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See a sample rate comparisonCPT 21338 Fee Schedule
Medicare rates as of October 2026
CPT 21338 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Open Treatment Of Nasoethmoid, Open Treatment Of Nasoethmoid Fracture Without Externalfixation Open Treatment Of Nasoethmoid Fracture Without External
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21Inpatient Hospital 22On Campus Outpatient Hospital |
| Common Modifiers | 51Multiple procedures GCService performed by resident under supervision |
| 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 | $626.94 national non-facility rate (2026)View Medicare rates for 21338 |
| Medicaid Fee Schedule | $509.43 median of the 8 states in the free previewView Medicaid rates for 21338 |
National average reimbursement for CPT 21338 by major payers:
$890.33
BCBS / Anthem
$926.00
UnitedHealthcare
$950.79
Aetna
$1,134.73
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 21338.
CPT 21338
5 of 25 sample ratesHigher to lower in this preview
North Dakota Surgery Center, LLC
North Dakota Surgery Center, LLP
$2,614.00Published rateMaryland Specialty Surgery Center, LLC
$1,840.00Published rateHighline South Ambulatory Surgery Center, LLC, Highline South Ambulatory Surgery Center
Highline South Ambulatory Surgery Center LLC
$1,335.00Published rateBlue Ash Endoscopy Center, LLC
$814.00Published rateEndoscopy Center Of Northeast Tennessee, PC
$425.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 21338 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 21338. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 21338-CPT | Open Treatment Of Nasoethmoid, Open Treatment Of Nasoethmoid Fracture Without Externalfixation Open Treatment Of Nasoethmoid Fracture Without External |
| 21339-CPT | Open Treatment Of Nasoethmoid, Open Treatment Of Nasoethmoid Fracture With Externalfixation Open Treatment Of Nasoethmoid Fracture With External |
| 21340-CPT | Percutaneous Treatment Of Naso, Percutaneous Treatment Of Nasoethmoid Complex Fracture Withsplint Wire Or Headcap Fixation Including Repair Of Canthal Ligaments Andor The Nasolacrimal Apparatus |
| 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 21338. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21338 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 21338 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 21338 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 21338 in an ambulatory surgery center?
CMS lists CPT 21338 with ASC payment indicator A2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with CPT 21338?
Hospital price transparency files list CPT 21338 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.