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See a sample rate comparisonCPT 21184 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.
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
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21 - Inpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service 78 - Return to OR - related procedure AS - PA/NP/CNS assistant at surgery |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 21184 |
| Medicaid Fee Schedule | View Medicaid rates for 21184 |
National average reimbursement for CPT 21184 by major payers:
$3,127.01
$3,331.84
$3,337.72
$4,094.20
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CPT 21184
5 of 25 sample ratesHigher to lower in this preview
Howard Community Surgery Center LLC
$10,317.00Published rateBanner Peoria Surgery Center LLC
$4,014.00Published rateCheckerspot Surgery Centers, LLC
Checkerspot Surgery Centers LLC
$3,000.00Published rateOutpatient Surgical Specialties Center, LLC
Outpatient Surgical Specialties Center LLC
$2,470.00Published rateLaser Surgery Holding Company, Ltd
Laser Surgery Holding Company Lt
$638.00Published rate
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See a sample payer proposalCPT 21184 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21184 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 21184 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-Latera, Reconstruction Superior-Lateral Orbital Rim And Lowerforehead Advancement Or Alteration With Or Without Grafts (Includes Obtaining Autografts) |
| 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 21184. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21184 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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