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See a sample rate comparisonRevenue Code (RC) 0421 Fee Schedule
Last Verified: September 2026
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.
Visit charge
| Key Fact | Detail |
|---|---|
| Service Type | Physical Therapy |
| Complexity Level | Moderate |
National average reimbursement for Revenue Code 0421 by major payers:
$440.04
$84.95
$215.37
$132.13
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RC 0421
5 of 25 sample ratesHigher to lower in this preview
Inspira Medical Centers, Inc., Inspira Medical Center Elmer
Inspira Medical Centers Inc
$563.00Published rateLakeview Medical Center, LLC, Lakeview Regional Medical Center
$130.00Published rateMarshall Drive Opco LLC, Aspire At Big Bend
Marshall Drive Opco LLC
$65.00Published rateLife Care Centers Of America, Inc., Life Care Center Of Ocala
Life Care Centers Of America, Inc.
$65.00Published rateCarrollwood Rehabilitation Center LLC, Northdale Rehabilitation Center
Carrollwood Rehabilitation Center LLC
$65.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalRevenue Code 0421 vs. Other Physical Therapy Codes
The Revenue Code 0421 code is part of the Physical Therapy services . 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 Revenue Code 0421 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 Revenue Code 0421. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 0421 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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