CPT 21077 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-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 | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • SC - Medically necessary service or supply • RT - Right side of body |
| Complexity Level | High |
National average reimbursement for CPT 21077 by major payers:

$2,710.96

$3,139.41

$3,050.17

$3,777.72
| 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 21077 | ||||||
United | 21077 | $1628.00 | 1588876817 - FREEWAY SURGERY CENTER LLC | 208957938 - (AR) FREEWAY SURGERY CENTER LLC | AR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21077 | $10989.00 | 1346235058 - EAST MEQUON SURGERY CENTER LLC | 861075286 - (WI) EAST MEQUON SURGERY CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21077 | $1905.00 | 1720175573 - COLUMBIA EYE SURGERY CENTER INC | 570879468 | SC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21077 | $5354.00 | 1053453134 - ADVANCED SURGICAL CONCEPTS LLC | 331035210 - (LA) ADVANCED SURGICAL CONCEPTS LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21077 | $3275.00 | 1811546575 - FIRST COAST ORTHOPEDIC CENTER, LLC, FIRST COAST SURGERY CENTER | 822929226 - (FL) FIRST COAST ORTHOPEDIC CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21077 | $1618.00 | 1740529064 - ASC DEVELOPMENT COMPANY, LLC | 203405773 - (MD) ASC DEVELOPMENT COMPANY LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21077 | $2009.00 | 1336231059 - CENTINELA VALLEY ENDOSCOPY CENTER INC. | 200244220 - (CA) CENTINELA VALLEY ENDOSCOPY CENTER INC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21077 | $1350.00 | 1235163171 - SEVEN SPRINGS SURGERY CENTER INC | 593044807 - (FL) SEVEN SPRINGS SURGERY CENTER INC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21077 | $3935.00 | 1275158495 - BCC CHANDLER LLC | 851284830 - (AZ) BCC CHANDLER LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21077 | $4080.00 | 1730378498 - TORRANCE CA MULTISPECIALTY ASC LLC, SURGERY CENTER OF SOUTH BAY | 204259636 - (CA) TORRANCE CA MULTISPECIALTY ASC LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21077 | $2014.00 | 1457465403 - VENTURE AMBULATORY SURGERY CENTER | 743257508 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21077 | $2270.00 | 1295714301 - ENDOSCOPY CENTER OF SOUTHEAST TEXAS LP, ENDOSCOPY CENTER OF SOUTHEAST TEXAS | 621536529 - (TX) ENDOSCOPY CENTER OF SOUTHEAST TEXAS LP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21077 | $3500.00 | 1437894276 - GEORGIA INTERVENTIONAL PAIN | 872711994 - (GA) GEORGIA INTERVENTIONAL PAIN | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21077 | $5433.00 | 1508942665 - THE ENDOSCOPY CENTER AT GATEWAY LLC | 272800486 | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21077 | $2144.00 | 1528130879 - PACIFIC SURGICAL INSTITUTE OF PAIN MANAGEMENT | 330776873 - (CA) PACIFIC SURGICAL INSTITUTE OF PAIN MANAGEMENT | 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 |
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CPT 21077 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21077 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 21077 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 |
|---|---|---|
| 21076-CPT | High | Impression And Custom Preparation; Surgical Obturator Prosthesis |
| 21077-CPT | High | Impression And Custom Preparation; Orbital Prosthesis |
| 21086-CPT | High | Impression & Custom Preparation; Auricular Prosthesis- Commercial Only Rn Review 7/25/2018-9/9/2021 |
| 21087-CPT | High | Impress/Prep Nasal Prosth |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21077. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21077 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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