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See a sample rate comparisonCPT 21181 Fee Schedule
Last Verified: October 2026
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.
Reconstr By Contour Of Bnign Tumor Of Cranial Bones (Eg Fib, Reconstruction By Contouring Of Benign Tumor Of Cranial Bones (Eg Fib
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | None SG - Scene to Hospital ESRD facility AS - PA/NP/CNS assistant at surgery |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 21181 |
| Medicaid Fee Schedule | View Medicaid rates for 21181 |
National average reimbursement for CPT 21181 by major payers:
$890.81
$986.74
$1,004.61
$1,203.87
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CPT 21181
5 of 25 sample ratesHigher to lower in this preview
South Emerson Surgery Center, LLC
$7,842.00Published rateGastrointestinal Associates Endoscopy Center, LLC
$2,529.00Published rateVoorhees Surgery Center, LLC
Voorhees Surgery Center LLC
$1,725.00Published rateRiverside Ambulatory Surgery Center, LLC
$1,066.00Published rateGynemed Surgical Center
$465.00Published rate
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See a sample payer proposalCPT 21181 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21181 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 21181 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 |
|---|---|---|
| 21181-CPT | Moderate | Reconstr By Contour Of Bnign Tumor Of Cranial Bones (Eg Fib, Reconstruction By Contouring Of Benign Tumor Of Cranial Bones (Eg Fib |
| 21182-CPT | High | Reconstruct Cranial Bone, Reconstruction Of Orbital Walls Rims Forehead Nasoethmoid Complex Following Intra And Extracranial Excision Of Benign Tumor Of Cranial Bone Eg Fibrous Dysplasia With Multiple Autografts Includes Obtaining Grafts Total Area Of Bone Grafting Less Than 40 Sq Cm |
| 21183-CPT | High | Reconstruct Cranial Bone, Reconstruction Of Orbital Walls Rims Forehead Nasoethmoid Complex Following Intra And Extracranial Excision Of Benign Tumor Of Cranial Bone Eg Fibrous Dysplasia With Multiple Autografts Includes Obtaining Grafts Total Area Of Bone Grafting Greater Than 40 Sq Cm But Less Than 80 Sq Cm |
| 21184-CPT | High | Reconstruct Cranial Bone, Reconstruction Of Orbital Walls Rims Forehead Nasoethmoid Complex Following Intra And Extracranial Excision Of Benign Tumor Of Cranial Bone Eg Fibrous Dysplasia With Multiple Autografts Includes Obtaining Grafts Total Area Of Bone Grafting Greater Than 80 Sq Cm |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21181. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21181 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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