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 22868 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 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
| 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 59 - Distinct Procedural Service AS - PA/NP/CNS assistant at surgery |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 22868 |
| Medicaid Fee Schedule | View Medicaid rates for 22868 |
National average reimbursement for CPT 22868 by major payers:
$309.05
$341.69
$335.03
$404.17
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 22868.
CPT 22868
5 of 25 sample ratesHigher to lower in this preview
Jonesboro Ambulatory Surgery Center, LLC
Jonesboro Ambulatory Surgery Center LLC
$1,708.00Published rateBriarcliff Ambulatory Surgery Center Lp, Briarcliff Surgery Center
Briarcliff Ambulatory Surgery Center Lp
$566.00Published rateEye Specialists Surgery Centers, LLC, Muncie Surgical Care Center
$424.00Published rateNovamed Surgery Center Of St Peters LLC, St Peters Ambulatory Surgery Center
Novamed Surgery Center Of St Peters LLC
$190.00Published rateAllegany Ambulatory Surgery Center LLC
$52.00Published 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 22868 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22868 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 22868 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 22868. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22868 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 22868) and we'll show you how you compare in 15 minutes or less.