Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 20101 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.
Exploration Of Chest
| 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 | Moderate |
| Medicare Fee Schedule | View Medicare rates for 20101 |
| Medicaid Fee Schedule | View Medicaid rates for 20101 |
National average reimbursement for CPT 20101 by major payers:
$580.75
$595.19
$712.15
$360.06
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 20101.
CPT 20101
5 of 25 sample ratesHigher to lower in this preview
North State Surgery Centers Lp, Court Street Surgery Center
$3,513.00Published rateNorthern Arizona Healthcare Orthopedic Surgery Center, LLC
$1,181.00Published rateSarah Volkman
Deaconess Hospital Inc
$784.04Published ratePasadena Surgery Center LLC, Pasadena Surgery Center
Pasadena Surgery Center LLC
$525.00Published rateFour Corners Ambulatory Surgical Center LLC
$197.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 20101 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 20101 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 20101 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 |
|---|---|---|
| 20100-CPT | Moderate | Exploration Of Penetrating Wound; Neck |
| 20101-CPT | Moderate | Exploration Of Chest |
| 20103-CPT | Moderate | Exploration Of Extremity |
| 32551-CPT | Moderate | Tube Thoracostomy Includes Co, Tube Thoracostomy Includes Connection To Drainagesystem (Eg Water Seal) When Performed Open (Se Parate Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 20101. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 20101 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 20101) and we'll show you how you compare in 15 minutes or less.