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See a sample rate comparisonCPT 21209 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.
Osteoplasty Facial Reduction
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | None 51 - Multiple procedures 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 21209 |
| Medicaid Fee Schedule | View Medicaid rates for 21209 |
National average reimbursement for CPT 21209 by major payers:
$945.67
$1,069.73
$1,128.39
$1,029.00
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CPT 21209
5 of 25 sample ratesHigher to lower in this preview
Bethesda Chevy Chase Surgery Center, LLC
Bethesda Chevy Chase Surgery Cen
$6,506.00Published rateAsuch Surgery Center
$3,672.00Published rateAuburn Surgery Center Inc.
Auburn Surgery Center Inc
$3,300.00Published rateThe Surgery Center At Williamson LLC
$2,809.00Published rateBlue Ash Endoscopy Center, LLC
$987.00Published rate
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See a sample payer proposalCPT 21209 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21209 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 21209 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 |
|---|---|---|
| 21208-CPT | High | Osteoplast Facial Bones; Augment (Autogr Allogrft Or Pros, Osteoplasty Facial Bones; Augmentation (Autograft Allograft Or Pros |
| 21209-CPT | Moderate | Osteoplasty Facial Reduction |
| 21210-CPT | High | Reconstruction With Bone Graft, Surgery To Reconstruct The Nose Jaw Or Cheek With A Bone Graft. The Procedure Repairs The Bone After An Injury Infection Or Tumor. |
| 21230-CPT | High | Apply Cartilage Graft To Face, Surgery To Reconstruct An Area Of The Face Chin Nose Or Ear With A Cartilage Graft Taken From Rib Or Ear. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21209. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21209 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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