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See a sample rate comparisonCPT 21073 Fee Schedule
CPT 21073 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Manipulation Of Temporomandibu, Manipulation Of Temporomandibular Joint(S) (Tmj) Therapeutic Requiring An Anesthesia Service (I.E. General Or Monitored Anesthesia Care)
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 11Office 22On Campus Outpatient Hospital |
| Common Modifiers | RTRight side of body LTLeft side of body |
| Hospital Outpatient Group (APC) | APC 5163 - Level 3 ENT Procedures |
| Surgery Center Payment (ASC) | P3 - Office-based; paid from physician fee schedule practice expense |
| Common Revenue Codes | 03600361Sign up to view all 3 |
| Medicare Fee Schedule | View Medicare rates for 21073 |
| Medicaid Fee Schedule | $336.17 median of the 8 states in the free previewView Medicaid rates for 21073 |
National average reimbursement for CPT 21073 by major payers:
$446.01
BCBS / Anthem
$503.04
UnitedHealthcare
$511.04
Aetna
$428.98
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 21073.
CPT 21073
5 of 25 sample ratesHigher to lower in this preview
Columbia North Hills Hospital Subsidiary Lp, Medical City North Hills
Columbia North Hills Hospital Subsidiary Lp
$4,278.00Published rateLowcountry Ambulatory Center, LLC
Lowcountry Ambulatory Center LLC
$1,400.00Published rateRome Orthopaedic Clinic Asc, Inc.
Rome Orthopaedic Clinic Asc Inc
$941.00Published rateMarin Ophthalmic Surgery Center
$646.00Published rateTriad Surgery Center LLC, Triad Eye Medical Clinic And Cataract Institute PLLC
$461.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 21073 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 21073. 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 21073. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21073 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 21073 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 21073 to APC 5163 (Level 3 ENT Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 21073 in an ambulatory surgery center?
CMS lists CPT 21073 with ASC payment indicator P3: Office-based; paid from physician fee schedule practice expense.
Which revenue codes are billed with CPT 21073?
Hospital price transparency files list CPT 21073 under these revenue codes: 0360, 0361 and 0761. A revenue code names the hospital department or charge category for the line; it does not change what the service is.