CPT 10021 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 • General Surgical Procedures |
| Common Place of Service | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • RT - Right side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 10021 by major payers:
$133.51
$148.14
$155.84
$185.60
| 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 10021 | ||||||
United | 10021 | $322.35 | 1407961485 - COLLEEN CONRY | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Family Medicine Physician (207Q00000X) |
United | 10021 | $124.45 | 1548575368 - DEREK HAVERLEY | 800348943 - POUDRE VALLEY MEDICAL GROUP LLC | CO | Orthopedic Physical Therapist (2251X0800X) |
United | 10021 | $150.00 | 1619037066 - THE EL DORADO AR MULTISPECIALTY ASC LLC, SOUTH ARKANSAS SURGERY CENTER | 203954951 - (AR) THE EL DORADO AR MULTISPECIALTY ASC LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10021 | $328.41 | 1316162001 - AMY GROVER | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Pediatric Emergency Medicine (Pediatrics) Physician (2080P0204X) |
United | 10021 | $115.00 | 1285944504 - NEWBRIDGE SURGERY CENTER AT PRINCE FREDERICK, LLC | 272840356 - (MD) NEWBRIDGE SURGERY CENTER AT PRINCE FREDERICK LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 10021 | $162.71 | 1366754616 - DARNELL BROWN | 850454692 | IN | Surgery Physician (208600000X) |
United | 10021 | $151.77 | 1760418198 - ABBAS SYED | 381415390 - (MI) DECKERVILLE COMMUNITY HOSPITAL INC | CO | Surgery Physician (208600000X) |
United | 10021 | $410.26 | 1841621570 - MARY CARSON | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Pediatric Nurse Practitioner (363LP0200X) |
United | 10021 | $410.26 | 1477954741 - JENNIFER GRIFFIN | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Pediatric Nurse Practitioner (363LP0200X) |
United | 10021 | $124.45 | 1144777350 - GIOVANNA CANTOR | 800348943 - POUDRE VALLEY MEDICAL GROUP LLC | FL | Family Nurse Practitioner (363LF0000X) |
United | 10021 | $339.52 | 1134421464 - SARAH PIHL | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Pediatric Nurse Practitioner (363LP0200X) |
United | 10021 | $141.25 | 1063825768 - SAMIR HASAN | 111631781 - FLUSHING HOSPITAL & MEDICAL CENTER | CO | Plastic and Reconstructive Surgery Physician (2086S0122X) |
United | 10021 | $161.67 | 1144200296 - DANIEL FREESE | 800348943 - POUDRE VALLEY MEDICAL GROUP LLC | CO | Gastroenterology Physician (207RG0100X) |
United | 10021 | $161.67 | 1972829737 - BRENDA GEORGE | 800348943 - POUDRE VALLEY MEDICAL GROUP LLC | CO | Neurology Physician (2084N0400X) |
United | 10021 | $328.79 | 1790854792 - SAMUEL GUBBELS | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | CO | Otology & Neurotology Physician (207YX0901X) |
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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 10021 vs. Other General Surgical Procedures Codes
The CPT 10021 code is part of the Surgery services used for General Surgical Procedures. 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 10021 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 |
|---|---|---|
| 10004 | Low | Fine Needle Aspiration Biopsy, Without Imaging Guidance; Each Additional Lesion (List Separately In Addition To Code For Primary Procedure) |
| 10005 | Low | Fine Needle Aspiration Biopsy Including Ultrasound Guidance; First Lesion |
| 10006 | Low | Fine Needle Aspiration Biopsy Including Ultrasound Guidance; Each Additional Lesion (List Separately In Addition To Code For Primary Procedure) |
| 10021 | Low | Fine Needle Aspiration Biopsy Without Imaging Guidance; First Lesion (Desc Rvsd 1/1/19) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 10021. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 10021 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 10021) and we'll show you how you compare in 15 minutes or less.
Medicare Reimbursement Lookup Tool
PayerPrice provides a free medicare lookup tool for physician fee schedule, drug ASP, MS-DRG weights, anesthesia conversion factors and other medicare related data.