGEMENT | 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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