Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 22864 Fee Schedule
Last Verified: October 2026
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.
Once Per Dos Removal Of Total Disc Arthroplasty, Anterior Approach, Single Interspace; Cervical-Medicaid:Rn Review>9/15/2015.Commercial Rn Review=9/15/2015-3/31/2022
| 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 | High |
| Medicare Fee Schedule | View Medicare rates for 22864 |
| Medicaid Fee Schedule | View Medicaid rates for 22864 |
National average reimbursement for CPT 22864 by major payers:
$2,535.79
$2,726.60
$2,904.63
$3,268.99
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 22864.
CPT 22864
5 of 25 sample ratesHigher to lower in this preview
Middle Tennessee Ambulatory Surgery Center, L.P.
Middle Tennessee Ambulatory Surgery Center Lp
$7,888.00Published rateEssex Endoscopy Center LLC
$5,484.00Published rateBaylor Surgicare At North Dallas, LLC, Baylor Scott & White Surgicare-North Dallas
$4,234.00Published rateGrossmont Outpatient Surgical Center
Grossmont Outpatient Surgical Ce
$2,600.00Published rateThe Endoscopy Center Of Bristol
$425.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 22864 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22864 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 22864 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 |
|---|---|---|
| 22856-CPT | High | Total Disc Arthroplasty (Artificial Disc) Anterior Approach Including Discectomy With End Plate Preparation (Includes Osteophytectomy For Nerve Root Or Spinal Cord Decompression And Microdissection) Single Interspace Cervical (Desc Revised 01/01/15) |
| 22858-CPT | Moderate | Tot Disc Arthrp 2nd Lvl Crv, Total Disc Arthroplasty Artificial Disc Anterior Approach Including Discectomy With End Plate Preparation Includes Osteophytectomy For Nerve Root Or Spinal Cord Decompression And Microdissection Second Level Cervical List Separately In Addition To Code For Primary Procedure |
| 22864-CPT | High | Once Per Dos Removal Of Total Disc Arthroplasty, Anterior Approach, Single Interspace; Cervical-Medicaid:Rn Review>9/15/2015.Commercial Rn Review=9/15/2015-3/31/2022 |
| 22865-CPT | High | 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 22864. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22864 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 22864) and we'll show you how you compare in 15 minutes or less.