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See a sample rate comparisonCPT 21330 Fee Schedule
CPT 21330 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Open Treatment Of Nasal Fractu, Open Treatment Of Nasal Fracture Complicated With Internalandor External Skeletal Fixation Open Treatment Of Nasal Fracture Complicated With Internal
| 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 | 51Multiple procedures 59Distinct Procedural Service |
| Hospital Outpatient Group (APC) | APC 5165 - Level 5 ENT Procedures |
| Surgery Center Payment (ASC) | A2 - Paid separately, from the OPPS relative weight |
| Common Revenue Codes | 0360 |
| Medicare Fee Schedule | View Medicare rates for 21330 |
| Medicaid Fee Schedule | $398.10 median of the 8 states in the free previewView Medicaid rates for 21330 |
National average reimbursement for CPT 21330 by major payers:
$688.11
BCBS / Anthem
$752.44
UnitedHealthcare
$760.43
Aetna
$905.22
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 21330.
CPT 21330
5 of 25 sample ratesHigher to lower in this preview
Hamilton Surgery Center LLC
$4,588.00Published rateSaint Lukes South Surgery Center LLC
$1,834.00Published rateBarnet Dulaney Perkins Eye Center, PC, Bdpec Showlow
Barnet Dulaney Perkins Eye Center PLLC
$1,505.00Published rateMarietta Outpatient Surgery, Ltd
Marietta Outpatient Surgery Ltd
$1,175.00Published rateAllegany Ambulatory Surgery Center LLC
$616.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 21330 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 21330. 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 |
| 21345-CPT | Closed Treatment Of Nasomaxill, Closed Treatment Of Nasomaxillary Complex Fracture(Lefortii Type) With Interdental Wire Fixation O R Fixation Of Denture Or Splint |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21330. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21330 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 21330 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 21330 to APC 5165 (Level 5 ENT Procedures). An APC groups outpatient services that Medicare pays at the same base rate.
How does Medicare pay for CPT 21330 in an ambulatory surgery center?
CMS lists CPT 21330 with ASC payment indicator A2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with CPT 21330?
Hospital price transparency files list CPT 21330 under these revenue codes: 0360. A revenue code names the hospital department or charge category for the line; it does not change what the service is.