CPT 22595 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 • AS - PA/NP/CNS assistant at surgery • GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 22595 |
National average reimbursement for CPT 22595 by major payers:
$1,943.92
$2,022.07
$2,254.80
$2,496.38
| 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 22595 | ||||||
United | 22595 | $8076.00 | 1497087399 - DELMONT SURGERY CENTER, LLC | 270683745 - (PA) DELMONT SURGERY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22595 | $20842.00 | 1689832438 - INOVA WOODBURN SURGERY CENTER LLC | 540620889 - INOVA HEALTH CARE SERVICES | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22595 | $9324.00 | 1528077658 - PRINCE WILLIAM AMBULATORY SURGERY CENTER, LLC, PRINCE WILLIAM SURGERY CENTER | 770594498 - (VA) PRINCE WILLIAM AMBULATORY | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22595 | $4265.00 | 1093766289 - CAPITAL WOMENS CARE LLC, FREDERICK OB/GYN AMBULATORY SURGERY CENTER | 522112078 - (MD) CAPITAL WOMENS CARE, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22595 | $4350.00 | 1588039465 - SARATOGA SURGICAL CENTER, LLC | 471313246 - (TX) SARATOGA SURGICAL CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22595 | $7006.00 | 1619037066 - THE EL DORADO AR MULTISPECIALTY ASC LLC, SOUTH ARKANSAS SURGERY CENTER | 203954951 - (AR) THE EL DORADO AR MULTISPECIALTY ASC LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22595 | $1133.00 | 1194832949 - CHOICES WOMEN'S MEDICAL CENTER, INC. | 112715115 - CHOICES WOMENS MEDICAL CENTER IN | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22595 | $7610.00 | 1821242488 - SPECIALTY SURGICAL CENTER OF NORTH BRUNSWICK, LLC | 208770654 - (NJ) SPECIALTY SURGICAL CENTER OF N | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22595 | $7368.00 | 1073758298 - BAPTIST SURGERY AND ENDOSCOPY CENTERS LLC, BAPTIST HEALTH ENDOSCOPY CENTER AT GALLOWAY NORTH | 201796841 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22595 | $10326.00 | 1902036049 - PHYSICIANS AMBULATORY SURGERY CENTER, LLC | 800444943 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22595 | $9430.00 | 1962007757 - SURGERY CENTER AT GROVE CREEK, LLC | 854085559 - (UT) SURGERY CENTER AT GROVE CREEK LLC | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22595 | $11924.00 | 1396796249 - TAMPA BAY SURGERY CENTER ASSOCIATES, LTD. | 593210851 - (FL) TAMPA BAY SURGERY CENTER ASSOC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22595 | $8939.00 | 1588679179 - SPECIALTY SURGICAL CENTER OF ENCINO LP | 954816334 - (CA) SPECIALTY SURGICAL CENTER OF ENCINO, LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22595 | $7575.00 | 1336204668 - PHYSICIANS SURGICENTER LLC | 223550463 - (NJ) PHYSICIANS' SURGICENTER, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22595 | $7250.00 | 1124068549 - CROWN VALLEY SURGERY CENTER | 454125214 | CA | 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 22595 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22595 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 22595 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 |
|---|---|---|
| 22590-CPT | High | Arthrodesis Post-Craniocervical |
| 22595-CPT | High | Arthrodesis,Poster.Tech,Atlas-Axis,C1-C2 |
| 22600-CPT | High | Arthrodesis Posterior Or Posterolateral Technique Single Interspace; Cervical Below C2 Segment (Desc Rvsd 1/1/22) |
| 22610-CPT | High | Arthrodesis Posterior Or Posterolateral Technique Single Interspace Thoracic (With Or Without Lateral Transverse Technique) (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 22595. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22595 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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