CPT 21010 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital • 11 - Office |
| Common Modifiers | • None • LT - Left side of body • RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 21010 |
National average reimbursement for CPT 21010 by major payers:
$1,004.85
$997.07
$1,016.36
$1,248.39
| 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 21010 | ||||||
United | 21010 | $3427.00 | 1245372531 - NEWPORT BAY SURGERY CENTER, LLC | 562518360 - (CA) NEWPORT BAY SURGERY CENTER, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21010 | $2406.00 | 1184666364 - LONG ISLAND CENTER FOR DIGESTIVE HEALTH LLC | 364444162 - (NY) LONG ISLAND CENTER FOR DIGESTIVE HEALTH, LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21010 | $4617.00 | 1336695188 - HHC HARTFORD SURGERY CENTER, LLC | 812637261 - (CT) HHC HARTFORD SURGERY CENTER, LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21010 | $2388.00 | 1750363461 - BARKLEY SURGICENTER, LLC | 650428622 - (FL) BARKLEY SURGICENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21010 | $798.00 | 1124443809 - POOLE ENDOSCOPY CENTER, LLC | 521831316 | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21010 | $618.33 | 1225421886 - ASHTIN COLLINS | 350593390 - DEACONESS HOSPITAL INC | IN | Nurse Practitioner (363L00000X) |
United | 21010 | $1280.00 | 1518280684 - NORTHWEST SURGERY CENTER, INC. | 364663721 - (CA) NORTHWEST SURGERY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21010 | $1083.00 | 1003871104 - MEMPHIS SURGERY CENTER LTD, LP, MEMPHIS SURGERY CENTER | 621218330 - (TN) MEMPHIS SURGERY CENTER, LTD, LP | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21010 | $3767.00 | 1447768411 - WISCONSIN INSTITUTE OF SURGICAL EXCELLENCE LLC | 821710492 - (WI) WISCONSIN INSTITUTE OF SURGICAL EXCELLENCE LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21010 | $1125.00 | 1831637875 - UCSC LLC, UNION CITY SURGERY CENTER | 814012677 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21010 | $8705.00 | 1811172729 - INDIANA ENDOSCOPY CENTERS LLC, INDIANA ENDOSCOPY CENTER WEST | 208398421 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21010 | $360.00 | 1497895676 - DEKALB GASTROENTEROLOGY ASSOCIATES III, LLC, DEKALB ENDOSCOPY CENTER | 582316075 - (GA) DEKALB GASTROENTEROLOGY ASSOCIATES III LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21010 | $1700.00 | 1376605279 - MIDWEST CENTER FOR DAY SURGERY, LLC | 208103522 - (IL) MIDWEST CENTER FOR DAY SURGERY, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21010 | $1350.00 | 1336649714 - HEALTHQARE SERVICES ASC LLC, HEALTHQARE SERVICES ASC LLC | 815460194 - (VA) HEALTHQARE SERVICES ASC LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21010 | $2655.00 | 1033635206 - MEDSTAR SURGERY CENTER AT TIMONIUM, LLC | 821874292 - (MD) MEDSTAR SURGERY CENTER AT TIMO | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
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 |
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CPT 21010 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21010 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 21010 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 |
|---|---|---|
| 20950-CPT | Moderate | Monitoring Of Interstitial Fluid Pressure (Includes Insertion Of Device, Eg, Wick Catheter Technique, Needle Manometer Technique) In Detection Of Muscle Compartment Syndrome |
| 20974-CPT | Low | Stimulate Bone Electric Noninvasive |
| 20975-CPT | Moderate | Electrical Stim Aid Bone Heal Invasive |
| 21010-CPT | High | Arthrotomy Temporomandibular Unil |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21010. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21010 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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