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See a sample rate comparisonCPT 22859 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 Methylmethacrylate To Intervertebral Disc Space Or Vertebral Body Defect Without 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 80 - Assistant surgeon |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 22859 |
| Medicaid Fee Schedule | View Medicaid rates for 22859 |
National average reimbursement for CPT 22859 by major payers:
$443.49
$471.45
$500.25
$551.61
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CPT 22859
5 of 25 sample ratesHigher to lower in this preview
Toms River Surgery Center, LLC, Toms River Surgery Center
Toms River Surgery Center LLC
$11,975.00Published rateGreenwood Asc LLC, Greenwood Ambulatory Surgery Center
Greenwood Asc LLC
$574.00Published rateHeights Surgery Center, Inc., Heights Surgey Center
Heights Surgery Center Inc
$200.00Published rateMid- America Surgery Center, LLC
Mid America Surgery Center LLC
$150.00Published rateFoot And Ankle Center At The Burkland Medical Center Inc.
Foot And Ankle Center At The Burkland Medical Center Inc
$46.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 22859 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22859 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 22859 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 | Removal Of Posterior Nonsegmen, Removal Of Posterior Nonsegmental Instrumentation (Egharrington Rod) Removal Of Posterior Nonsegmental Instrumentation (Eg |
| 22859-CPT | Moderate | Insj Biomechanical Device, Insertion Of Intervertebral Biomechanical Device S Eg Synthetic Cage Mesh Methylmethacrylate To Intervertebral Disc Space Or Vertebral Body Defect Without 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 22859. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22859 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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