CPT 21127 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 • 21 - Inpatient Hospital |
| Common Modifiers | • None • UB • XS - Separate Structure |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 21127 |
National average reimbursement for CPT 21127 by major payers:
$3,927.07
$4,950.18
$5,186.34
$6,416.63
| 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 21127 | ||||||
United | 21127 | $1100.00 | 1912971326 - ADVANCED SURGERY CENTER, LLC | 351991340 - (IN) ADVANCED SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21127 | $3127.00 | 1881001758 - ASUCH SURGERY CENTER | 455067682 | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21127 | $4324.00 | 1215978945 - SAPLING GROVE AMBULATORY SURGERY CENTER, LLC | 204450153 - (TN) SAPLING GROVE AMBULATORY SURGERY CENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21127 | $5433.00 | 1891298089 - MICHIGAN OUTPATIENT SURGICAL SOLUTIONS, LLC | 821706937 - (MI) MICHIGAN OUTPATIENT SURGICAL SOLUTIONS LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21127 | $2950.00 | 1447260575 - CENTRAL INDIANA ORTHOPEDIC SURGERY CENTER, LLC | 352033226 - (IN) CENTRAL INDIANA ORTHOPEDIC SURGERY CENTER LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21127 | $1683.00 | 1124099635 - HUNTINGTON SURGERY CENTER LIMITED PARTNERSHIP, CABELL HUNTINGTON SURGERY CENTER | 550647724 - (WV) CABELL HUNTINGTON SURGERY CENTER | WV | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21127 | $2668.00 | 1215990247 - SOUTHERN HILLS SURGERY CENTER LP, SOUTHERN HILLS SURGERY CENTER | 200533890 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21127 | $4014.00 | 1790452126 - AZENDO LLC, TRI-POINTE SURGERY CENTER | 854150358 - (AZ) AZENDO LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21127 | $1725.00 | 1770724122 - NATIONAL SURGICAL CENTERS OF AMERICA LLC, NSCOA | 264278807 - (FL) NATIONAL SURGICAL CENTERS OF AMERICA LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21127 | $2668.00 | 1720566433 - PAVILION SURGICENTER, LLC, PHYSICIANS PAVILION SURGERY CENTER | 830619935 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21127 | $2266.00 | 1740785096 - GASTROINTESTINAL ENDOSCOPY CENTER LLC | 822081770 - (PA) GASTROINTESTINAL ENDOSCOPY CENTER LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21127 | $3154.61 | 1134178569 - ZACHARY EDWARDS | 350593390 - DEACONESS HOSPITAL INC | AL | Certified Registered Nurse Anesthetist (367500000X) |
United | 21127 | $4074.00 | 1861782591 - CENTER FOR AMBULATORY AND MINIMALLY INVASIVE SURGERY LLC, CAMIS | 270907140 - (NJ) CENTER FOR AMBULATORY AND MINI | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21127 | $742.00 | 1588797807 - SPOKANE DIGESTIVE DISEASE CENTER, P.S., SOUTH ASC | 911013238 - (WA) SPOKANE DIGESTIVE DISEASE CENTER P.S. | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21127 | $4014.00 | 1144333881 - NORTH SCOTTSDALE AMBULATORY SURGERY CENTER, LLC | 200554616 - (AZ) NORTH SCOTTSDALE AMBULATORY SURGERY CENTER LLC | AZ | 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 21127 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21127 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 21127 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 |
|---|---|---|
| 21120-CPT | Moderate | Genioplasty; Augmentation (Autograft, Allograft, Prosthetic Material) |
| 21121-CPT | Moderate | Genioplasty Sliding Osteotomy Single Pie |
| 21122-CPT | Moderate | Genioplasty; Sliding Osteotomies, 2 Or More Osteotomies (Eg, Wedge Excision Or Bone Wedge Reversal For Asymmetrical Chin) |
| 21127-CPT | High | Augmentation, Mandibular Body Or Angle; With Bone Graft, Onlay Or Interpositional -Commercial Rn Review>=1/1/1996: Medicaid Rn Review=1/1/1996-9/30/2020 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21127. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21127 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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