A CPT (Current Procedural Terminology) code is a five-digit numerical code used by medical professionals to describe medical, surgical, and diagnostic services. They are crucial for billing and insurance purposes, ensuring standardized communication about healthcare services.

How can I find the cost of a medical procedure?

Finding the exact cost of a medical procedure can be complex due to varying factors like your insurance plan, location, and healthcare provider. To get a specific estimate, you can contact your insurance provider or the healthcare facility directly. For general fee schedule information based on CPT codes and location, tools like Payerprice can be very helpful.

Where can I look up fee schedules for medical services?

You can look up fee schedules through various sources. Your insurance company can provide information specific to your plan and network. For a broader lookup using CPT codes and specific locations, Payerprice offers a dedicated fee schedule lookup tool. This can provide valuable insights into expected costs for your specific situation.

Payerprice is a service that provides tools for healthcare price transparency, including a fee schedule lookup tool. Users can search for medical service costs using CPT codes and specific locations, helping them understand potential out-of-pocket expenses relevant to their situation.

CMS stands for the Centers for Medicare & Medicaid Services. It is a federal agency within the United States Department of Health and Human Services that administers the Medicare program and works with state governments to administer Medicaid and the Children's Health Insurance Program (CHIP). CMS publishes extensive data, including fee schedules for Medicare services.

How do Payerprice and CMS differ for price lookups?

CMS primarily provides fee schedules for Medicare services, which are specific to government-funded programs. While CMS data can offer a baseline, private insurance plans and commercial payers often have different reimbursement rates. Payerprice, on the other hand, offers a lookup tool designed to provide fee schedule information relevant to a broader range of payers and locations, making it suitable for users looking for information beyond just Medicare rates for their specific situation.

Why should I use Payerprice for specific fee schedule information?

You should use Payerprice for specific fee schedule information, especially when looking beyond Medicare rates or needing data tailored to a specific location and CPT code. Payerprice's fee schedule lookup tool allows users to search with CPT codes and specific locations to find relevant pricing information, which can be more aligned with commercial insurance and private payer rates compared to general CMS data. This helps in understanding potential costs based on your specific situation.

CPT 20999 Fee Schedule

Q: What factors affect fee schedules?

Fee schedules are affected by 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.), and Provider Type (Hospital providers may have different rates than private practice.).

Last Verified: October 2026

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.

Unlisted Proc Musculoskele System Gnral, Unlisted Procedure Musculoskeletal System General

Key Fact	Detail
Service Type	Surgery Surgical Procedures on the Musculoskeletal System
Common Place of Service	11 - Office 24 - Ambulatory Surgical Center
Common Modifiers	None RT - Right side of body LT - Left side of body
Complexity Level	High
Medicare Fee Schedule	View Medicare rates for 20999
Medicaid Fee Schedule	View Medicaid rates for 20999

National average reimbursement for CPT 20999 by major payers:

$1,174.62

$130.00

$1,420.68

$1,739.75

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CPT 20999

5 of 25 sample ratesHigher to lower in this preview

Westside Surgery Center LLC, Westside Surgery Center Ltd
Westside Surgery Center LLC
FLAmbulatory Surgical Clinic/CenterNPI 1215990627Tax ID 59-3026856
$653.00Published rate
Southwestern Ambulatory Surgery Center, LLC
Southwestern Ambulatory Surgery Center
PAAmbulatory Surgical Clinic/CenterNPI 1912933680Tax ID 56-2422009
$531.00Published rate
North Point Surgery Center, LLC
North Point Surgery Center LLC
MOAmbulatory Surgical Clinic/CenterNPI 1700263415Tax ID 46-4488421
$179.00Published rate
Cutting Edge Surgery Center, LLC
Cutting Edge Surgery Center LLC
CAAmbulatory Surgical Clinic/CenterNPI 1538569207Tax ID 47-1696819
$130.00Published rate
20-20 Surgery Center LLC
2020 Surgery Center LLC
PAAmbulatory Surgical Clinic/CenterNPI 1194718940Tax ID 33-1066427
$60.00Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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CPT 20999 vs. Other Surgical Procedures on the Musculoskeletal System Codes

The CPT 20999 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 20999 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
20974-CPT	Low	Electronic Fracture Therapy, Therapy Using Electrodes Placed Over The Skin And Administration Of Low Voltage Current To Stimulate Bone Healing.
20975-CPT	Moderate	Electronic Fracture Therapy, Therapy Using Electrodes Placed Over The Skin And Administration Of Low Voltage Current To Stimulate Bone Healing.
20979-CPT	Low	Low Intens Ultrasou Stimul To Aid Bone Healing Noninvasi, Low Intensity Ultrasound Stimulation To Aid Bone Healing Noninvasive
20999-CPT	High	Unlisted Proc Musculoskele System Gnral, Unlisted Procedure Musculoskeletal System General

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 20999. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 20999 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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CPT 20999 Fee Schedule

Compare published rates across providers.

Westside Surgery Center LLC, Westside Surgery Center Ltd

Southwestern Ambulatory Surgery Center, LLC

North Point Surgery Center, LLC

Cutting Edge Surgery Center, LLC

20-20 Surgery Center LLC