CPT 22905 Fee Schedule
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.
| 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 • 51 - Multiple procedures • GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 22905 |
National average reimbursement for CPT 22905 by major payers:
$1,674.68
$1,834.71
$1,863.49
$2,232.12
| 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 22905 | ||||||
United | 22905 | $1685.00 | 1285889378 - PARADIGM CLINICAL ASSOCIATES LLC, STRATHAM AMBULATORY SURGERY CENTER | 262382365 - (NH) PARADIGM CLINICAL ASSOCIATES, LLC | NH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22905 | $2844.00 | 1669111274 - KENOSHA SURGICENTER LLC | 854072921 - (WI) KENOSHA SURGICENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22905 | $1804.00 | 1760869093 - ORTHOPEDIC AMBULATORY SURGERY CENTER OF CHESTERFIELD, LLC | 473506918 - (MO) ORTHOPEDIC AMBULATORY SURGERY CENTER OF CHESTERFIELD LLC | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22905 | $1568.00 | 1013138536 - WESTERN WASHINGTON MEDICAL GROUP, INC, PS, DBA: GATEWAY SURGERY CENTER | 911602128 - (WA) WESTERN WASHINGTON MEDICAL GROUP, INC., P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22905 | $1550.00 | 1174634778 - THE CENTER FOR SPECIALIZED SURGERY, LP | 203364256 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22905 | $1845.00 | 1558785683 - SOUTHERN SPORTS SURGICAL, LLC., INDIAN LAKE SURGERY CENTER | 463690503 - (TN) SOUTHERN SPORTS SURGICAL LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22905 | $614.00 | 1326563537 - OPTUMCARE COLORADO ASC, LLC | 352597463 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22905 | $1200.00 | 1831801117 - SIGHT PARTNERS, LLC, EMPIRE EYE PHYSICIANS | 833467355 | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22905 | $2046.00 | 1255001525 - ALLINA HEALTH SURGERY CENTER- BROOKLYN PARK, LLC | 871746250 - (MN) ALLINA HEALTH SURGERY CENTER BROOKLYN PARK LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22905 | $2795.00 | 1881667368 - FLORHAM PARK ENDOSCOPY ASC LLC, FLORHAM PARK ENDOSCOPY CENTER | 621774936 - (NJ) FLORHAM PARK ENDOSCOPY CENTER, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22905 | $2156.00 | 1588656508 - SAINT THOMAS CAMPUS SURGICARE LP | 752959131 - (TN) SAINT THOMAS CAMPUS SURGICARE LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22905 | $920.00 | 1720752629 - BAY SURGERY CENTERS | 453365193 - (MD) BAY SURGERY CENTERS | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22905 | $1670.00 | 1467128819 - BLOOMINGTON ADVANCED SURGERY CENTER, LLC, BLOOMINGTON ADVANCED SURGERY CENTER | 871240828 - (IN) BLOOMINGTON ADVANCED SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22905 | $2307.00 | 1366684326 - PRINCE FREDERICK SURGERY CENTER LLC | 264387021 - (MD) PRINCE FREDERICK SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22905 | $774.00 | 1407247208 - COLONOSCOPY AND ENDOSCOPY CENTER LLC | 471628673 - (OH) COLONOSCOPY AND ENDOSCOPY CENTER LLC | OH | 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 22905 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22905 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 22905 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 |
| 22905-CPT | High | Radical Resection Of Tumor (Eg Sarcoma) Soft Tissue Of Abdominal Wall; 5 Cm Or Greater (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 22905. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22905 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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