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 |
| Medicare Fee Schedule | View Medicare rates for 22586 |
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 | $3579.00 | 1487765897 - BAY MICROSURGICAL UNIT | 570799855 - (SC) BAY MICROSURGICAL UNIT | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22586 | $2686.00 | 1447388574 - MACON PAIN CENTER, P.C. | 582452607 - (GA) MACON PAIN CENTER, PC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22586 | $5000.00 | 1952834277 - AMERICAN ACCESS CARE OF TOWSON ASC LLC | 814571016 - (MD) AMERICAN ACCESS CARE OF TOWSON ASC LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22586 | $1836.00 | 1518279504 - EVANS PROCEDURE CENTER, LLC | 272289325 - (GA) EVANS PROCEDURE CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22586 | $8917.00 | 1912265653 - BRASELTON ENDOSCOPY CENTER, LLC | 453369410 - (GA) BRASELTON ENDOSCOPY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22586 | $4500.00 | 1033468442 - CORNERSTONE SURGICARE LLC | 460563529 - (FL) CORNERSTONE SURGICARE LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22586 | $4622.00 | 1053585125 - BJOSC, LLC, BONE & JOINT SURGERY CENTER | 300391378 - BJOSC LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22586 | $8671.00 | 1437427333 - TOWER CLOCK SURGERY CENTER LLC | 453636581 - (WI) TOWER CLOCK SURGERY CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22586 | $7727.00 | 1942231204 - SURGICAL INSTITUTE, LLC | 810911558 - (NJ) SURGICAL INSTITUTE LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22586 | $4807.00 | 1215283866 - EC LASER AND SURGERY INSTITUTE OF WI, LLC | 454182045 - (WI) EC LASER AND SURGERY INSTITUTE OF WI LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22586 | $6968.00 | 1922334101 - ORTHOPEDIC SURGERY CENTER OF GREEN BAY, LLC | 264677834 - (WI) ORTHOPEDIC SURGERY CENTER OF GREEN BAY | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22586 | $3872.00 | 1376616060 - NORTHSHORE SURGICAL CENTER, LLC | 202339324 - (LA) NORTHSHORE SURGICAL CENTER LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22586 | $8163.00 | 1033351119 - SSM ST CLARE SURGICAL CENTER LLC, SSM ST CLARE SURGICAL CENTER | 261439695 - (MO) SSM ST CLARE SURGICAL CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22586 | $6180.00 | 1043845340 - NORTHEAST ENDOSCOPY LLC | 824889052 - (NY) NORTHEAST ENDOSCOPY LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22586 | $41032.00 | 1528069218 - NORTHSHORE REGIONAL MEDICAL CENTER DBA THE SURGERY SUITE, THE SURGERY SUITE | 720502505 - (LA) OCHSNER CLINIC FOUNDATION | LA | 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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