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See a sample rate comparisonCPT 21215 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.
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.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None 52 - Reduced Services 59 - Distinct Procedural Service |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 21215 |
| Medicaid Fee Schedule | View Medicaid rates for 21215 |
National average reimbursement for CPT 21215 by major payers:
$4,033.67
$4,952.42
$5,251.44
$1,847.73
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CPT 21215
5 of 25 sample ratesHigher to lower in this preview
Sundeep Mummaneni
Deaconess Hospital Inc
$7,020.37Published rateJonesboro Ambulatory Surgery Center, LLC
Jonesboro Ambulatory Surgery Center LLC
$3,690.00Published rateBrentwood Surgery Center, LLC, Brentwood Surgery Center
$2,978.00Published rateBuffalo Ambulatory Services, Inc, Buffalo Ambulatory Surgery Center
Buffalo Ambulatory Services, Inc
$1,605.00Published rateOak & Main Surgicenter LLC
Oak Main Surgicenter LLC
$1,042.00Published rate
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See a sample payer proposalCPT 21215 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21215 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 21215 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. |
| 21215-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. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21215. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21215 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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