CPT 22900 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 | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | Moderate |
National average reimbursement for CPT 22900 by major payers:
$661.33
$709.99
$764.80
$904.65
| 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 22900 | ||||||
United | 22900 | $1062.00 | 1598729329 - SURGICARE OF ST ANDREWS LTD | 611276561 - (FL) SURGICARE OF ST ANDREWS LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22900 | $3314.43 | 1447221486 - ORTHOPAEDIC OUTPATIENT SURGERY CENTER, LLC | 421508092 - (IA) ORTHOPAEDIC OUTPATIENT SURGERY CENTER LLC | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22900 | $1418.00 | 1558612762 - QUEENS BOULEVARD ASC LLC | 274614930 | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22900 | $1071.00 | 1447612114 - LPC SURGERY CENTER LLC | 473748606 - (IN) LPC SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22900 | $776.00 | 1346693124 - VILLAGES ENDOSCOPY CENTER LLC | 813250494 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22900 | $960.00 | 1770796757 - LAPEER COUNTY SURGERY CENTER LLC | 202918877 - (MI) LAPEER COUNTY SURGERY CENTER L | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22900 | $4141.00 | 1902844426 - SOUTH ARLINGTON SURGICAL PROVIDERS, LLC, SAME DAY SURGICARE | 752723958 - (TX) SOUTH ARLINGTON SURGICAL PROVIDERS LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22900 | $748.00 | 1588802987 - NATIONAL PARK ENDOSCOPY CENTER, LLC, SOUTH CENTRAL ENDOSCOPY | 900881332 - (AR) NATIONAL PARK ENDOSCOPY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22900 | $938.00 | 1760770903 - ASSOCIATED SURGICAL CENTER OF DEARBORN LLC | 275209399 - (MI) ASSOCIATED SURGICAL CENTER OF DEARBORN LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22900 | $2621.00 | 1295176139 - LOWCOUNTRY AMBULATORY CENTER, LLC | 274109893 - (SC) LOWCOUNTRY AMBULATORY CENTER LLC | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22900 | $2388.00 | 1366982845 - JACKSONVILLE ENDOSCOPY CENTERS LLC, JACKSONVILLE CENTER FOR ENDOSCOPY | 384016302 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22900 | $1713.00 | 1265009005 - SURGCENTER NORTHERN PHOENIX LLC | 854160690 - (AZ) SURGCENTER NORTHERN PHOENIX LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22900 | $1000.00 | 1043564784 - COMPREHENSIVE SURGICAL CENTER OF GREEN, LLC | 461313857 - (OH) COMPREHENSIVE SURGICAL CENTER OF GREEN LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22900 | $1260.00 | 1164946984 - NORTHWEST RENAL CLINIC, INC., NORTHWEST DIALYSIS ACCESS CENTER | 930751490 - (OR) NORTHWEST RENAL CLINIC, PC | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22900 | $2252.25 | 1073149365 - MEDFORD SURGERY CENTER LLC | 384079196 - (MA) MEDFORD SURGERY CENTER LLC | MA | 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 22900 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22900 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 22900 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 |
|---|---|---|
| 22900-CPT | Moderate | Excision, Tumor, Soft Tissue Of Abdominal Wall, Subfascial (E.G., Intramuscular); Less Than 5 Cm |
| 22901-CPT | Moderate | Exc Tumor Soft Tissue Abdl Wall Subfascial 5 Cm |
| 22902-CPT | Moderate | Exc Tumor Soft Tissue Abdominal Wall Subq 3cm |
| 22904-CPT | High | Radical Resection Of Tumor (Eg Sarcoma) Soft Tissue Of Abdominal Wall; Less Than 5 Cm (Revised 01/01/2014) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 22900. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22900 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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