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See a sample rate comparisonCPT 21087 Fee Schedule
Medicare rates as of October 2026
CPT 21087 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Prepare Nose Prosthesis, Creation Of A Prosthesis For The Nose From A Cast Model Of Impressions. It Is Used To Restore The Shape Of The Nose.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21Inpatient Hospital 11Office 22On Campus Outpatient Hospital |
| Common Modifiers | ASPA/NP/CNS assistant at surgery 80Assistant surgeon |
| Hospital Outpatient Group (APC) | APC 5165 - Level 5 ENT Procedures |
| Surgery Center Payment (ASC) | P3 - Office-based; paid from physician fee schedule practice expense |
| Common Revenue Codes | 0360 |
| Medicare Fee Schedule | $1,627.29 national non-facility rate (2026)View Medicare rates for 21087 |
| Medicaid Fee Schedule | $1,291.015 median of the 8 states in the free previewView Medicaid rates for 21087 |
National average reimbursement for CPT 21087 by major payers:
$2,070.40
BCBS / Anthem
$2,320.86
UnitedHealthcare
$2,269.50
Aetna
$2,322.21
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 21087.
CPT 21087
5 of 25 sample ratesHigher to lower in this preview
Lake Spivey Ambulatory Surgery Care, LLC, Spivey Station Surgery Center
Emory University
$6,846.00Published rateDelaware Surgery Center, LLC
$3,690.00Published rateSouthwest Medical Associates, Inc, Southwest Medical Associates - Tenaya
$2,305.00Published rateSouthwestern Eye Center Ltd, Southwestern Eye Surgicenter-Casa Grande
Southwestern Eye Center, Ltd.
$1,550.00Published rateBrooklyn Endoscopy Sc, LLC, Gnyesc
Brooklyn Endoscopy Sc LLC
$432.00Published rate
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See a sample payer proposalCPT 21087 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 21087. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 21084-CPT | Custom Artificial Palate, A Prosthesis Made For The Roof Of The Mouth (Palate) From A Cast Model Of Impressions. It Is Used To Restore Oral Functions Such As Chewing Swallowing And Speech. |
| 21086-CPT | Prepare Artificial Ear Contour, Creation Of A Prosthesis For The Ear From A Cast Model Of Impressions. It Is Used To Restore The Shape Of The Ear. |
| 21087-CPT | Prepare Nose Prosthesis, Creation Of A Prosthesis For The Nose From A Cast Model Of Impressions. It Is Used To Restore The Shape Of The Nose. |
| 21088-CPT | Impression And Custom Preparat, Impression And Custom Preparation Facial Prosthesisimpression And Custom Preparation Facial Prosthesis |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21087. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21087 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 21087 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 21087 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 21087 in an ambulatory surgery center?
CMS lists CPT 21087 with ASC payment indicator P3: Office-based; paid from physician fee schedule practice expense.
Which revenue codes are billed with CPT 21087?
Hospital price transparency files list CPT 21087 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.