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See a sample rate comparisonCPT 21335 Fee Schedule
CPT 21335 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Open Treatment Of Nasal Fractu, Open Treatment Of Nasal Fracture With Concomitantopentreatment Of Fractured Septum Open Treatment Of Nasal Fracture With Concomitant Open
| 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 51Multiple procedures |
| 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 | 0360 |
| Medicare Fee Schedule | View Medicare rates for 21335 |
| Medicaid Fee Schedule | $525.255 median of the 8 states in the free previewView Medicaid rates for 21335 |
National average reimbursement for CPT 21335 by major payers:
$885.88
BCBS / Anthem
$963.21
UnitedHealthcare
$1,000.69
Aetna
$1,185.95
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 21335.
CPT 21335
5 of 25 sample ratesHigher to lower in this preview
Memorial Hermann Surgery Center Pinecroft, LLC
Memorial Hermann Surgery Center Pinecroft LLC
$5,729.00Published rateClear Creek Surgery Center LLC
Clear Creek Surgery Center, LLC
$2,119.00Published ratePort Arthur Surgical Center, LLC, Gulf Coast Surgery Center
Port Arthur Surgical Center LLC
$1,550.00Published rateThe Arcadia Ca Endoscopy Asc Lp, Valley Digestive Health Center
$927.00Published rateBrighton Surgery Center, LLC
$580.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 21335 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 21335. 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 21335. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21335 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 21335 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 21335 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 21335 in an ambulatory surgery center?
CMS lists CPT 21335 with ASC payment indicator A2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with CPT 21335?
Hospital price transparency files list CPT 21335 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.