CPT 21150 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 | Repair, Revision, and/or Reconstruction Procedures on the Head Surgical Procedures on the Head |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 62 - Co-Surgeons 58 - Staged or related procedure during postoperative period UB 51 - Multiple procedures 80 - Assistant surgeon |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 21150 |
National average reimbursement for CPT 21150 by major payers:
$2,125.82
$2,239.78
$2,259.87
$2,703.67
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 21150 | $1272.00 | 1740251909 - NORTH FLORIDA GI CENTER LTD, HCA FLORIDA NORTH FLORIDA ENDOSCOPY CENTER | 621727350 - (FL) NORTH FLORIDA GI CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21150 | $1401.00 | 1487094058 - COMPREHENSIVE PAIN CENTER FOR SURGERY, FOUNTAINS SPECIALTY SURGICAL CENTER | 460896509 - (MS) COMPREHENSIVE PAIN CENTER FOR SURGERY | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21150 | $8279.00 | 1548844400 - SAINT LUKES SOUTH PAIN MANAGEMENT CENTER LLC | 863451115 - (KS) SAINT LUKES SOUTH PAIN MANAGEMENT CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21150 | $2808.00 | 1306281563 - VIVERE HEALTH NEW ORLEANS, LLC, VIVERE AUDUBON SURGERY CENTER | 300726133 - (LA) VIVERE HEALTH NEW ORLEANS LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21150 | $3000.00 | 1033564414 - TEXAS CENTER FOR INTERVENTIONAL SURGERY, LLC | 811952779 - (TX) TEXAS CENTER FOR INTERVENTIONAL SURGERY LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21150 | $5249.00 | 1043303894 - DOCTORS OUTPATIENT SURGERY CENTER OF JUPITER, LLC, LASER & SURGERY CENTER OF THE PALM BEACHES | 650953183 - (FL) DRS. OUTPATIENT SURGERY CENTER OF JUPITER, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21150 | $5354.00 | 1043605934 - SEASIDE SURGERY CENTER, LLC | 472399984 - (FL) SEASIDE SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21150 | $1125.00 | 1538109384 - PLASTIC SURGERY SPECIALISTS, PC | 521357688 - (MD) PLASTIC SURGERY SPECIALISTS, P.C. | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21150 | $4215.00 | 1952885543 - REGENERATIVE ORTHOPAEDICS SURGERY CENTER, LLC | 824793737 - (GA) REGENERATIVE ORTHOPAEDICS SURGERY CENTER LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21150 | $1765.00 | 1285874065 - WEST CHASE SURGERY CENTER LTD | 260167338 - (FL) WEST CHASE SURGERY CENTER LTD | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21150 | $2917.00 | 1073578019 - BLUE RIDGE DAY SURGERY CENTER, LP, BLUE RIDGE DAY SURGERY CENTER | 621530122 - (NC) BLUE RIDGE DAY SURGERY CENTER LP | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21150 | $3484.00 | 1245436823 - EASTERN MASSACHUSETTS SURGERY CENTER LLC, EASTERN MASSACHUSETTS SURGERY CENTER | 260393450 - (MA) EASTERN MASSACHUSETTS SURGERY CENTER | MA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21150 | $1700.00 | 1164478764 - SURGERY CENTER OF LAWTON PROFESSIONAL LLC | 731579076 - (OK) SURGERY CENTER OF LAWTON PROFESSIONAL LLC | OK | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21150 | $6000.00 | 1730603622 - DULUTH SURGICAL SUITES LLC | 820668583 - (MN) DULUTH SURGICAL SUITES LLC | MN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21150 | $5249.00 | 1336246099 - VALLEY BAPTIST AMBULATORY SURGERY CENTER, LLC, PLATINUM SURGERY CENTER | 871904768 | TX | 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 21150 vs. Other Surgical Procedures on the Head Codes
The CPT 21150 code is part of the Repair, Revision, and/or Reconstruction Procedures on the Head services used for Surgical Procedures on the Head. 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 21150 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 |
|---|---|---|
| 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 |
| 21151-CPT | High | Reconstruction Midface Lefort, Reconstruction Midface Lefort Ii Any Direction Requiring Bone Grafts (Includes Obtaining Autografts) Reconstruction Midface Lefort Ii Any Direction Requiring |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21150. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21150 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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