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See a sample rate comparisonCPT 22869 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.
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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 SG - Scene to Hospital ESRD facility 74 - Discontinued After Anesthesia |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 22869 |
| Medicaid Fee Schedule | View Medicaid rates for 22869 |
National average reimbursement for CPT 22869 by major payers:
$605.81
$680.59
$645.08
$785.86
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CPT 22869
5 of 25 sample ratesHigher to lower in this preview
Specialty Surgical Center Of Beverly Hills Lp, Specialty Surgical Center
Specialty Surgical Center Of Beverly Hills, Lp
$13,200.00Published rateFairfield Surgery Center, LLC
Fairfield Surgery Center LLC
$5,246.00Published rateCenter For Visual Surgical Excellence, LLC
Center For Visual Surgical Excellence LLC
$2,922.00Published rateEndoscopy Center Of Knoxville Lp, The Endoscopy Center
Endoscopy Center Of Knoxville Lp
$1,477.00Published rateSurgery Center Of Eye Specialists Of Indiana, PC
Surgery Center Of Eye Specialists Of Indiana PC
$830.00Published rate
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See a sample payer proposalCPT 22869 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22869 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 22869 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 22869. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22869 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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