CPT 21029 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 | • 24 - Ambulatory Surgical Center • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 21029 |
National average reimbursement for CPT 21029 by major payers:
$988.21
$1,008.08
$1,043.10
$1,268.41
| 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 21029 | ||||||
United | 21029 | $681.00 | 1528053311 - AMERICAN ENDOSCOPY CENTER, P.C. | 593795864 - (TN) AMERICAN ENDOSCOPY CENTER PC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21029 | $825.00 | 1730570003 - SMART PAIN SURGERY CENTER AT GERMANTOWN, LLC, CLEARWAY SURGERY CENTER OF GERMANTOWN | 472908671 - (MD) SMART PAIN SURGERY CENTER AT GERMANTOWN LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21029 | $4464.00 | 1629738471 - ST VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST FRANCIS, PREVEA SURGERY CENTER | 390817529 - ST VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST FRANCIS | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21029 | $2000.00 | 1396832549 - GENESEE CARE L.L.C., THE SURGERY CENTER OF GENESEE COUNTY | 383242685 - (MI) GENESEE CARE LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21029 | $2486.00 | 1942883764 - MCLEAN TYSONS ORTHOPEDIC SURGERY CENTER, LLC | 851995349 - (VA) MCLEAN TYSONS ORTHOPEDIC SURGERY CENTER, LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21029 | $2307.00 | 1720085277 - ROSWELL SURGERY CENTER LLC, ROSWELL SURGERY CENTER | 582577112 - (GA) ROSWELL SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21029 | $4623.00 | 1982871935 - NORTHERN VIRGINIA SURGERY CENTER LLC | 203502477 - (VA) NORTHERN VIRGINIA SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21029 | $1058.00 | 1942397104 - PREMIER ENDOSCOPY, LLC | 50599351 - (NJ) PREMIER ENDOSCOPY LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21029 | $1249.00 | 1083694319 - KINGS EYE CENTER MEDICAL GROUP, INC., KINGS EYE SURGICAL CENTER | 770566388 - (CA) KINGS EYE CENTER MEDICAL GROUP, INC. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21029 | $1091.00 | 1104894369 - VALLEY OUTPATIENT SURGICAL CENTER INC | 860585124 - (AZ) VALLEY OUTPATIENT SURGICAL CENTER INC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21029 | $3500.00 | 1639146541 - CENTENNIAL ASC, LLC, BAYLOR SURGICARE AT CENTENNIAL | 352199232 - (TX) CENTENNIAL ASC LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21029 | $4141.00 | 1134663677 - CASTLE HILLS SURGICARE, LLC | 813020487 - (TX) CASTLE HILLS SURGICARE LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21029 | $1561.00 | 1578918124 - CENTER FOR PAIN MEDICINE SURGERY CENTER LLC | 811657416 - (ND) CENTER FOR PAIN MEDICINE SURGERY CENTER LLC | ND | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21029 | $1600.00 | 1932496908 - CONCOURSE DIAGNOSTIC SURGERY CENTER, LLC, CONCOURSE DIAGNOSTIC SURGERY CENTER,LLC | 273205326 - (CA) CONCOURSE DIAGNOSTIC & SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21029 | $1400.00 | 1831139955 - ABINGTON SURGICAL CENTER | 232561054 - (PA) ABINGTON SURGICAL CENTER | PA | 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 21029 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21029 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 21029 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 |
| 21016-CPT | High | Radical Resection Of Tumor (Eg Sarcoma) Soft Tissue Of Face Or Scalp; 2cm Or Greater (Revised 01/01/2014) |
| 21029-CPT | Moderate | Removal By Contouring Of Benign Tumor Of Facial Bone -Commercial Rn Review=8/1/2001-5/31/2022: Medicaid Rn Review=8/1/2001-9/30/2020 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21029. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21029 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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