CPT 22558 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 • 62 - Co-Surgeons • AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 22558 |
National average reimbursement for CPT 22558 by major payers:
$1,977.73
$2,075.04
$2,237.73
$2,542.22
| 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 22558 | ||||||
United | 22558 | $11960.00 | 1912909912 - BRFHH SHREVEPORT LLC, UNIVERSITY HEALTH SHREVEPORT | 831173631 | LA | General Acute Care Hospital (282N00000X) |
United | 22558 | $15011.00 | 1124305065 - BAYLOR SCOTT & WHITE MEDICAL CENTERS, BAYLOR SCOTT & WHITE MEDICAL CENTER - MCKINNEY | 751037591 - (TX) BAYLOR MEDICAL CENTERS AT GARLAND AND MCKINNEY | TX | General Acute Care Hospital (282N00000X) |
United | 22558 | $5360.93 | 1760877526 - MAYGEN DEL CASTILLO | 760386391 - KELSEY-SEYBOLD MEDICAL GROUP PLLC | TX | Cardiovascular Disease Physician (207RC0000X) |
United | 22558 | $9616.00 | 1982942298 - STOCKTON OUTPATIENT SURGERY CENTER LLC, AMBULATORY SURGERY CENTER OF STOCKTON | 371709575 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22558 | $1924.06 | 1205847522 - VIJAYA POKALA | 204250365 - NACOGDOCHES CARDIAC CENTER, P.A. | TX | Interventional Cardiology Physician (207RI0011X) |
United | 22558 | $1441.81 | 1437153020 - MARK SCHNEE | 742161176 - (TX) CARDIOLOGY CONSULTANTS OF HOUSTON, PLLC | TX | Cardiovascular Disease Physician (207RC0000X) |
United | 22558 | $1682.11 | 1023029071 - MIGUEL TAN | 1023029071 - (TX) MIGUEL TAN | TX | Nephrology Physician (207RN0300X) |
United | 22558 | $15194.00 | 1114903523 - BRIM HEALTHCARE OF TEXAS LLC | 264178850 | TX | General Acute Care Hospital (282N00000X) |
United | 22558 | $1842.98 | 1396934113 - MOHAMAD SAAD | 270535750 - (TX) SHARIF SURGICAL, LLC | TX | Surgery Physician (208600000X) |
United | 22558 | $1682.11 | 1881791762 - DONALD BEHR | 752327902 | TX | Surgery Physician (208600000X) |
United | 22558 | $2643.33 | 1730319252 - ROBERT WIDMER | 742958277 - SCOTT & WHITE CLINIC | TX | Interventional Cardiology Physician (207RI0011X) |
United | 22558 | $1763.71 | 1215083894 - SHWETA BANSAL | 742932237 - (TX) COMMUNITY MEDICINE ASSOCIATES | TX | Nephrology Physician (207RN0300X) |
United | 22558 | $11960.00 | 1023341740 - OPHTHALMOLOGY SURGERY CENTER OF DALLAS, LLC | 261914835 - (TX) OPHTHALMOLOGY SURGERY CENTER OF DALLAS | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22558 | $1514.93 | 1255335501 - MAYANK PARIKH | 760687469 - (TX) FORT BEND CARDIOLOGY, P.A. | TX | Cardiovascular Disease Physician (207RC0000X) |
United | 22558 | $2600.08 | 1134303696 - VAN-HIEN TRAN | 300520570 - (TX) METHODIST HOSPITAL | TX | Surgery Physician (208600000X) |
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 22558 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22558 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 22558 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 |
| 22558-CPT | High | Arthrodesis, Anterior Interbody Technique, Including Minimal Discectomy To Prepare Interspace (Other Than For Decompression); Lumbar |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 22558. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22558 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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