CPT 22870 Fee Schedule
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.
| 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 • SG - Scene to Hospital ESRD facility |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 22870 |
National average reimbursement for CPT 22870 by major payers:
$172.10
$184.66
$174.58
$222.54
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 22870 | ||||||
United | 22870 | $466.00 | 1619995180 - MED CITY DALLAS OUTPATIENT SURGERY CENTER, L.P., MEDICAL CITY SURGERY CENTER/DALLAS | 201043104 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22870 | $103.00 | 1104822808 - AGMG ENDOSCOPY CENTER A GENERAL PARTNERSHIP | 330885760 - (CA) AGMG ENDOSCOPY CENTER A GENERAL PARTNERSHIP | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22870 | $688.00 | 1396211264 - PALM BEACH SURGICAL SUITES LLC | 830558319 - (FL) PALM BEACH SURGICAL SUITES LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22870 | $154.00 | 1881850386 - THE CORVALLIS CLINIC PC | 931221257 - (OR) THE CORVALLIS CLINIC, P.C. | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22870 | $121.00 | 1093779951 - EYE SURGERY AND LASER CLINIC, INC. | 562172461 - (NC) EYE SURGERY AND LASER CLINIC INC | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22870 | $1108.00 | 1841444593 - TEANECK SURGICAL CENTER, LLC | 10776897 - (NJ) TEANECK SURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22870 | $746.00 | 1780853044 - HACIENDA SURGERY CENTER, LLC | 320439356 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22870 | $366.00 | 1073758298 - BAPTIST SURGERY AND ENDOSCOPY CENTERS LLC, BAPTIST HEALTH ENDOSCOPY CENTER AT GALLOWAY NORTH | 201796841 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22870 | $200.00 | 1376194431 - ASCENT SURGERY CENTER LLC | 823347568 - (TX) ASCENT SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22870 | $120.00 | 1265435176 - POCONO AMBULATORY SURGERY CENTER LTD | 232611442 - (PA) POCONO AMBULATORY SURGERY CENTER LTD | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22870 | $242.00 | 1629142666 - ENDOSCOPY CENTER OF BUCKS COUNTY, LP | 841693856 - (PA) ENDOSCOPY CENTER OF BUCKS COUNTY LP | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22870 | $318.00 | 1558792598 - PARIS SURGERY CENTER, LLC | 461871794 - (TX) PARIS SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22870 | $300.00 | 1023567260 - SKI AMBULATORY SURGICAL CENTERS, LLC | 813831008 - (AZ) SKI AMBULATORY SURGICAL CENTERS LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22870 | $118.00 | 1376692129 - STUART CARDON, CASCADE FOOT AND ANKLE PLLC | 205179809 - (WA) STUART CARDON DBA CASCADE FOOT & | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22870 | $665.00 | 1659793040 - SUMMIT AMBULATORY SURGICAL CENTER, LLC | 522148280 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 22870 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22870 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 22870 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 |
|---|---|---|
| 22632-CPT | Moderate | Arthrodesis, Posterior Interbody Technique, Including Laminectomy And/Or Discectomy To Prepare Interspace (Other Than For Decompression), Single Interspace; Each Additional Interspace (List Separately In Addition To Code For Primary Procedure) |
| 22634-CPT | Moderate | Arthodesis Combined Posterior Or Posterolateral Technique With Posterior Interbody Technique Including Laminectomy And/Or Discectomy Suffcient To Prepare Interspace (Other Than For Decom- Pression) Single Interspace; Each Additional Interspace And Segment (List Separately In Addition To Code For Primary Procedure) (Desc Rvsd 1/1/22) |
| 22867-CPT | High | Insertion Of Interlaminar/Interspinous Process Stabilization/Distraction Device Without Fusion Including Imaging Guidance When Per- Formed With Open Decompression Lumbar; Single Level |
| 22870-CPT | Low | 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 22870. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22870 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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