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See a sample rate comparisonCPT 21325 Fee Schedule
Medicare rates as of October 2026
CPT 21325 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Open Treatment Of Nasal Fractu, Open Treatment Of Nasal Fracture Uncomplicatedopen Treatment Of Nasal Fracture Uncomplicated
| 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 | 59Distinct Procedural Service SGScene to Hospital ESRD facility |
| 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 | 03600450Sign up to view all 4 |
| Medicare Fee Schedule | $413.50 national non-facility rate (2026)View Medicare rates for 21325 |
| Medicaid Fee Schedule | $336.765 median of the 8 states in the free previewView Medicaid rates for 21325 |
National average reimbursement for CPT 21325 by major payers:
$552.47
BCBS / Anthem
$601.61
UnitedHealthcare
$622.28
Aetna
$746.35
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 21325.
CPT 21325
5 of 25 sample ratesHigher to lower in this preview
Indiana Endoscopy Centers LLC, Indiana Endoscopy Center West
$8,705.00Published rateFocus Hand Surgicenter LLC, Focus Hand And Arm Surgery Center
$2,119.00Published rateNorthern Ec LLC
$1,268.00Published rateMaruthi Penumetsa
Deaconess Hospital Inc
$819.60Published rateExecutive Surgery Center, Inc.
$520.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 21325 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 21325. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 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 |
| 21335-CPT | Open Treatment Of Nasal Fractu, Open Treatment Of Nasal Fracture With Concomitantopentreatment Of Fractured Septum Open Treatment Of Nasal Fracture With Concomitant Open |
| 21336-CPT | Open Treatment Of Nasal Septal, Open Treatment Of Nasal Septal Fracture With Or Withoutstabilization Open Treatment Of Nasal Septal Fracture With Or Without |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21325. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21325 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 21325 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 21325 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 21325 in an ambulatory surgery center?
CMS lists CPT 21325 with ASC payment indicator A2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with CPT 21325?
Hospital price transparency files list CPT 21325 under these revenue codes: 0360, 0450, 0490 and 0361. A revenue code names the hospital department or charge category for the line; it does not change what the service is.