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See a sample rate comparisonCPT 21116 Fee Schedule
Medicare rates as of October 2026
CPT 21116 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Inject Proc For Temporomandibu Joint Arthrography, Injection Procedure For Temporomandibular Joint Arthrography
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 11Office 24Ambulatory Surgical Center |
| Common Modifiers | RTRight side of body LTLeft side of body |
| Surgery Center Payment (ASC) | N1 - Packaged; no separate payment |
| Add-on Codes | 77002 |
| Common Revenue Codes | 03610360Sign up to view all 3 |
| Medicare Fee Schedule | $222.45 national non-facility rate (2026)View Medicare rates for 21116 |
| Medicaid Fee Schedule | $175.255 median of the 8 states in the free previewView Medicaid rates for 21116 |
National average reimbursement for CPT 21116 by major payers:
$214.01
BCBS / Anthem
$242.43
UnitedHealthcare
$259.77
Aetna
$317.05
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 21116.
CPT 21116
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Katy LLP
$1,831.00Published rateSurgical Specialty Center Of Mid Atlantic, LLC
Surgical Specialty Center Of Mid-Atlantic, LLC
$531.00Published ratePinnacle Cataract And Laser Institute LLC
$283.00Published rateSouthside Specialty Surgical Center LLC
$150.00Published rateSurgical Specialty Associates LLC, Doctors Same Day Surgery Center LLC
Surgical Specialty Associates
$69.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 21116 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 21116. 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 |
| 21116-CPT | 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 21116. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21116 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
How does Medicare pay for CPT 21116 in an ambulatory surgery center?
CMS lists CPT 21116 with ASC payment indicator N1: Packaged; no separate payment.
Which add-on codes are billed with CPT 21116?
CMS add-on code edits list CPT 21116 as a primary code for these add-on codes: 77002.
Which revenue codes are billed with CPT 21116?
Hospital price transparency files list CPT 21116 under these revenue codes: 0361, 0360 and 0761. A revenue code names the hospital department or charge category for the line; it does not change what the service is.