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See a sample rate comparisonCPT 21070 Fee Schedule
Medicare rates as of October 2026
CPT 21070 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Coronoidectomy Unilateral
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22On Campus Outpatient Hospital 21Inpatient Hospital |
| Common Modifiers | 50Bilateral Procedure RTRight 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 | $540.09 national non-facility rate (2026)View Medicare rates for 21070 |
| Medicaid Fee Schedule | $439.275 median of the 8 states in the free previewView Medicaid rates for 21070 |
National average reimbursement for CPT 21070 by major payers:
$854.35
BCBS / Anthem
$843.15
UnitedHealthcare
$869.99
Aetna
$1,019.32
Cigna
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CPT 21070
5 of 25 sample ratesHigher to lower in this preview
Southwest Connecticut Surgery Center, LLC
$5,731.00Published rateAdvanced Center For Surgery, The Advanced Center For Surgery
Advanced Center For Surgery
$5,020.00Published rateLiberty Corner Surgical Center LLC
$3,100.00Published rateMt Pleasant Surgery Center LLC
$2,137.00Published rateGraystone Eye Surgery Center LLC
$1,230.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 21070 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 21070. 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 21070. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21070 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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Frequently Asked Questions
What APC is CPT 21070 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 21070 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 21070 in an ambulatory surgery center?
CMS lists CPT 21070 with ASC payment indicator A2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with CPT 21070?
Hospital price transparency files list CPT 21070 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.