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See a sample rate comparisonCPT 22854 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.
Insj Biomechanical Device, Insertion Of Intervertebral Biomechanical Device S Eg Synthetic Cage Mesh With Integral Anterior Instrumentation For Device Anchoring Eg Screws Flanges When Performed To Vertebral Corpectomy Ies Vertebral Body Resection Partial Or Complete Defect In Conjunction With Interbody Arthrodesis Each Contiguous Defect 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 22854 |
| Medicaid Fee Schedule | View Medicaid rates for 22854 |
National average reimbursement for CPT 22854 by major payers:
$437.34
$471.62
$527.66
$550.39
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CPT 22854
5 of 25 sample ratesHigher to lower in this preview
Bailey Square Ambulatory Surgical Center, Ltd
Bailey Square Ambulatory Surgical Center Ltd
$10,491.00Published rateJoel Phelps
Deaconess Hospital Inc
$569.16Published rateSinus Surgery Center Idaho PA
$365.00Published rateVip Surg Asc, LLC, Vip Surgical Center
Vip Surg Asc LLC
$235.00Published rateVillages Endoscopy Center LLC
$48.00Published rate
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See a sample payer proposalCPT 22854 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22854 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 22854 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 |
| 22850-CPT | Moderate | Removal Of Posterior Nonsegmen, Removal Of Posterior Nonsegmental Instrumentation (Egharrington Rod) Removal Of Posterior Nonsegmental Instrumentation (Eg |
| 22852-CPT | Moderate | Removal Of Posterior Segmental, Removal Of Posterior Segmental Instrumentationremoval Of Posterior Segmental Instrumentation |
| 22854-CPT | Moderate | Insj Biomechanical Device, Insertion Of Intervertebral Biomechanical Device S Eg Synthetic Cage Mesh With Integral Anterior Instrumentation For Device Anchoring Eg Screws Flanges When Performed To Vertebral Corpectomy Ies Vertebral Body Resection Partial Or Complete Defect In Conjunction With Interbody Arthrodesis Each Contiguous Defect 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 22854. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22854 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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