CPT 22999 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
National average reimbursement for CPT 22999 by major payers:
$1,449.37
$154.80
$1,419.12
$1,267.50
| 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 22999 | ||||||
United | 22999 | $118.00 | 1659340404 - LITTLE ROCK SURGERY CENTER, LLC | 203687986 - (AR) LITTLE ROCK SURGERY CENTER | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22999 | $82.00 | 1104829597 - HOGAN SURGICAL CENTER, P. A. | 300399671 - (MS) HOGAN SURGICAL CENTER P A | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22999 | $506.00 | 1821421256 - MONOCACY SURGERY CENTER LLC | 462861862 - (MD) MONOCACY SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22999 | $110.00 | 1205800752 - MEDICAL EYE ASSOCIATES, INC. | 581606296 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22999 | $120.00 | 1720129893 - PACIFIC GASTROENTEROLOGY ENDOSCOPY CENTER | 330898866 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22999 | $557.00 | 1396700159 - DOCTORS SAME DAY SURGERY CENTER, LTD | 621614361 - (FL) DOCTORS SAME DAY SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22999 | $939.98 | 1205030731 - PIERCE STREET SAME DAY SURGERY, LC, PIERCE STREET SAME DAY SURGERY, LC | 205895205 - (IA) PIERCE STREET SAME DAY SURGERY | IA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22999 | $225.00 | 1801825880 - SURGERY CENTER AT RIVER ROAD, LLC, AESTHETIC SURGERY AT HACIENDA DEL SOL | 760824670 - (AZ) SURGERY CENTER AT RIVER ROAD, LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22999 | $150.00 | 1619920501 - CENTER FOR DIGESTIVE HEALTH | 364532301 - (IL) THE CENTER FOR DIGESTIVE HEALTH, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22999 | $1051.00 | 1801058292 - METROPOLITAN SURGICAL INSTITUTE, LLC | 204513856 - (NJ) METROPOLITAN SURGICAL INSTITUTE | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22999 | $59.00 | 1801110275 - GA PAIN MANAGEMENT CENTER, LLC | 271069156 - (GA) GA PAIN MANAGEMENT CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22999 | $395.00 | 1902228455 - PROVIDENCE HEALTH & SERVICES WASHINGTON, PROVIDENCE SURGERY AND PROCEDURE CENTER | 881232814 - (WA) PROVIDENCE SURGERY AND PROCEDURE CENTER LLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22999 | $650.00 | 1972572964 - CENTRAL ILLINOIS SURGERY CENTER, LLC | 370661199 - DECATUR MEMORIAL HOSPITAL | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22999 | $175.00 | 1225627094 - GEORGIA INTERVENTIONAL PAIN | 851355715 - (GA) GEORGIA INTERVENTIONAL PAIN | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 22999 | $117.00 | 1881147965 - ULNA SURGERY CENTER LLC | 813050347 - (GA) ULNA SURGERY CENTER LLC | GA | 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 22999 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 22999 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 22999 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 |
| 22999-CPT | High | Unlisted Procedure, Abdomen, Musculoskeletal System |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 22999. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 22999 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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