CPT 22862 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 • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 62 - Co-Surgeons • FA - Left hand, thumb • 59 - Distinct Procedural Service • 22 - Increased Procedural Services • 78 - Return to OR - related procedure • GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 22862 |
National average reimbursement for CPT 22862 by major payers:
$2,894.49
$2,897.42
$3,140.54
$3,605.94
| 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 22862 | ||||||
United | 22862 | $4480.00 | 1679658710 - STADIUM CAMPUS AMBULATORY SURGICAL CENTER, LLC, WILLS EYE SURGERY CENTER | 232981922 - (PA) STADIUM CAMPUS AMBULATORY SURGICAL CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22862 | $1216.00 | 1942272851 - INDEPENDENCE ASC LLC, THE ENDOSCOPY CENTER - LIBERTY | 621707564 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22862 | $6700.00 | 1659753358 - ST. MICHAEL SURGERY CENTER, LLC | 473008701 - (CA) ST MICHAEL SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22862 | $6676.00 | 1609815075 - ORTHOATLANTA SURGERY CENTER OF FAYETTEVILLE, LLC | 202961633 - (GA) ORTHOATLANTA SURGERY CENTER OF FAYETTEVILLE LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22862 | $1500.00 | 1487014361 - GRIFFIN CENTER FOR PAIN AND SPINE | 473061907 - (GA) GRIFFIN CENTER FOR PAIN AND SPINE | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22862 | $13955.00 | 1518344043 - MEMORIAL HERMANN SURGERY CENTER KIRBY, LLC, MEMORIAL HERMANN SURGERY CENTER KIRBY GLEN | 364801162 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22862 | $6428.43 | 1124022595 - THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS, LLC, SURGERY CENTER CEDAR RAPIDS | 721550812 - (IA) THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS LLC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22862 | $3289.00 | 1992701049 - NORTHWEST FLORIDA SURGERY CENTER | 593123289 - (FL) NORTHWEST FLORIDA SURGERY CENTER | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22862 | $14000.00 | 1033714001 - SURGERY CENTER AT SOUTH OGDEN, LLC | 854070407 - (UT) SURGERY CENTER AT SOUTH OGDEN LLC | UT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22862 | $3428.00 | 1629181136 - JOON Y. KIM, MD, PC, CLAYTON CATARACT & LASER SURGERY CENTER | 581603174 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22862 | $9000.00 | 1659335438 - RESTON SURGERY CENTER, LP | 113654617 - (VA) RESTON SURGERY CENTER LP | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22862 | $6600.00 | 1760847792 - OCALA FL ORTHOPAEDIC ASC LLC | 472831130 - (FL) OCALA FL ORTHOPAEDIC ASC, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22862 | $1385.00 | 1437512993 - UNITED SKIN SPECIALISTS MISSOURI LTD, PC, CHESTERFIELD ASC | 811166184 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22862 | $8917.00 | 1053574244 - SURGERY CENTER AT UNIVERSITY PARK, LLC, PREMIER SURGERY CENTER OF SARASOTA | 203757623 - (FL) SURGERY CENTER AT UNIVERSITY PARK LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22862 | $9243.00 | 1285912600 - THE EMORY CLINIC INC, THE EMORY CLINIC LAGRANGE SURGERY CENTER | 582030692 - EMORY UNIVERSITY | GA | 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 22862 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22862 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 22862 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 |
|---|---|---|
| 22852-CPT | Moderate | Removal Post Segmental Instrument |
| 22855-CPT | High | Removal Of Anterior Instrumentation |
| 22857-CPT | High | Total Disc Arthroplasty (Artificial Disc) Anterior Approach Including Discectomy To Prepareinterspace (Other Than For Decompression); Single Interspace Lumbar (Desc Rvsd 1/1/23) |
| 22862-CPT | High | Once Per Dos Revision Including Replacement Of Total Disc Arthroplasty, Anterior Approach, Single Interspace; Lumbar - Deny Inv/N10 Except Uhs <12/31/2020 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 22862. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22862 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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