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See a sample rate comparisonCPT 21340 Fee Schedule
Medicare rates as of October 2026
CPT 21340 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Percutaneous Treatment Of Naso, Percutaneous Treatment Of Nasoethmoid Complex Fracture Withsplint Wire Or Headcap Fixation Including Repair Of Canthal Ligaments Andor The Nasolacrimal Apparatus
| 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 58Staged or related procedure during postoperative period 59Distinct Procedural Service 62Co-Surgeons |
| 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 | $660.00 national non-facility rate (2026)View Medicare rates for 21340 |
| Medicaid Fee Schedule | $532.865 median of the 8 states in the free previewView Medicaid rates for 21340 |
National average reimbursement for CPT 21340 by major payers:
$1,002.85
BCBS / Anthem
$1,027.22
UnitedHealthcare
$1,032.42
Aetna
$1,251.84
Cigna
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CPT 21340
5 of 25 sample ratesHigher to lower in this preview
River Valley Asc LLC, River Valley Asc, LLC
River Valley Asc LLC
$5,922.00Published rateAnkeny Medical Park Surgery Center Lc
$4,659.60Published rateThe Ambulatory Surgery Center At St. Mary, LLC
Ambulatory Surgical Center At St. Mary'S
$3,200.00Published rateAscent Surgery Center, LLC
Ascent Surgery Center LLC
$1,900.00Published rateOutpatient Surgery Center, Inc, Mariner Surgery Center
Outpatient Surgery Center Inc
$869.00Published rate
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See a sample payer proposalCPT 21340 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 21340. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 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 |
| 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 |
| 21343-CPT | Open Treatment Of Depressed Fr, Open Treatment Of Depressed Frontal Sinus Fractureopen Treatment Of Depressed Frontal Sinus Fracture |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21340. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21340 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 21340 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 21340 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 21340 in an ambulatory surgery center?
CMS lists CPT 21340 with ASC payment indicator A2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with CPT 21340?
Hospital price transparency files list CPT 21340 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.