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See a sample rate comparisonCPT 22630 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.
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.
| 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 59 - Distinct Procedural Service |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 22630 |
| Medicaid Fee Schedule | View Medicaid rates for 22630 |
National average reimbursement for CPT 22630 by major payers:
$1,956.94
$2,115.11
$2,257.96
$2,521.01
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CPT 22630
5 of 25 sample ratesHigher to lower in this preview
Surgical Specialty Center Of Mid Atlantic, LLC
Surgical Specialty Center Of Mid-Atlantic, LLC
$17,900.00Published rateCardio-Kidney Vascular Care LLC
$7,790.00Published rateEye Specialists Surgery Centers, LLC, Muncie Surgical Care Center
$4,244.00Published rateChelmsford Surgery Center LLC
$3,180.00Published ratePremier Endoscopy Center,LLC
$383.00Published rate
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See a sample payer proposalCPT 22630 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22630 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 22630 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 |
| 22614-CPT | Moderate | Fuse Additional 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. |
| 22630-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. |
| 22632-CPT | Moderate | Arthrd Pst Tq 1ntrspc Lm Ea, Arthrodesis Posterior Interbody Technique Including Laminectomy And Or Discectomy To Prepare Interspace Other Than For Decompression Single Interspace Lumbar Each Additional Interspace List Separately In Addition To Code For Primary Procedure |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 22630. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22630 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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