CPT 21340 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 51 - Multiple procedures • 58 - Staged or related procedure during postoperative period • 59 - Distinct Procedural Service • 62 - Co-Surgeons |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 21340 |
National average reimbursement for CPT 21340 by major payers:
$1,002.85
$1,027.22
$1,032.42
$1,280.23
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 21340 | ||||||
United | 21340 | $1680.00 | 1831636752 - RIVER VIEW SURGERY CENTER, LLC | 814790945 - (ID) RIVER VIEW SURGERY CENTER, LLC | ID | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21340 | $5249.00 | 1952749491 - HAYMARKET SURGERY CENTER, LLC | 462874962 - (VA) HAYMARKET SURGERY CENTER | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21340 | $999.00 | 1639618036 - PRESENCE LAKESHORE GASTROENTEROLOGY, LLC | 811750563 - (IL) PRESENCE LAKESHORE GASTROENTEROLOGY LLC DBA DES PLAINES ENDOSCOPY CENT | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21340 | $3200.00 | 1154624526 - THE AMBULATORY SURGERY CENTER AT ST. MARY, LLC | 272871206 - (PA) AMBULATORY SURGICAL CENTER AT ST. MARY'S | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21340 | $3526.00 | 1710091517 - HERSHEY OUTPATIENT SURGERY CENTER LP, HERSHEY OUTPATIENT SURGERY CENTER | 200469951 - (PA) HERSHEY OUTPATIENT SURGERY CENTER LP | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21340 | $1753.00 | 1336439645 - ACADEMIC UROLOGY OF PA, LLC | 205328092 - (PA) ACADEMIC UROLOGY OF PA, LLC | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21340 | $4703.00 | 1144291261 - OCEAN SURGICAL PAVILION, PC, OCEAN SURGICAL PAVILION | 223182653 | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21340 | $2600.00 | 1649393695 - COLUMBIA MD ORTHOPAEDIC ASC, LLC, HICKORY RIDGE SURGERY CENTER | 522377233 - (MD) COLUMBIA MD ORTHOPAEDIC ASC LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21340 | $5922.00 | 1821332370 - RIVER VALLEY ASC LLC, RIVER VALLEY ASC, LLC | 460758315 - (CT) RIVER VALLEY ASC LLC | CT | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21340 | $2686.00 | 1588802466 - SALMON CREEK PLASTIC SURGERY PC, SALMON CREEK PLASTIC SURGERY PC/ASC FACILITY | 205914560 - (WA) SALMON CREEK PLASTIC SURGERY, PC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21340 | $912.00 | 1699748855 - MIDDLETOWN ENDOSCOPY ASC LLC, THE GI ENDOSCOPY CENTER | 621835826 - (OH) MIDDLETOWN ENDOSCOPY ASC LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21340 | $5249.00 | 1366684326 - PRINCE FREDERICK SURGERY CENTER LLC | 264387021 - (MD) PRINCE FREDERICK SURGERY CENTER, LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21340 | $3690.00 | 1013136456 - SOUTH JERSEY MUSCULOSKELETAL INSTITUTE, LLC, ADVANCED SURGICAL INSTITUTE | 204481032 - (NJ) SOUTH JERSEY MUSCULOSKELETAL INSTITUTE, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21340 | $2576.00 | 1215126438 - THE ARCADIA CA ENDOSCOPY ASC LP, VALLEY DIGESTIVE HEALTH CENTER | 204484163 | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21340 | $3000.00 | 1376054007 - HUDSON YARDS SURGERY CENTER, LLC, HUDSON SPECIALTY SURGERY CENTER | 463753455 - (NY) HUDSON YARDS SURGERY CENTER LLC | NY | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 21340 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21340 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 21340 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 21335-CPT | Moderate | Open Treat Nasal Frac W/Concomitant Frac |
| 21339-CPT | Moderate | Open Treat Nasoethmoid Frac W/Fix |
| 21340-CPT | High | Percutaneous Treatment Of Nasoethmoid Complex Fracture, With Splint, Wire Or Headcap Fixation, Including Repair Of Canthal Ligaments And/Or The Nasolacrimal Apparatus |
| 21343-CPT | High | Open Depress Front Sinus Fract |
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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