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See a sample rate comparisonCPT 22558 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 62 - Co-Surgeons AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 22558 |
| Medicaid Fee Schedule | View Medicaid rates for 22558 |
National average reimbursement for CPT 22558 by major payers:
$1,977.73
$2,075.04
$2,237.73
$2,482.44
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CPT 22558
5 of 25 sample ratesHigher to lower in this preview
Brim Healthcare Of Texas LLC
$15,194.00Published rateSheetal Patel
Nhcs Physicians Inc
$4,659.00Published rateIrfan Iftikhar
Cardiac Intervention Specialists, P. A.
$2,406.22Published rateDonald Behr
$1,682.11Published rateCyfair Cardiology Assoc PA
$1,201.52Published rate
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See a sample payer proposalCPT 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 | 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. |
| 22558-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 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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