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See a sample rate comparisonCPT 21315 Fee Schedule
Last Verified: September 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.
Closed Treatment Of Nasal Bon, Closed Treatment Of Nasal Bone Fracture Withoutstabilization Closed Treatment Of Nasal Bone Fracture Without
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 11 - Office 23 - Emergency Room |
| Common Modifiers | None 54 - Surgical Care Only 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 21315 |
| Medicaid Fee Schedule | View Medicaid rates for 21315 |
National average reimbursement for CPT 21315 by major payers:
$235.67
$343.59
$305.68
$322.74
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CPT 21315
5 of 25 sample ratesHigher to lower in this preview
St Davids Austin Area Asc LLC, St . David'S Austin Surgery Center
St Davids Austin Area Asc LLC
$2,622.00Published rateSurgicare Of Miramar LLC
$1,276.00Published rateSullivan Surgicenter,LLC
Sullivan Surgicenter LLC
$789.00Published rateTec North, LLC, The Endoscopy Center North
Tec North LLC
$667.00Published rateOutpatient Eye Surgery Center
$450.00Published rate
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See a sample payer proposalCPT 21315 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21315 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 21315 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 |
|---|---|---|
| 21315-CPT | Moderate | Closed Treatment Of Nasal Bon, Closed Treatment Of Nasal Bone Fracture Withoutstabilization Closed Treatment Of Nasal Bone Fracture Without |
| 21320-CPT | Moderate | Closed Treatment Of Nasal Bone, Closed Treatment Of Nasal Bone Fracture With Stabilization Closed Treatment Of Nasal Bone Fracturewith Stabilization |
| 21330-CPT | Moderate | Open Treatment Of Nasal Fractu, Open Treatment Of Nasal Fracture Complicated With Internalandor External Skeletal Fixation Open Treatment Of Nasal Fracture Complicated With Internal |
| 21335-CPT | Moderate | Open Treatment Of Nasal Fractu, Open Treatment Of Nasal Fracture With Concomitantopentreatment Of Fractured Septum Open Treatment Of Nasal Fracture With Concomitant Open |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21315. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21315 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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