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 |
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 | $261.77 | 1841243755 - MOHAMMAD DIAB | 943281660 | CA | Orthopaedic Surgery Physician (207X00000X) |
United | 22853 | $195.52 | 1023044500 - CHRISTOPHER JOBE | 842115780 - (CA) HASAN SYED MD INC | CA | Orthopaedic Surgery Physician (207X00000X) |
United | 22853 | $501.35 | 1962573576 - BRIAN FREETO | 270096920 - (CA) NAPA VALLEY ORTHOPAEDIC | CA | Sports Medicine (Orthopaedic Surgery) Physician (207XX0005X) |
United | 22853 | $245.96 | 1215108709 - KIRSTINA OLSON | 943281657 | CA | Orthopaedic Surgery Physician (207X00000X) |
United | 22853 | $1547.22 | 1417902172 - RALPH COUGHLIN | 943281657 | CA | Orthopaedic Foot and Ankle Surgery Physician (207XX0004X) |
United | 22853 | $261.77 | 1609286343 - STEPHANIE WONG | 943281657 | CA | Sports Medicine (Orthopaedic Surgery) Physician (207XX0005X) |
United | 22853 | $299.94 | 1558388066 - NORMAN VERHOOG | 1558388066 - (CA) NORMAN VERHOOG | CA | Orthopaedic Surgery Physician (207X00000X) |
United | 22853 | $556.05 | 1457315269 - THOMAS DONALDSON | 330672915 - FACULTY PHYSICIANS AND SURGEONS OF LLUSM | CA | Adult Reconstructive Orthopaedic Surgery Physician (207XS0114X) |
United | 22853 | $263.20 | 1831162593 - GEORGE LIAN | 680236681 - GEORGE LIAN MD | CA | Orthopaedic Surgery Physician (207X00000X) |
United | 22853 | $972.39 | 1235167107 - SAMUEL ROSENFELD | 953887518 - (CA) REGENTS OF THE UNIVERSITY OF CALIFORNIA | CA | Pediatric Orthopaedic Surgery Physician (207XP3100X) |
United | 22853 | $200.38 | 1134108103 - NITIN SHAH | 953910515 - (CA) NITIN A. SHAH, M.D., INC. | 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 | $648.73 | 1275582918 - FACULTY PHYSICIANS AND SURGEONS OF LLUSM | 330672915 - FACULTY PHYSICIANS AND SURGEONS OF LLUSM | CA | Orthopaedic Surgery Physician (207X00000X) |
United | 22853 | $2073.06 | 1407098163 - JACQUES HACQUEBORD | 135562308 - NEW YORK UNIVERSITY | NY | Orthopaedic Surgery Physician (207X00000X) |
United | 22853 | $329.70 | 1841638699 - JUN KIM | 453220509 - (CA) REEDLEY COMMUNITY HOSPITAL | CA | Adult Reconstructive Orthopaedic Surgery Physician (207XS0114X) |
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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