CPT 22556 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 | Anterior or Anterolateral Approach Technique Arthrodesis Procedures on the Spine (Vertebral Column) Arthrodesis Procedures on the Spine (Vertebral Column) |
| 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 22556 |
National average reimbursement for CPT 22556 by major payers:
$2,174.66
$2,253.20
$2,423.79
$2,708.90
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 22556 | $10353.00 | 1407981327 - ARIA HEALTH TORRESDALE -SPU | 230596940 - (PA) JEFFERSON HEALTH-NORTHEAST | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22556 | $3940.00 | 1639682503 - SOUTH PLAINS SURGERY CENTER LLC | 822142398 - (TX) SOUTH PLAINS SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22556 | $4590.00 | 1790744175 - WESTERN WASHINGTON ENDOSCOPY CENTERS LLC, PUYALLUP ENDOSCOPY CENTER | 200289310 - (WA) WESTERN WASHINGTON ENDOSCOPY CENTERS LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22556 | $4224.00 | 1821285073 - GLENDORA CA ENDOSCOPY ASC LP, GLENDORA DIGESTIVE DISEASE INSTITUTE | 205732678 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22556 | $13955.00 | 1508837899 - MEMORIAL HERMANN SURGERY CENTER NORTHWEST, LLP, MEMORIAL HERMANN SURGERY CENTER GREATER HEIGHTS | 200689650 - (TX) MEMORIAL HERMANN SURGERY CENTER NORTHWEST LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22556 | $4350.00 | 1124406632 - COMPREHENSIVE PAIN ASC, LLC | 473944400 - (CA) COMPREHENSIVE PAIN ASC LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22556 | $1265.00 | 1023399318 - CANDESCENT EYE SURGICENTER LLC | 452898656 | RI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22556 | $21741.00 | 1366406233 - MIDDLE TENNESSEE AMBULATORY SURGERY CENTER, L.P. | 621699667 - (TN) MIDDLE TENNESSEE AMBULATORY SURGERY CENTER LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22556 | $945.00 | 1447319603 - NORTHERN BALTIMORE SURGERY CENTER, LLC | 522234559 - (MD) NORTHERN BALTIMORE SURGERY CENTER 401(K) PLAN | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22556 | $9510.00 | 1962788059 - SURGCENTER OF SILVER SPRING, LLC | 452950933 - (MD) SURGCENTER OF SILVER SPRING LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22556 | $9834.00 | 1023071560 - MEDICAL PLAZA AMBULATORY SURGERY CENTER ASSOCIATES, L.P., MEDICAL CITY SURGERY CENTER/FORT WORTH | 621489404 - (TX) MEDICAL PLAZA AMBULATORY SURGERY CENTER ASSOCIATES LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22556 | $3971.00 | 1215994280 - SLOAN EYE CLINIC, ARKANSAS SURGERY CENTER | 710815680 - (AR) SLOAN EYE CLINIC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22556 | $4176.00 | 1720001928 - CAMPBELL CLINIC SURGERY CENTER, LLC | 621826300 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22556 | $1100.00 | 1962466847 - GULF COAST ENDOSCOPY CENTER OF VENICE LLC | 621767599 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22556 | $5790.00 | 1679696157 - ORTHOPEDIC HEALTHCARE ANCILLARY SERVICES, LLC, SLOCUM AMBULATORY SURGERY CENTER | 770590285 - (OR) ORTHOPEDIC HEALTHCARE ANCILLARY SERVICES LLC | OR | 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 22556 vs. Other Arthrodesis Procedures on the Spine (Vertebral Column) Codes
The CPT 22556 code is part of the Anterior or Anterolateral Approach Technique Arthrodesis Procedures on the Spine (Vertebral Column) services used for Arthrodesis Procedures on the Spine (Vertebral Column). 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 22556 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 22556. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22556 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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