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See a sample rate comparisonCPT 21249 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 Jaw And Teeth, Surgery To Reconstruct The Jaw Using An Artificial Part With Posts That Extend Through The Upper Or Lower Jaw Into The Mouth. Dentures Are Attached To The Posts To Replace Missing Teeth.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service 58 - Staged or related procedure during postoperative period |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 21249 |
| Medicaid Fee Schedule | View Medicaid rates for 21249 |
National average reimbursement for CPT 21249 by major payers:
$1,681.36
$1,919.47
$1,894.09
$1,940.15
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CPT 21249
5 of 25 sample ratesHigher to lower in this preview
Surgery Center Of Southwest Ohio, LLC, The Surgery Center Of Southwest Ohio
The Surgery Center Of Southwest
$11,102.00Published rateYuma Advanced Surgical Suites LLC
Yuma Advanced Surgical Suites, LLC
$5,433.00Published rateAdventist Healthcare Sc At National Harbor, LLC
Adventist Healthcare Sc At National Harbor LLC
$3,019.00Published rateOrchard Surgical Center, LLC, Orchard Surgical Center
Orchard Surgical Center, LLC
$2,365.00Published rateGreece Asc, LLC, Cornerstone Surgery Center
Greece Asc LLC
$1,444.00Published rate
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See a sample payer proposalCPT 21249 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21249 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 21249 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 |
|---|---|---|
| 21244-CPT | High | Reconstruct Jaw And Teeth, Surgery To Reconstruct The Jaw Using An Artificial Part With Posts That Extend Through The Upper Or Lower Jaw Into The Mouth. Dentures Are Attached To The Posts To Replace Missing Teeth. |
| 21245-CPT | High | Reconstruct Jaw And Teeth, Surgery To Reconstruct The Jaw Using An Artificial Part With Posts That Extend Through The Upper Or Lower Jaw Into The Mouth. Dentures Are Attached To The Posts To Replace Missing Teeth. |
| 21246-CPT | High | Reconstruct Jaw And Teeth, Surgery To Reconstruct The Jaw Using An Artificial Part With Posts That Extend Through The Upper Or Lower Jaw Into The Mouth. Dentures Are Attached To The Posts To Replace Missing Teeth. |
| 21249-CPT | High | Reconstruct Jaw And Teeth, Surgery To Reconstruct The Jaw Using An Artificial Part With Posts That Extend Through The Upper Or Lower Jaw Into The Mouth. Dentures Are Attached To The Posts To Replace Missing Teeth. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21249. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21249 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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