CPT 22812 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 • 11 - Office |
| Common Modifiers | • None • 62 - Co-Surgeons • AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 22812 |
National average reimbursement for CPT 22812 by major payers:

$2,797.92

$3,005.89

$3,251.73

$3,691.51
| 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 22812 | ||||||
United | 22812 | $2518.00 | 1316189095 - CARILLON SURGERY CENTER LLC | 261116740 - (FL) CARILLON SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22812 | $8384.00 | 1568867075 - POTOMAC VIEW SURGERY CENTER, LLC | 471352116 - (MD) POTOMAC VIEW SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22812 | $4479.93 | 1942202221 - NORTHLAKE ENDOSCOPY, LLC | 721515370 - (LA) NORTHLAKE ENDOSCOPY LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22812 | $4946.00 | 1548238140 - DENTON SURGICARE PARTNERS LTD, BAYLOR SCOTT & WHITE SURGICARE - DENTON | 752708579 - (TX) DENTON SURGICARE PARTNERS LTD | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22812 | $5495.00 | 1043708019 - OAK POINT SURGICAL SUITES LLC | 823437812 - (TX) OAK POINT SURGICAL SUITES LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22812 | $4334.00 | 1780699546 - CASCADES ENDOSCOPY CENTER, LLC, WHITEMARSH ENDOSCOPY CENTER | 203496335 - (MD) CASCADES ENDOSCOPY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22812 | $10873.00 | 1386165504 - THE EMORY CLINIC INC, EMORY AMBULATORY SURGERY CENTER AT SPIVEY STATION | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22812 | $4006.00 | 1578534459 - BOSTON OUT-PATIENT SURGICAL SUITES, LLC | 270050256 - (MA) BOSTON OUT-PATIENT SURGICAL SUITES, LLC | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22812 | $5029.00 | 1043690126 - BELLINGHAM UROLOGY GROUP, PLLC | 472435308 | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22812 | $3898.00 | 1528197191 - RWMC AMBULATORY SURGERY CENTER, LLC, SCOTTSBLUFF SURGERY CENTER | 205026191 - (NE) RWMC AMBULATORY SURGERY CENTER LLC | NE | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22812 | $5858.00 | 1871838003 - NORTHWEST REGIONAL SURGERY CENTER, LLC | 460823847 - (IN) NORTHWEST REGIONAL SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22812 | $3822.00 | 1487608071 - SAN BERNARDINO EYE SURGERY CENTER, LLC, THE EYE SURGERY CENTER | 330991348 - SAN BERNARDINO EYE SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22812 | $1337.00 | 1295708964 - COLUMBIA TN ENDOSCOPY ASC LLC, MID-SOUTH ENDOSCOPY CENTER | 810558898 - (TN) COLUMBIA TN ENDOSCOPY ASC LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22812 | $9510.00 | 1003813221 - UNIVERSITY SURGERY CENTER LTD | 742894406 - (FL) UNIVERSITY SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22812 | $8150.00 | 1679913552 - SPINE SPORTS SURGERY CENTER, LLC, SPINE AND SPORTS SURGERY CENTER | 461141188 | 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 22812 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22812 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 22812 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 22812. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22812 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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