CPT 27222 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 • 23 - Emergency Room • 11 - Office |
| Common Modifiers | • None • RT - Right side of body • LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 27222 |
National average reimbursement for CPT 27222 by major payers:

$1,331.42

$1,311.66

$1,355.38

$1,629.31
| 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 27222 | ||||||
United | 27222 | $174.00 | 1912267592 - SURGCENTER AT NATIONAL HARBOR, LLC, HARBORSIDE SURGERY CENTER | 454110190 - (MD) HARBORSIDE SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27222 | $555.00 | 1750363461 - BARKLEY SURGICENTER, LLC | 650428622 - (FL) BARKLEY SURGICENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27222 | $225.00 | 1275158495 - BCC CHANDLER LLC | 851284830 - (AZ) BCC CHANDLER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27222 | $135.00 | 1285664466 - NEWPORT MULTI SPECIALTY SURGERY CENTER LLC | 842619042 - (CA) NEWPORT MULTI SPECIALTY SURGER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27222 | $225.00 | 1215245238 - AMERICAN ACCESS CARE OF NEW JERSEY, LLC, AZURA SURGERY CENTER CHERRY HILL | 223783657 - (NJ) AMERICAN ACCESS CARE OF NEW JERSEY LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27222 | $963.00 | 1861766016 - HAYS SURGERY CENTER, LLC | 274579547 - (TX) HAYS SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27222 | $249.00 | 1568244192 - TOWER CLOCK SURGERY CENTER APPLETON, LLC | 921425291 - (WI) TOWER CLOCK SURGERY CENTER APPLETON LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27222 | $506.00 | 1245605633 - HARBOR HEIGHTS SURGERY CENTER, LLC | 473886948 - (MD) HARBOR HEIGHTS SURGERY CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27222 | $515.00 | 1760778765 - GASTROINTESTINAL DIAGNOSTIC ENDOSCOPY WOODSTOCK, LLC, TOWN LAKE ENDOSCOPY CENTER | 274193796 - (GA) GASTROINTESTINAL DIAGNOSTIC ENDOSCOPY WOODSTOCK LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27222 | $491.00 | 1346205481 - BLOOMINGTON EYE INSTITUTE LLC | 371361486 - (IL) BLOOMINGTON EYE INSTITUTE LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27222 | $125.00 | 1184819930 - EAST COBB PODIATRY SURGERY CENTER, LLC | 581486442 - (GA) EAST COBB PODIATRY SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27222 | $153.00 | 1740491422 - PV PENINSULA PLASTIC SURGERY CENTER | 208545497 - (CA) PV PENINSULA PLASTIC SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27222 | $81.00 | 1710931134 - NOVAMED SURGERY CENTER OF JONESBORO, LLC, EYE SURGERY CENTER OF ARKANSAS | 204407053 - (AR) NOVAMED SURGERY CENTER OF JONESBORO LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27222 | $197.00 | 1033135314 - MED ATLANTIC INC, MED ATLANTIC INC DBA UROSURGICAL CTR OF RICHMOND | 541759643 | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 27222 | $505.00 | 1063427706 - PROHEALTH AMBULATORY SURGERY CENTER INC | 113447394 - (NY) PROHEALTH AMBULATORY SURGERY CENTER INC | NY | 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 27222 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 27222 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 27222 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 27222. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 27222 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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