CPT 21015 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 59 - Distinct Procedural Service • LT - Left side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 21015 by major payers:
$852.26
$868.31
$924.80
$1,119.65
| 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 21015 | ||||||
United | 21015 | $616.00 | 1225133994 - VALLEY AMBULATORY SURGICAL CENTER | 203882105 - (PA) VALLEY AMBULATORY SURGICAL CENTER | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21015 | $800.00 | 1659885325 - GOLDEN SPRINGS SURGICAL CENTER | 814517992 - (CA) GOLDEN SPRINGS SURGICAL CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21015 | $890.00 | 1629032446 - AMBULATORY SURGERY CENTER GROUP LTD | 592073099 - (FL) AMBULATORY SURGERY CENTER GROUP LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21015 | $420.00 | 1033106612 - PSHS ALPHA PARTNERS LLC, LAKE WORTH SURGICAL CENTER | 650793962 - (FL) PSHS ALPHA PARTNERS LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21015 | $1190.00 | 1780021188 - ENDOSCOPY CENTER OF NIAGARA, LLC | 453630889 - (NY) ENDOSCOPY CENTER OF NIAGARA LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21015 | $560.00 | 1114361185 - WARM SPRINGS SURGICAL CENTER, LLC, WARM SPRINGS SURGICAL CENTER | 461892306 - (NV) WARM SPRINGS SURGICAL CENTER LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21015 | $3563.00 | 1467920389 - KU MEDWEST AMBULATORY SURGERY CENTER, LLC | 20664568 - (KS) KU MEDWEST AMBULATORY SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21015 | $1179.00 | 1124125604 - MURDOCK AMBULATORY SURGERY CENTER LLC | 201543128 - (FL) MURDOCK AMBULATORY SURGERY CENTE | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21015 | $665.00 | 1427092279 - IPM SURGERY CENTERS LLC, SPINALCARE SURGICENTER | 330983021 - (CA) IPM SURGERY CENTERS, INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21015 | $3105.00 | 1548844400 - SAINT LUKES SOUTH PAIN MANAGEMENT CENTER LLC | 863451115 - (KS) SAINT LUKES SOUTH PAIN MANAGEMENT CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21015 | $800.00 | 1669181822 - ALLIANCE SURGERY CENTER AT CUMMING | 881953675 - (GA) ALLIANCE SURGERY CENTER AT CUMMING | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21015 | $700.00 | 1033564414 - TEXAS CENTER FOR INTERVENTIONAL SURGERY, LLC | 811952779 - (TX) TEXAS CENTER FOR INTERVENTIONAL SURGERY LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21015 | $1004.00 | 1710234455 - PITTSBURG CATARACT CENTER PA | 460720134 - (KS) PITTSBURG CATARACT CENTER PA | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21015 | $455.00 | 1295739217 - WATERSIDE AMBULATORY SURGICAL CENTER LLC | 650270415 - (FL) WATERSIDE AMBULATORY SURGICAL CE | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21015 | $686.00 | 1962455964 - CYPRESS SURGERY CENTER LLC | 481214301 - (KS) CYPRESS SURGERY CENTER LLC | KS | 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 21015 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21015 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 21015 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 |
|---|---|---|
| 21013-CPT | Moderate | Excision, Tumor, Soft Tissue Of Face And Scalp, Subfascial (Eg, Subgaleal, Intramuscular); Less Than 2 Cm |
| 21014-CPT | Moderate | Exc Tumor Soft Tiss Face & Scalp Subfascial 2 Cm |
| 21015-CPT | Moderate | Radical Resection Of Tumor (Eg Sarcoma) Soft Tissue Of Face Or Scalp; Less Than 2 Cm (Revised 01/01/2014) |
| 21016-CPT | High | Radical Resection Of Tumor (Eg Sarcoma) Soft Tissue Of Face Or Scalp; 2cm Or Greater (Revised 01/01/2014) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21015. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21015 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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