CPT 22849 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 • 51 - Multiple procedures |
| Complexity Level | High |
National average reimbursement for CPT 22849 by major payers:
$1,654.66
$1,766.40
$1,911.27
$2,166.50
| 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 22849 | ||||||
United | 22849 | $10197.00 | 1770252868 - STONESPRINGS SURGICENTER, LLC | 812929320 - (VA) STONESPRINGS SURGICENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22849 | $1169.00 | 1881875227 - SKIN & MOHS SURGERY CENTER, LLC | 431823843 - SKIN MOHS SURGERY CENTER LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22849 | $10306.00 | 1285912600 - THE EMORY CLINIC INC, THE EMORY CLINIC LAGRANGE SURGERY CENTER | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22849 | $4723.00 | 1801849427 - MAIN STREET ASC LLC, OPHTHALMIC ASSOCIATES SURGERY AND LASER CENTER | 383711415 - (PA) MAIN STREET ASC LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22849 | $7525.00 | 1326045014 - GROVE PLACE SURGERY CENTER ,LLC | 10619096 - (FL) GROVE PLACE SURGERY CENTER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22849 | $2941.00 | 1396897260 - LITTLE ROCK FERTILITY CENTER | 861078562 - (AR) LITTLE ROCK FERTILITY CENTER | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22849 | $2180.00 | 1497724942 - PARK VENTURA ENDOSCOPY CENTER, LLC, DIGESTIVE HEALTH CENTER OF PLANO | 412059014 - (TX) PARK VENTURA ENDOSCOPY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22849 | $12141.00 | 1750517561 - CANON CITY CO MULTI SPECIALTY ASC LLC, ARKANSAS VALLEY SURGERY CENTER | 264730485 - (CO) CANON CITY CO MULTI SPECIALTY ASC LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22849 | $3960.00 | 1376501064 - SOUTH CENTRAL SURGICAL CENTER, LLC, CENTER FOR SPECIALTY CARE | 411952256 - (MN) SOUTH CENTRAL SURGICAL CENTER LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22849 | $6760.00 | 1619933264 - SALEM SURGERY CENTER, LLC | 742462470 - (OR) SALEM SURGERY CENTER LLC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22849 | $5539.00 | 1922237213 - ENDOSCOPY CENTER OF TOMS RIVER, LLC | 300568338 - (NJ) ENDOSCOPY CENTER OF TOMS RIVER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22849 | $3940.00 | 1679804355 - LONESTAR AMBULATORY SURGICAL CENTER | 263806076 - (TX) LONESTAR AMBULATORY SURGICAL CENTER | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22849 | $6000.00 | 1801811443 - PHYSICIANS OF WINTER HAVEN LLC, DAY SURGERY CENTER | 200324393 - (FL) PHYSICIANS OF WINTER HAVEN, LLC DBA DAY | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22849 | $975.00 | 1104125939 - GASTROENTEROLOGY CARE INC | 263101232 - (NY) GASTROENTEROLOGY CARE INC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22849 | $13552.00 | 1376780916 - HAMILTON SURGERY CENTER LLC | 352061413 - (IN) HAMILTON SURGERY CENTER LLC | IN | 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 22849 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22849 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 22849 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 |
|---|---|---|
| 22849-CPT | High | Reinsert Spinal Fixation Device |
| 22852-CPT | Moderate | Removal Post Segmental Instrument |
| 22853-CPT | Moderate | Insertion Of Interbody Biomechanical Device(S) (Egsynthetic Cage Mesh) With Integral Anterior With Integral Anterior Instrumentation For Device An- Choring (Eg Screws Flanges) When Performed To Intervertebral Disc Space In Conjunction With In- Terbody Arthrodesis Each Interspace (List Separately In Addition To Code For Primary Pro- Cedure |
| 22854-CPT | Moderate | Insertion Of Intervertebral Biomechanical De Vice(S) Eg Synthetic Cage Mesh) With Integral Anterior Instrumentation For Device Anchoring (Eg Screws Flanges) When Performed To Verte- Bral Corpectomy(Ies) (Vertebral Body Resection Partial Or Complete) Defect In Conjunction With Interbody Arthrodesis Each Contiguous Defect (List Eparately 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 22849. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22849 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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