CPT 21182 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • RT - Right side of body • GC - Service performed by resident under supervision • 59 - Distinct Procedural Service |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 21182 |
National average reimbursement for CPT 21182 by major payers:
$2,673.74
$2,810.43
$2,828.44
$3,479.38
| 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 21182 | ||||||
United | 21182 | $5020.00 | 1881905792 - SURGCENTER PINELLAS, LLC | 271372259 - (FL) SURGCENTER PINELLAS, LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21182 | $1083.00 | 1538110713 - CENTER FOR DIGESTIVE HEALTH LLC | 201606438 - (MS) CENTER FOR DIGESTIVE HEALTH LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21182 | $3067.00 | 1083384432 - NASHVILLE SURGICENTER, LLC | 474086590 - (TN) NASHVILLE SURGICENTER LLC | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21182 | $2270.00 | 1558787614 - DIGESTIVE CARE ENDOSCOPY | 464923646 - (GA) DIGESTIVE CARE ENDOSCOPY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21182 | $7635.00 | 1306472063 - THE EMORY CLINIC INC, EMORY ENDOSCOPY CENTER AT DECATUR | 582030692 - EMORY UNIVERSITY | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21182 | $2249.00 | 1740944487 - ADVANCED AMBULATORY SURGERY CENTER LLC | 822160115 - (KS) ADVANCED AMBULATORY SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21182 | $1699.00 | 1467153718 - WATERFRONT SURGERY CENTER LLC | 881302078 - (KS) WATERFRONT SURGERY CENTER LLC | KS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21182 | $2200.00 | 1659574283 - PROVIDENCE VENTURES, LLC, BONE AND JOINT SURGERY CENTER OF NOVI | 161704029 - (MI) PROVIDENCE VENTURES, LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21182 | $5354.00 | 1275198673 - UROLOGY ASC- PHOENIX, LLC, UROLOGIC SURGERY CENTER OF ARIZONA | 320586987 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21182 | $5056.00 | 1841858024 - VANGUARD ASC, LLC, VANGUARD SURGICAL CENTER | 352661529 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21182 | $2734.00 | 1467783233 - SOUTH SOUND SURGERY, PLLC, AUBURN SURGICAL CENTER | 204413058 - (WA) SOUTH SOUND SURGERY PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21182 | $1950.00 | 1962695122 - NORTH ORANGE COUNTY SURGERY CENTER | 260625103 - (CA) NORTH ORANGE COUNTY SURGERY CENTER, LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21182 | $3139.00 | 1912678947 - ECCS ACQUISITION COMPANY LLC | 352656413 | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21182 | $3558.00 | 1609206614 - HURST AMBULATORY SURGERY CENTER, LLC, PRECINCT AMBULATORY SURGERY CENTER, LLC | 463648821 - (TX) HURST AMBULATORY SURGERY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21182 | $2996.00 | 1801944343 - HUDSON VALLEY AMBULATORY SURGERY, LLC | 510451539 - (NY) HUDSON VALLEY AMBULATORY | NY | 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 21182 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21182 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 21182 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 |
|---|---|---|
| 21172-CPT | High | Reconstruction Superior-Lateral Orbital Rim And Lower Forehead, Advancement Or Alteration, With Or Without Grafts (Includes Obtaining Autografts) |
| 21175-CPT | High | Reconstruction, Bifrontal, Superior-Lateral Orbital Rims And Lower Forehead, Advancement Or Alteration (Eg, Plagiocephaly, Trigonocephaly, Brachycephaly), With Or Without Grafts (Includes Obtaining Autografts) |
| 21179-CPT | High | Recon All/Maj Forehead/Rim W/Allograft/P |
| 21182-CPT | High | 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 S |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21182. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21182 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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