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See a sample rate comparisonCPT 22612 Fee Schedule
Last Verified: October 2026
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.
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
| 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 |
| Medicaid Fee Schedule | View Medicaid rates for 22612 |
National average reimbursement for CPT 22612 by major payers:
$1,953.21
$2,151.75
$2,340.73
$2,576.85
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CPT 22612
5 of 25 sample ratesHigher to lower in this preview
Texas Health Harris Methodist Hospital Hurst-Euless-Bedford
$14,780.00Published rateSurgicare Associates, LLC
Surgicare Associates LLC
$4,600.00Published rateM/S Surgery Center LLC, M/S Surgery Center LLC Whit
Ms Surgery Center LLC
$2,207.00Published rateBenjamin Christian
Deaconess Hospital Inc
$1,248.85Published rateCrystal River Endoscopy Asc Lp, Citrus Endoscopy & Surgery Center
Crystal River Endoscopy Asc Lp
$695.00Published rate
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See a sample payer proposalCPT 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 | Arthrd Ant Ntrbd Min Dsc Ea, 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 | Arthrd Pre Sac Ntrbdy L5 S1, 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 | 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. |
| 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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