CPT 21110 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 | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 58 - Staged or related procedure during postoperative period 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 21110 |
| Medicaid Fee Schedule | View Medicaid rates for 21110 |
National average reimbursement for CPT 21110 by major payers:
$991.57
$1,041.69
$1,113.43
$1,144.06
CPT 21110 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21110 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 21110 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 |
|---|---|---|
| 21089-CPT | High | Unlisted Maxillofacial Prosthe, Unlisted Maxillofacial Prosthetic Procedureunlisted Maxillofacial Prosthetic Procedure |
| 21100-CPT | Moderate | Device To Prevent Motion, Application Of A Halo (Ring-Shaped Fixture) To Prevent Movement Of The Head Neck Pelvis Or Leg. The Halo Is Used For X-Rays Traction Or Surgery. |
| 21110-CPT | Moderate | Application Of Interdental Fix, Application Of Interdental Fixation Device For Conditionsother Than Fracture Or Dislocation Includes Removal |
| 21116-CPT | Moderate | Inject Proc For Temporomandibu Joint Arthrography, Injection Procedure For Temporomandibular Joint Arthrography |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21110. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21110 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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