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See a sample rate comparisonCPT 21147 Fee Schedule
Last Verified: October 2026
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.
Lefort I 3 Piece W Graft, Reconstruction Midface Lefort I 3 Or More Pieces Segment Movement In Any Direction Requiring Bone Grafts Includes Obtaining Autografts Eg Ungrafted Bilateral Alveolar Cleft Or Multiple Osteotomies
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital 11 - Office |
| Common Modifiers | None 80 - Assistant surgeon AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 21147 |
| Medicaid Fee Schedule | View Medicaid rates for 21147 |
National average reimbursement for CPT 21147 by major payers:
$2,132.48
$2,264.90
$2,372.12
$2,782.25
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CPT 21147
5 of 25 sample ratesHigher to lower in this preview
Front Range Orthopedic Surgery Center LLC
$28,000.00Published rateMichigan Outpatient Surgical Solutions, LLC
Michigan Outpatient Surgical Solutions LLC
$5,354.00Published rateCenter For Pain Medicine Surgery Center LLC
$2,846.00Published rateProgressive Laser Surgical Institute Ltd
$1,450.00Published rateAdvanced Colon Care Inc, Shoreline Colonoscopy Suites
Advanced Colon Care Inc
$658.00Published rate
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See a sample payer proposalCPT 21147 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21147 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 21147 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 |
|---|---|---|
| 21145-CPT | High | Reconstruction Midface, Lefort I; Single Piece Segment Movement In Any Direction Requiring Bone Grafts -Commercial Rn Review>=8/1/2001: Medicaid Rn Review=8/1/2001-9/30/2020 |
| 21146-CPT | High | Rcnstj Mdfc Lefort I 2 W/Grf, Reconstruction Midface Lefort I; 2 Pieces Segment Movement In Any Direction Requiring Bone Grafts (Includes Obtaining Autografts) (Eg Ungrafted Unilateral Alveolar Cleft) |
| 21147-CPT | High | Lefort I 3 Piece W Graft, Reconstruction Midface Lefort I 3 Or More Pieces Segment Movement In Any Direction Requiring Bone Grafts Includes Obtaining Autografts Eg Ungrafted Bilateral Alveolar Cleft Or Multiple Osteotomies |
| 21150-CPT | High | Reconstruction Midface Lefort, Reconstruction Midface Lefort Ii Anterior Intrusion (Egtreacher-Collins Syndrome) Reconstructionmidface Lefort Ii Anterior Intrusion (Eg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21147. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21147 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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