Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 21280 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.
Revision Of Eyelid, Tightening Of Tendon Of Inner Port Of Lower Eyelid
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 21280 |
| Medicaid Fee Schedule | View Medicaid rates for 21280 |
National average reimbursement for CPT 21280 by major payers:
$749.53
$750.00
$797.80
$947.61
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 21280.
CPT 21280
5 of 25 sample ratesHigher to lower in this preview
Indiana University Health Saxony Surgery Center LLC, Saxony Surgery Center
$11,291.00Published rateLebanon Endoscopy Center LLC, Lebanon Endoscopy Center
Lebanon Endoscopy Center LLC
$5,249.00Published rateWentworth Surgery Center, LLC
Wentworth Surgery Center LLC
$2,500.00Published rateWaterfront Surgery Center LLC
Waterfront Surgery Center
$1,789.00Published rateEye Surgery Center Of New Albany, LLC, Novamed Eye Surgery Center Of New Albany, LLC
Eye Surgery Center Of New Albany LLC
$733.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 21280 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21280 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 21280 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 |
|---|---|---|
| 21255-CPT | High | Reconstruction With Bone Graft, Surgery To Reconstruct The Face Just Below The Cheekbone Using Bone And Cartilage From The Hip Rib Or Skull. |
| 21256-CPT | High | Reconstruction Of Orbit With O, Reconstruction Of Orbit With Osteotomies (Extracranial) And With Bone Grafts (Includes Obtaining Autografts) (Eg Microophthalmia) |
| 21260-CPT | High | Periorbital Osteotomies For Orbital Hypertelorism W/ Bone Grafts, Periorbital Osteotomies For Orbital Hypertelorism With Bone Grafts; E |
| 21280-CPT | Moderate | Revision Of Eyelid, Tightening Of Tendon Of Inner Port Of Lower Eyelid |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21280. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21280 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 21280) and we'll show you how you compare in 15 minutes or less.