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See a sample rate comparisonCPT 20101 Fee Schedule
Medicare rates as of October 2026
CPT 20101 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Exploration Of Chest
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21Inpatient Hospital 22On Campus Outpatient Hospital |
| Common Modifiers | 51Multiple procedures GCService performed by resident under supervision |
| Hospital Outpatient Group (APC) | APC 5054 - Level 4 Skin Procedures |
| Surgery Center Payment (ASC) | G2 - Paid separately, from the OPPS relative weight |
| Common Revenue Codes | 04500360Sign up to view all 4 |
| Medicare Fee Schedule | $626.27 national non-facility rate (2026)View Medicare rates for 20101 |
| Medicaid Fee Schedule | $485.14 median of the 8 states in the free previewView Medicaid rates for 20101 |
National average reimbursement for CPT 20101 by major payers:
$580.75
BCBS / Anthem
$595.19
UnitedHealthcare
$712.15
Aetna
$360.06
Cigna
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
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Payer Contract Negotiation
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See a sample payer proposalCPT 20101 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 20101. Select one to see its fee schedule.
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.
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Frequently Asked Questions
What APC is CPT 20101 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 20101 to APC 5054 (Level 4 Skin Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 20101 in an ambulatory surgery center?
CMS lists CPT 20101 with ASC payment indicator G2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with CPT 20101?
Hospital price transparency files list CPT 20101 under these revenue codes: 0450, 0360, 0361 and 0981. A revenue code names the hospital department or charge category for the line; it does not change what the service is.