CPT 22853 Fee Schedule
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.
| 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 22853 |
National average reimbursement for CPT 22853 by major payers:
$336.75
$364.59
$398.38
$438.58
| 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 22853 | ||||||
United | 22853 | $179.00 | 1326091513 - PAIN TREATMENT CENTERS OF MICHIGAN LLC, MATRIX SURGERY CENTER | 770623438 - (MI) PAIN TREATMENT CENTERS OF MICHIGAN LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22853 | $965.53 | 1568695641 - SPENCER GEORGE | 341996544 | CA | Orthopaedic Surgery Physician (207X00000X) |
United | 22853 | $261.77 | 1720079072 - LEO CALAFI | 943375456 - (CA) GOLDEN STATE ORTHOPEDICS & SPINE | CA | Orthopaedic Surgery Physician (207X00000X) |
United | 22853 | $313.39 | 1043474596 - IGOR IMMERMAN | 943281657 | CA | Orthopaedic Hand Surgery Physician (207XS0106X) |
United | 22853 | $282.67 | 1952559353 - MAXIMINO BRAMBILA | 942525145 - FAMILY HEALTHCARE NETWORK | CA | Orthopaedic Hand Surgery Physician (207XS0106X) |
United | 22853 | $333.58 | 1003045683 - KALI TILESTON | 770460802 | CA | Pediatric Orthopaedic Surgery Physician (207XP3100X) |
United | 22853 | $1293.43 | 1255531182 - NIRAV SHAH | 954377219 | CA | Adult Reconstructive Orthopaedic Surgery Physician (207XS0114X) |
United | 22853 | $195.52 | 1184864423 - AHMED BATA | 822613312 - (CA) NILE ORTHOPEDIC AND REHABILITATION ASSOCIATION | CA | Orthopaedic Surgery Physician (207X00000X) |
United | 22853 | $261.77 | 1538694138 - AJITH MALIGE | 473460551 - (CA) ADVANCED ORTHOPEDICS AND SPORTS MEDICINE | CA | Sports Medicine (Orthopaedic Surgery) Physician (207XX0005X) |
United | 22853 | $108.00 | 1679526297 - WEST BLOOMFIELD SURGERY CENTER, LLC, LAKES SURGERY CENTER | 200449191 - (MI) WEST BLOOMFIELD SURGERY CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22853 | $1121.95 | 1770831026 - ANDREW MEYERS | 680273974 - SUTTER VALLEY MEDICAL FOUNDATION | CA | Orthopaedic Surgery Physician (207X00000X) |
United | 22853 | $349.32 | 1083619910 - LAWRENCE WALKER | 330376200 - (CA) SAN BERNARDINO MEDICAL ORTHOPAEDIC GROUP INC. | CA | Orthopaedic Surgery Physician (207X00000X) |
United | 22853 | $385.66 | 1104904093 - HILLARY REDLIN | 472710655 - (CA) HILLARY G. REDLIN, M.D., A MEDICAL CORPORATION | CA | Orthopaedic Surgery Physician (207X00000X) |
United | 22853 | $313.39 | 1043474596 - IGOR IMMERMAN | 943281660 | CA | Orthopaedic Hand Surgery Physician (207XS0106X) |
United | 22853 | $972.39 | 1699269126 - VINCENT MISEO | 952226406 - REGENTS OF THE UNIVERSITY OF CALIFORNIA AT IRVINE | CA | Orthopaedic Surgery Physician (207X00000X) |
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 22853 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22853 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 22853 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 |
|---|---|---|
| 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 |
| 22849-CPT | High | Reinsert Spinal Fixation Device |
| 22850-CPT | Moderate | Remv Nonseg.Instrument-Harrngtn Rod |
| 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 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 22853. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22853 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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