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See a sample rate comparisonCPT 22842 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Insert Spine Fixation Device, Posterior Segmental Instrumentation Eg Pedicle Fixation Dual Rods With Multiple Hooks And Sublaminar Wires 3 To 6 Vertebral Segments List Separately In Addition To Code For Primary Procedure
| 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 | Moderate |
| Medicare Fee Schedule | View Medicare rates for 22842 |
| Medicaid Fee Schedule | View Medicaid rates for 22842 |
National average reimbursement for CPT 22842 by major payers:
$948.57
$1,058.38
$1,170.58
$1,243.63
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CPT 22842
5 of 25 sample ratesHigher to lower in this preview
Pearland Surgery Center, LLC
$2,079.00Published rateWindsor Mill Surgery Center, LLC
Windsor Mill Surgery Center LLC
$555.00Published rateIndependent Surgery Center LLC
$283.00Published rateFvc Long Beach Asc LLC, Azura Surgery Center Long Beach
Fvc Long Beach Asc LLC
$120.00Published rateScac LLC, Surgery Center At Cranberry
Scac LLC
$50.00Published rate
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See a sample payer proposalCPT 22842 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22842 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 22842 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 |
|---|---|---|
| 22840-CPT | Moderate | Insert Spine Fixation Device, Posterior Non Segmental Instrumentation Eg Harrington Rod Technique Pedicle Fixation Across 1 Interspace Atlantoaxial Transarticular Screw Fixation Sublaminar Wiring At C1 Facet Screw Fixation List Separately In Addition To Code For Primary Procedure |
| 22841-CPT | Moderate | Insert Spine Fixation Device, Internal Spinal Fixation By Wiring Of Spinous Processes (List Separately In Addition To Code For Primary Procedure) |
| 22842-CPT | Moderate | Insert Spine Fixation Device, Posterior Segmental Instrumentation Eg Pedicle Fixation Dual Rods With Multiple Hooks And Sublaminar Wires 3 To 6 Vertebral Segments List Separately In Addition To Code For Primary Procedure |
| 22843-CPT | High | Insert Spine Fixation Device, Posterior Segmental Instrumentation Eg Pedicle Fixation Dual Rods With Multiple Hooks And Sublaminar Wires 7 To 12 Vertebral Segments 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 22842. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22842 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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