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See a sample rate comparisonCPT 21344 Fee Schedule
Medicare rates as of October 2026
CPT 21344 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
Open Tx Compl Front Sinus Fx, Open Treatment Of Complicated Eg Comminuted Or Involving Posterior Wall Frontal Sinus Fracture Via Coronal Or Multiple Approaches
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21Inpatient Hospital 22On Campus Outpatient Hospital |
| Common Modifiers | 62Co-Surgeons GCService performed by resident under supervision |
| Hospital Outpatient Group (APC) | APC 5165 - Level 5 ENT Procedures |
| Surgery Center Payment (ASC) | G2 - Paid separately, from the OPPS relative weight |
| Common Revenue Codes | 0360 |
| Medicare Fee Schedule | $1,215.46 national non-facility rate (2026)View Medicare rates for 21344 |
| Medicaid Fee Schedule | $981.21 median of the 8 states in the free previewView Medicaid rates for 21344 |
National average reimbursement for CPT 21344 by major payers:
$1,936.85
BCBS / Anthem
$1,923.57
UnitedHealthcare
$2,015.37
Aetna
$2,322.34
Cigna
Compare published rates across providers.
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CPT 21344
5 of 25 sample ratesHigher to lower in this preview
Pediatric Ambulatory Surgery Center Southlake, Childrenshealth Surgery Center
$7,124.00Published rateBrightside Surgical, LLC
Brightside Surgical LLC
$4,247.00Published rateNorthwest Community Day Surgery Center II LLC
$3,283.00Published rateCardiac And Vascular Institute Ambulatory Surgery Center, LLC
Cardiac And Vascular Institute Ambulatory Surgery Center LLC
$2,731.00Published rateFour Corners Ambulatory Surgical Center LLC
$774.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 21344 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 21344. 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 |
| 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 |
| 21344-CPT | Open Tx Compl Front Sinus Fx, Open Treatment Of Complicated Eg Comminuted Or Involving Posterior Wall Frontal Sinus Fracture Via Coronal Or Multiple Approaches |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21344. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21344 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 21344 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 21344 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 21344 in an ambulatory surgery center?
CMS lists CPT 21344 with ASC payment indicator G2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with CPT 21344?
Hospital price transparency files list CPT 21344 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.