CPT 22612 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 • 58 - Staged or related procedure during postoperative period |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 22612 |
National average reimbursement for CPT 22612 by major payers:
$1,953.21
$2,151.75
$2,340.73
$2,647.91
| 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 22612 | ||||||
United | 22612 | $3100.00 | 1134363690 - OAM SURGERY CENTER AT MIDTOWNE, LLC, METRO HEALTH OAM SURGERY CENTER | 261805066 - (MI) OAM SURGERY CENTER AT MIDTOWNE LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22612 | $14780.00 | 1104845015 - TEXAS HEALTH HARRIS METHODIST HOSPITAL HURST-EULESS-BEDFORD | 751438726 - (TX) TEXAS HEALTH HARRIS METHODIST HOSPITAL HURST-EULESS-BEDFORD | TX | General Acute Care Hospital (282N00000X) |
United | 22612 | $8169.00 | 1831629526 - EBD BEMC BURLESON, LLC, BAYLOR SCOTT & WHITE EMERGENCY HOSPITAL GRAND PRAIRIE | 364755936 | TX | General Acute Care Hospital (282N00000X) |
United | 22612 | $1248.85 | 1871000133 - BENJAMIN CHRISTIAN | 350593390 - DEACONESS HOSPITAL INC | KY | Certified Registered Nurse Anesthetist (367500000X) |
United | 22612 | $3975.00 | 1194489757 - WALNUT CREEK SURGICAL SUITES, LLC | 852525715 - (OH) WALNUT CREEK SURGICAL SUITES LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22612 | $2231.00 | 1962963728 - VISIONARY SURGERY CENTER OF NEVADA, LLC | 832017500 - (NV) VISIONARY SURGERY CENTER OF NEVADA LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22612 | $8296.00 | 1194753590 - THHBP MANAGEMENT COMPANY LLC, BAYLOR SCOTT & WHITE THE HEART HOSPITAL - DENTON | 263603862 - (TX) THHBP MANAGEMENT COMPANY LLC | TX | General Acute Care Hospital (282N00000X) |
United | 22612 | $4170.00 | 1801987805 - ENDO SURGI CENTER OF OLD BRIDGE LLC | 223679920 - (NJ) ENDO-SURGI CENTER OF OLD BRIDGE, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22612 | $2207.00 | 1578994265 - M/S SURGERY CENTER LLC, M/S SURGERY CENTER LLC WHIT | 205219388 - (CA) MS SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22612 | $2005.66 | 1316936990 - EL PASO COUNTY HOSPITAL DISTRICT, UNIVERSITY MEDICAL CENTER OF EL PASO | 746000756 - (TX) EL PASO COUNTY HOSPITAL DISTRICT | TX | General Acute Care Hospital (282N00000X) |
United | 22612 | $2160.00 | 1831195379 - LARGO SURGERY LLC, WEST BAY SURGERY CENTER | 10553657 - (FL) LARGO SURGERY LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22612 | $9013.00 | 1255325817 - MIDLAND COUNTY HOSPITAL DISTRICT, MIDLAND MEMORIAL HOSPITAL | 751584559 - (TX) MIDLAND COUNTY HOSPITAL DISTRICT | TX | General Acute Care Hospital (282N00000X) |
United | 22612 | $900.00 | 1164528527 - CENTER FOR DIGESTIVE CARE LLC | 30447062 - (MI) CENTER FOR DIGESTIVE CARE LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22612 | $695.00 | 1952373086 - CRYSTAL RIVER ENDOSCOPY ASC LP, CITRUS ENDOSCOPY & SURGERY CENTER | 621666148 - (FL) CRYSTAL RIVER ENDOSCOPY ASC LP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22612 | $5325.00 | 1235685892 - FAIRFIELD HOSPITAL DISTRICT, FREESTONE MEDICAL CENTER | 741774669 | TX | General Acute Care Hospital (282N00000X) |
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 22612 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22612 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 22612 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 |
| 22600-CPT | High | Arthrodesis Posterior Or Posterolateral Technique Single Interspace; Cervical Below C2 Segment (Desc Rvsd 1/1/22) |
| 22612-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 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 22612. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22612 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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