CPT 22802 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 22802 |
National average reimbursement for CPT 22802 by major payers:

$2,810.32

$2,871.88

$3,167.89

$3,518.83
| 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 22802 | ||||||
United | 22802 | $4000.00 | 1467491407 - DEARBORN SURGERY CENTER, LLC, DEARBORN SURGERY CENTER | 383494075 - (MI) DEARBORN SURGERY CENTER, LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22802 | $9324.00 | 1366406233 - MIDDLE TENNESSEE AMBULATORY SURGERY CENTER, L.P. | 621699667 - (TN) MIDDLE TENNESSEE AMBULATORY SURGERY CENTER LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22802 | $1244.00 | 1376574814 - ROCHESTER ENDOSCOPY & SURGERY CENTER, L.L.C. | 61683897 - (MI) ROCHESTER ENDOSCOPY SURGERY CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22802 | $3329.00 | 1760447866 - MOBILE-SC, LTD, MOBILE SURGERY CENTER | 630883553 | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22802 | $7009.00 | 1336268754 - MOUNTAIN VISTA ORTHOPAEDIC SURGERY CENTER, LLC | 710936920 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22802 | $1148.00 | 1386277069 - SOUTHWEST ENDOSCOPY LLC | 261261804 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22802 | $2518.00 | 1801899687 - TRINITY SURGERY CENTER LLC, BAYCARE SURGERY CENTER | 20656933 - (FL) TRINITY SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22802 | $9834.00 | 1043874621 - BROWNSVILLE SURGICENTER, LLC | 825464594 - (TX) BROWNSVILLE SURGICENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22802 | $4000.00 | 1730463753 - PEACHTREE ORTHOPAEDIC SURGERY CENTER AT PERIMETER | 201285759 - (GA) PEACHTREE ORTHOPAEDIC SURGERY CENTER AT PERIMETER | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22802 | $3062.00 | 1982211728 - FT SCOTT SURGERY CENTER LLC | 853127325 | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22802 | $10279.00 | 1578914891 - DH PHYSICIANS AMBULATORY SERVICES | 812885619 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22802 | $12928.00 | 1942278692 - FOLSOM OUTPATIENT SURGERY CENTER, LP, FOLSOM SURGERY CENTER | 202468634 - (CA) FOLSOM OUTPATIENT SURGERY CENTER LP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22802 | $4850.00 | 1255896676 - ASCENTIST ASC MERRIAM, LLC, ASCENTIST EAR, NOSE AND THROAT INSTITUTE | 831973214 - (KS) ASCENTIST ASC MERRIAM LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22802 | $4424.00 | 1538117841 - SHELBY BAPTIST AMBULATORY SURGERY CENTER, LLC, SHELBY AMBULATORY SURGERY AT THE PHYSICIANS CENTER | 203150946 - (AL) SHELBY BAPTIST AMBULATORY SURGERY CENTER, LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22802 | $10000.00 | 1932155470 - SUSQUEHANNA SURGERY CENTER INC | 233046101 - (PA) SUSQUEHANNA SURGERY CENTER INC | PA | 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 22802 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22802 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 22802 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 |
|---|---|---|
| 22800-CPT | High | Arthrod,Post,Spin.Deform,Gft;6/Less |
| 22802-CPT | High | Arthrod,Post,Spin.Deform,Gft;7+Vert |
| 22804-CPT | High | Arthrodesis, 13 Or More Vertebral Segments |
| 22818-CPT | High | Kyphectomy, Circumferential Exposure Of Spine And Resection Of Vertebral Segment(S) (Including Body And Posterior Elements); Single Or 2 Segments |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 22802. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22802 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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