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See a sample rate comparisonCPT 22867 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.
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| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 22867 |
| Medicaid Fee Schedule | View Medicaid rates for 22867 |
National average reimbursement for CPT 22867 by major payers:
$1,292.22
$1,374.03
$1,394.65
$1,683.64
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CPT 22867
5 of 25 sample ratesHigher to lower in this preview
Valley Ambulatory Surgery Center, Lp, Valley Ambulatory Surgery Center
Valley Ambulatory Surgery Center
$12,000.00Published rateThe Surgery Center, LLC
The Surgery Center LLC
$4,872.00Published rateSouthern Illinois Orthopedic Center,LLC
Southern Illinois Orthopedic Centerllc
$3,091.00Published rateTruxtun Surgery Center Inc
Truxtun Surgery Center, Inc.
$1,899.00Published rateMedical Eye Associates, Inc.
$920.00Published rate
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See a sample payer proposalCPT 22867 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22867 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 22867 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 |
|---|---|---|
| 22867-CPT | High | Insj Stablj Dev W Dcmprn, Insertion Of Interlaminar Interspinous Process Stabilization Distraction Device Without Fusion Including Image Guidance When Performed With Open Decompression Lumbar Single Level |
| 22868-CPT | Moderate | Insj Stablj Dev W Dcmprn, Insertion Of Interlaminar Interspinous Process Stabilization Distraction Device Without Fusion Including Image Guidance When Performed With Open Decompression Lumbar Second Level List Separately In Addition To Code For Primary Procedure |
| 22869-CPT | Moderate | Insj Stablj Dev W O Dcmprn, Insertion Of Interlaminar Interspinous Process Stabilization Distraction Device Without Open Decompression Or Fusion Including Image Guidance When Performed Lumbar Single Level |
| 22870-CPT | Low | Insj Stablj Dev W O Dcmprn, Insertion Of Interlaminar Interspinous Process Stabilization Distraction Device Without Open Decompression Or Fusion Including Image Guidance When Performed Lumbar Second Level 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 22867. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22867 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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