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See a sample rate comparisonCPT 22862 Fee Schedule
Medicare rates as of October 2026
CPT 22862 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Once Per Dos Revision Including Replacement Of Total Disc Arthroplasty, Anterior Approach, Single Interspace; Lumbar - Deny Inv/N10 Except Uhs <12/31/2020
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21Inpatient Hospital 24Ambulatory Surgical Center |
| Common Modifiers | 62Co-Surgeons FALeft hand, thumb 59Distinct Procedural Service 22Increased Procedural Services 78Return to OR - related procedure GCService performed by resident under supervision |
| Hospital Outpatient Group (APC) | APC 5116 - Level 6 Musculoskeletal Procedures |
| Surgery Center Payment (ASC) | J8 - Device-intensive procedure, paid at an adjusted rate |
| Add-on Codes | 0165T |
| Common Revenue Codes | 0360 |
| Medicare Fee Schedule | $2,267.92 national non-facility rate (2026)View Medicare rates for 22862 |
| Medicaid Fee Schedule | $1,660.28 median of the 8 states in the free previewView Medicaid rates for 22862 |
National average reimbursement for CPT 22862 by major payers:
$2,894.49
BCBS / Anthem
$2,897.42
UnitedHealthcare
$3,140.54
Aetna
$3,605.94
Cigna
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CPT 22862
5 of 25 sample ratesHigher to lower in this preview
Connecticut Orthopaedic Surgery Center, LLC
$16,991.00Published rateOrlando Surgicare Ltd
$10,197.00Published rateSt. Michael Surgery Center, LLC
St Michael Surgery Center LLC
$6,700.00Published rateNorthwest Florida Surgery Center
$3,289.00Published rateEndoscopy Center Of Toms River, LLC
Endoscopy Center Of Toms River LLC
$1,032.00Published rate
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See a sample payer proposalCPT 22862 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 22862. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 22857-CPT | Tot Disc Arthrp 1ntrspc Lmbr, Total Disc Arthroplasty Artificial Disc Anterior Approach Including Discectomy To Prepare Interspace Other Than For Decompression Single Interspace Lumbar |
| 22860-CPT | Tot Disc Arthrp 2ntrspc Lmbr, Total Disc Arthroplasty Artificial Disc Anterior Approach Including Discectomy To Prepare Interspace Other Than For Decompression Second Interspace Lumbar List Separately In Addition To Code For Primary Procedure |
| 22862-CPT | Once Per Dos Revision Including Replacement Of Total Disc Arthroplasty, Anterior Approach, Single Interspace; Lumbar - Deny Inv/N10 Except Uhs <12/31/2020 |
| 22865-CPT | Remval Of Total Disc Arthroplst (Artifici Disc) Anterio Approac, Removal Of Total Disc Arthroplasty (Artificial Disc) Anterior Approac |
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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Frequently Asked Questions
What APC is CPT 22862 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 22862 to APC 5116 (Level 6 Musculoskeletal Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 22862 in an ambulatory surgery center?
CMS lists CPT 22862 with ASC payment indicator J8: Device-intensive procedure, paid at an adjusted rate.
Which add-on codes are billed with CPT 22862?
CMS add-on code edits list CPT 22862 as a primary code for these add-on codes: 0165T.
Which revenue codes are billed with CPT 22862?
Hospital price transparency files list CPT 22862 under these revenue codes: 0360. A revenue code names the hospital department or charge category for the line; it does not change what the service is.