CPT 22830 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 • 59 - Distinct Procedural Service • AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 22830 |
National average reimbursement for CPT 22830 by major payers:
$1,052.80
$1,105.63
$1,228.92
$1,374.26
| 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 22830 | ||||||
United | 22830 | $1751.00 | 1306877261 - NORTHEAST ALABAMA EYE SURGERY CENTER, NORTHEAST AL EYE SURGERY | 631277373 - (AL) NORTHEAST ALABAMA EYE SURGERY CENTER | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22830 | $1074.00 | 1023498219 - GREAT LAKES AMBULATORY SURGERY CENTER | 352512220 - (OH) GREAT LAKES AMBULATORY SURGERY CENTER | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22830 | $1395.14 | 1568657450 - PIOTR TABACZEWSKI | 350593390 - DEACONESS HOSPITAL INC | CO | Internal Medicine Physician (207R00000X) |
United | 22830 | $6492.00 | 1801146535 - SURGCENTER AT PARADISE VALLEY, LLC, SURGCENTER AT PIMA CROSSING | 455364868 - (AZ) SURGCENTER AT PARADISE VALLEY | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22830 | $2428.00 | 1689652638 - INSTITUTE OF ORTHOPAEDIC SURGERY LLC | 731657293 - (NV) INSTITUTE OF ORTHOPAEDIC SURGERY LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22830 | $2959.00 | 1679791404 - SILVER SUMMIT MEDICAL CORPORATION, PREMIER SURGERY CENTER | 770284440 - (CA) SILVER SUMMIT MEDICAL CORPORATION | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22830 | $600.00 | 1053417402 - KEYSTONE KIDNEY ASSOCIATES, PC | 232470181 - (PA) KEYSTONE KIDNEY ASSOCIATES PC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22830 | $2324.00 | 1164697009 - BOX HILL SURGERY CENTER LLC | 262454678 - (MD) BOX HILL SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22830 | $6492.00 | 1932735677 - PARKCREEK ASC LLC | 843082809 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22830 | $2800.00 | 1457826125 - CENTRAL OREGON SURGICAL INSTITUTE, LLC | 830651822 - (OR) CENTRAL OREGON SURGICAL INSTITUTE LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22830 | $1001.00 | 1821166521 - PHYSICIANS SURGERY CENTER LLC | 860936521 - (AZ) PHYSICIANS SURGERY CENTER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22830 | $2412.00 | 1134300080 - METAIRIE LA ENDOSCOPY ASC LLC, MGA GASTROINTESTINAL DIAGNOSTIC AND THERAPEUTIC CENTER-METAIRIE | 205904604 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22830 | $3169.00 | 1447260575 - CENTRAL INDIANA ORTHOPEDIC SURGERY CENTER, LLC | 352033226 - (IN) CENTRAL INDIANA ORTHOPEDIC SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22830 | $4865.00 | 1538608138 - THE REGENTS OF THE UNIVERSITY OF CALIFORNIA, UCLA DEPT OF MEDICINE | 954373071 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22830 | $1700.00 | 1255303517 - ST DOMINIC AMBULATORY SURGERY CENTER L L C | 640908713 - (MS) ST DOMINIC AMBULATORY SURGERY CENTER L L C | MS | 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 22830 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22830 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 22830 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 |
|---|---|---|
| 22630-CPT | High | Arthrodesis, Posterior Interbody Technique, Including Laminectomy And/Or Discectomy To Prepare Interspace (Other Than For Decompression), Single Interspace; Lumbar |
| 22633-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 |
| 22818-CPT | High | Kyphectomy, Circumferential Exposure Of Spine And Resection Of Vertebral Segment(S) (Including Body And Posterior Elements); Single Or 2 Segments |
| 22830-CPT | High | Exploration Of Spinal Fusion |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 22830. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22830 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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