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See a sample rate comparisonCPT 21320 Fee Schedule
Medicare rates as of October 2026
CPT 21320 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Closed Treatment Of Nasal Bone, Closed Treatment Of Nasal Bone Fracture With Stabilization Closed Treatment Of Nasal Bone Fracturewith Stabilization
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 24Ambulatory Surgical Center 22On Campus Outpatient Hospital |
| Common Modifiers | SGScene to Hospital ESRD facility 59Distinct Procedural Service |
| Hospital Outpatient Group (APC) | APC 5164 - Level 4 ENT Procedures |
| Surgery Center Payment (ASC) | A2 - Paid separately, from the OPPS relative weight |
| Common Revenue Codes | 04500360Sign up to view all 9 |
| Medicare Fee Schedule | $220.78 national non-facility rate (2026)View Medicare rates for 21320 |
| Medicaid Fee Schedule | $176.985 median of the 8 states in the free previewView Medicaid rates for 21320 |
National average reimbursement for CPT 21320 by major payers:
$272.69
BCBS / Anthem
$331.28
UnitedHealthcare
$344.02
Aetna
$198.61
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 21320.
CPT 21320
5 of 25 sample ratesHigher to lower in this preview
Saint Lukes-Gi Diagnostics LLC
Saint Lukesgi Diagnostics LLC
$2,895.00Published ratePatient Partners LLC
$1,258.00Published rateThe Digestive Endoscopy Center Of Michigan, PLLC, Crowne Point Endoscopy & Surgery Center
The Digestive Endoscopy Center Of Michigan PLLC
$735.00Published rateFort Washington Surgery Center, LLC, The Surgery Center At Fort Washington
Foundation Surgery Affiliates Of Fort Washington, LLC
$502.00Published rateThe Asc At Waugh Chapel
$228.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 21320 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 21320. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 21315-CPT | Closed Treatment Of Nasal Bon, Closed Treatment Of Nasal Bone Fracture Withoutstabilization Closed Treatment Of Nasal Bone Fracture Without |
| 21320-CPT | Closed Treatment Of Nasal Bone, Closed Treatment Of Nasal Bone Fracture With Stabilization Closed Treatment Of Nasal Bone Fracturewith Stabilization |
| 21325-CPT | Open Treatment Of Nasal Fractu, Open Treatment Of Nasal Fracture Uncomplicatedopen Treatment Of Nasal Fracture Uncomplicated |
| 21330-CPT | Open Treatment Of Nasal Fractu, Open Treatment Of Nasal Fracture Complicated With Internalandor External Skeletal Fixation Open Treatment Of Nasal Fracture Complicated With Internal |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21320. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21320 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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Frequently Asked Questions
What APC is CPT 21320 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 21320 to APC 5164 (Level 4 ENT Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 21320 in an ambulatory surgery center?
CMS lists CPT 21320 with ASC payment indicator A2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with CPT 21320?
Hospital price transparency files list CPT 21320 under these revenue codes: including 0450, 0360, 0361, 0761 and 0981. A revenue code names the hospital department or charge category for the line; it does not change what the service is.