Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 21050 Fee Schedule
Medicare rates as of October 2026
CPT 21050 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Condylecyomy Temporomandibular
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22On Campus Outpatient Hospital 21Inpatient Hospital 24Ambulatory Surgical Center |
| Common Modifiers | 59Distinct Procedural Service LTLeft side of body |
| Hospital Outpatient Group (APC) | APC 5165 - Level 5 ENT Procedures |
| Surgery Center Payment (ASC) | A2 - Paid separately, from the OPPS relative weight |
| Common Revenue Codes | 0360 |
| Medicare Fee Schedule | $795.94 national non-facility rate (2026)View Medicare rates for 21050 |
| Medicaid Fee Schedule | $644.42 median of the 8 states in the free previewView Medicaid rates for 21050 |
National average reimbursement for CPT 21050 by major payers:
$1,175.49
BCBS / Anthem
$1,169.30
UnitedHealthcare
$1,190.43
Aetna
$1,432.71
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 21050.
CPT 21050
5 of 25 sample ratesHigher to lower in this preview
Physicians West Surgicenter, LLC
$10,749.00Published ratePhysicians Day Surgery Center, LLC, Physicians Day Surgery Center, Inc.
Physicians Day Surgery Center, Inc.
$3,275.00Published rateJohns Hopkins Surgery Centers Series
Johns Hopkins Surgery Center Series
$2,483.00Published rateAgmg Endoscopy Center A General Partnership
$1,932.00Published rateAmbulatory Foot And Ankle Center, Inc.
Ambulatory Foot And Ankle Center Inc
$898.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Looking for other data?
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 21050 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 21050. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 21050-CPT | Condylecyomy Temporomandibular |
| 21060-CPT | Meniscectomy Partial Or Compl, Meniscectomy Partial Or Complete Temporomandibular Joint(Separate Procedure) Meniscectomy Partial Or Complete Temporomandibular Joint |
| 21070-CPT | Coronoidectomy Unilateral |
| 21073-CPT | Manipulation Of Temporomandibu, Manipulation Of Temporomandibular Joint(S) (Tmj) Therapeutic Requiring An Anesthesia Service (I.E. General Or Monitored Anesthesia Care) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21050. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21050 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 21050) and we'll show you how you compare in 15 minutes or less.
Frequently Asked Questions
What APC is CPT 21050 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 21050 to APC 5165 (Level 5 ENT Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 21050 in an ambulatory surgery center?
CMS lists CPT 21050 with ASC payment indicator A2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with CPT 21050?
Hospital price transparency files list CPT 21050 under these revenue codes: 0360. A revenue code names the hospital department or charge category for the line; it does not change what the service is.