CPT 22586 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 |
National average reimbursement for CPT 22586 by major payers:
$2,427.65
$2,590.92
$2,724.24
$3,192.61
| 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 22586 | ||||||
United | 22586 | $9704.00 | 1194233189 - CHAPIN ORTHOPEDIC SURGERY CENTER | 473916029 - (SC) CHAPIN ORTHOPEDIC SURGERY CENTER | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22586 | $1012.00 | 1972577161 - TAMPA FL ENDOSCOPY ASC LLC, TAMPA BAY ENDOSCOPY CENTER | 200073189 - (FL) TAMPA FL ENDOSCOPY ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22586 | $9442.00 | 1245635093 - PARK RIDGE SURGERY CENTER, LLC | 464468691 - (CO) PARK RIDGE SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22586 | $9650.00 | 1174778047 - RSC ILLINOIS LLC, REGIONAL SURGICENTER | 261363389 | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22586 | $8316.00 | 1255339628 - BISMARCK SURGICAL ASSOCIATES, LLC | 450450254 - (ND) BISMARCK SURGICAL ASSOCIATES LLC | ND | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22586 | $7582.00 | 1306043617 - UROLOGY HEALTH SURGERY CENTER, LLC | 260412126 - (PA) UROLOGY HEALTH SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22586 | $5607.00 | 1467629147 - PACIFIC CATARACT AND LASER INSTITUTE, INC., P.C. | 911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22586 | $1253.00 | 1255792453 - MIDWEST EYE CONSULTANTS OHIO, INC, CATARACT & LASER INSTITUTE #351 | 300888250 - (OH) MIDWEST EYE CONSULTANTS OHIO INC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22586 | $1346.46 | 1285746263 - ORTHOPEDICS SURGICAL CENTER OF THE NORTH SHORE LLC | 10731399 - (MA) ORTHOPEDIC SURGICAL CENTER OF THE NORTH SHORE | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22586 | $10236.00 | 1700502150 - MOUNT PLEASANT OUTPATIENT SURGERY CENTER LLC | 883714959 - (SC) MOUNT PLEASANT OUTPATIENT SURGERY CENTER LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22586 | $2825.00 | 1366496143 - VIRGINIA SURGERY CENTER, LLC, CVP SURGERY CENTER | 541922041 - (VA) VIRGINIA SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22586 | $7525.00 | 1386647402 - PHYSICIANS DAY SURGERY CENTER, LLC, PHYSICIANS DAY SURGERY CENTER, INC. | 593438026 - (FL) PHYSICIANS DAY SURGERY CENTER, INC. | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22586 | $3049.00 | 1790798668 - UNIVERSITY HOSPITALS MANAGEMENT SERVICES ORGANIZATION INC, UHHS WESTLAKE SURGERY CENTER | 341567805 - UNIVERSITY HOSPITALS HEALTH SYSTEM INC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22586 | $5436.00 | 1821420571 - UPPER VALLEY SURGERY CENTER | 462617367 - (ID) UPPER VALLEY SURGERY CENTER | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22586 | $32832.00 | 1225064876 - ROCK HILL SURGERY CENTER, LLC, CAROLINA SURGICAL CENTER | 752562111 - (SC) ROCK HILL SURGERY CENTER LLC | SC | 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 22586 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22586 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 22586 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 |
|---|---|---|
| 22585-CPT | Moderate | Arthrodesis, Anterior Interbody Technique, Including Minimal Discectomy To Prepare Interspace (Other Than For Decompression); Each Additional Interspace (List Separately In Addition To Code For Primary Procedure) |
| 22586-CPT | High | Arthrodesis, Pre-Sacral Interbody Technique, Including Disc Space Preparation, Discectomy, With Posterior Instrumentation, With Image Guidance, Includes Bone Graft When Performed, L5-S1 Interspace |
| 22590-CPT | High | Arthrodesis Post-Craniocervical |
| 22600-CPT | High | Arthrodesis Posterior Or Posterolateral Technique Single Interspace; Cervical Below C2 Segment (Desc Rvsd 1/1/22) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 22586. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22586 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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