CPT 21070 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 • 21 - Inpatient Hospital |
| Common Modifiers | • None • 50 - Bilateral Procedure • RT - Right side of body |
| Complexity Level | Moderate |
National average reimbursement for CPT 21070 by major payers:
$854.35
$843.15
$869.99
$1,043.83
| 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 21070 | ||||||
United | 21070 | $6506.00 | 1285768903 - SURGERY CENTER OF RENO, LLC, SWIFT SURGERY CENTER LLC | 203707845 - (NV) SURGERY CENTER OF RENO, LLC | NV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21070 | $4704.00 | 1093383655 - SHERMAN ENDOSCOPY CENTER, LLC | 861402910 - (TX) SHERMAN ENDOSCOPY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21070 | $5079.00 | 1235770249 - WESTERN WYOMING MEDICAL LLC | 843044901 - (WY) WESTERN WYOMING MEDICAL LLC | WY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21070 | $973.00 | 1700884608 - SPRINGHILL SURGERY CENTER, DAUPHIN WEST SURGERY CENTER | 630982952 - (AL) SPRINGHILL SURGERY CENTER | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21070 | $1478.00 | 1336255827 - ROCKVILLE EYE SURGERY CENTER, LLC, PALISADES EYE SURGERY CENTER | 43713185 - (MD) PALISADES EYE SURGERY CENTER | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21070 | $5433.00 | 1154323988 - CENTRAL VIRGINIA SURGI-CENTER LP, SURGI-CENTER OF CENTRAL VIRGINIA | 752967162 - (VA) CENTRAL VIRGINIA SURGICENTER LP | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21070 | $1990.00 | 1831117704 - MEDICAL HEIGHTS SURGERY CENTER, INC., KENTUCKY SURGERY CENTER | 843280181 - (KY) BAPTIST HEALTH SURGERY CENTER, L | KY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21070 | $1119.35 | 1619912979 - PATRICIA COPLEY | 350593390 - DEACONESS HOSPITAL INC | TX | Pulmonary Disease Physician (207RP1001X) |
United | 21070 | $5354.00 | 1720530405 - GRAND RAPIDS SURGICAL SUITES LLC | 811321919 - (MI) GRAND RAPIDS SURGICAL SUITES, PLLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21070 | $2919.00 | 1346969789 - ADVENTHEALTH SURGERY CENTER INNOVATION TOWER, LLC | 882744377 - (FL) ADVENTHEALTH SURGERY CENTER INNOVATION TOWER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21070 | $1919.00 | 1750612446 - BAY SURGERY CENTERS, CLEARWAY SURGERY CENTER OF GLEN BURNIE | 271271303 - (MD) BAY SURGERY CENTERS | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21070 | $2000.00 | 1538167978 - VALLEY SURGICAL CENTER LTD, VALLEY SURGERY CENTER | 300035229 - (OH) VALLEY SURGICAL CENTER LTD | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21070 | $1648.00 | 1235187972 - NOBLE SURGERY CENTER | 43732499 - (CA) NOBLE SURGERY CENTER | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21070 | $2827.00 | 1528335148 - SHRINERS HOSPITALS FOR CHILDREN, SHRINERS HOSPITALS FOR CHILDREN - ERIE AMBULATORY SURGERY CENTER | 362193608 - SHRINERS HOSPITALS FOR CHILDREN | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21070 | $3708.00 | 1073794855 - SURGICARE OF LA VETA INC., BARRANCA SURGERY CENTER | 752507129 | CA | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 21070 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21070 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 21070 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 |
|---|---|---|
| 21050-CPT | High | Condylecyomy Temporomandibular |
| 21060-CPT | High | Meniscectomy Temporomandibular |
| 21070-CPT | Moderate | Coronoidectomy Unilateral |
| 21073-CPT | Moderate | Once Per Dos Manipulation Of Temporomandibular Joint, Tmj, Therapeutic, Requiring An Anesthesia Service- Rn Review: Medicaid>=5/14/2011, Commercial>=7/5/2011 |
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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 21070) and we'll show you how you compare in 15 minutes or less.