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See a sample rate comparisonCPT 22558 Fee Schedule
Medicare rates as of October 2026
CPT 22558 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
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 | 62 - Co-Surgeons AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
| Medicare Fee Schedule | $1,423.88 national non-facility rate (2026) · View Medicare rates for 22558 |
| Medicaid Fee Schedule | $1,109.10 median of the 8 states in the free preview · View Medicaid rates for 22558 |
National average reimbursement for CPT 22558 by major payers:
$1,977.73
BCBS / Anthem
$2,075.04
UnitedHealthcare
$2,237.73
Aetna
$2,482.44
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 22558.
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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Payer Contract Negotiation
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See a sample payer proposalCPT 22558 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 22558. Select one to see its fee schedule.
| 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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Frequently Asked Questions
CPT stands for Current Procedural Terminology. CPT codes are standardized five-digit alphanumeric codes used by healthcare providers to describe medical, surgical, and diagnostic services. They are crucial for consistent communication among providers, patients, and payers, and are used for billing purposes to identify the specific services rendered.
Finding the exact cost of a medical procedure can be complex due to varying factors like your insurance plan, location, and the specific provider. For an accurate estimate based on a specific CPT code and your location, you can use specialized tools. Payerprice offers a fee schedule lookup tool that allows you to search with a CPT code and specific location to get detailed pricing information relevant to your situation.
A fee schedule is a comprehensive listing of fees used by healthcare payers (such as insurance companies) to reimburse providers for services rendered. It outlines the maximum amount a payer will pay for each specific medical procedure or service, often identified by a CPT code. These schedules can vary significantly by payer, region, and type of service.
To look up specific medical procedure prices tailored to your location, you should use a dedicated fee schedule lookup tool. Payerprice provides such a tool, allowing users to search for prices based on CPT codes and their specific geographical location. This can help you understand potential costs for services in your area.
Medical costs can vary significantly due to several factors, including the healthcare provider's charges, your insurance plan's negotiated rates, your geographical location, the complexity of the procedure, and whether the provider is in-network or out-of-network. Tools like Payerprice can help you understand these variations by providing location-specific fee schedule data for CPT codes, allowing you to compare potential costs.