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See a sample rate comparisonCPT 21010 Fee Schedule
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.
Arthrotomy Temporomandibular Unil
| 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 |
| Medicaid Fee Schedule | View Medicaid rates for 21010 |
National average reimbursement for CPT 21010 by major payers:
$1,004.85
$997.07
$1,016.36
$1,222.71
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CPT 21010
5 of 25 sample ratesHigher to lower in this preview
Indiana Endoscopy Centers LLC, Indiana Endoscopy Center West
$8,705.00Published rateBarkley Surgicenter, LLC
Barkley Surgicenter LLC
$2,388.00Published rateSurgery Center Of Atlantis LLC
$1,518.00Published rateOhio Eye Associates, Inc., Ohio Eye Associates Eye Surgery & Laser Center
Ohio Eye Associates, Inc.
$1,020.00Published rateDekalb Gastroenterology Associates III, LLC, Dekalb Endoscopy Center
Dekalb Gastroenterology Associates III LLC
$360.00Published rate
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See a sample payer proposalCPT 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 |
|---|---|---|
| 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. |
| 21010-CPT | High | Arthrotomy Temporomandibular Unil |
| 21011-CPT | Moderate | Xcision Tumor Sft Tissue Of Face Or Scalp Subcutane Less Than, Excision Tumor Soft Tissue Of Face Or Scalp Subcutaneous; Less Than |
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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