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See a sample rate comparisonCPT 21345 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Closed Treatment Of Nasomaxill, Closed Treatment Of Nasomaxillary Complex Fracture(Lefortii Type) With Interdental Wire Fixation O R Fixation Of Denture Or Splint
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21 - Inpatient Hospital 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 51 - Multiple procedures 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 21345 |
| Medicaid Fee Schedule | View Medicaid rates for 21345 |
National average reimbursement for CPT 21345 by major payers:
$935.77
$1,044.59
$1,063.30
$1,055.25
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CPT 21345
5 of 25 sample ratesHigher to lower in this preview
Ochsner Medical Center, Ochsner Outpatient Surgery Suite
Ochsner Clinic Foundation
$3,825.00Published ratePotomac View Surgery Center, LLC
Potomac View Surgery Center LLC
$1,258.00Published rateWest Wilshire Medical Surgical Center Inc.
West Wilshire Medical Surgical C
$1,000.00Published ratePiedmont Outpatient Surgery Center, LLC
Piedmont Outpatient Surgery Center LLC
$729.00Published rateBay Area Endoscopy Center Limited Partnership
$343.00Published rate
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See a sample payer proposalCPT 21345 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21345 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 21345 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 |
|---|---|---|
| 21340-CPT | High | Percutaneous Treatment Of Naso, Percutaneous Treatment Of Nasoethmoid Complex Fracture Withsplint Wire Or Headcap Fixation Including Repair Of Canthal Ligaments Andor The Nasolacrimal Apparatus |
| 21344-CPT | High | Open Tx Compl Front Sinus Fx, Open Treatment Of Complicated Eg Comminuted Or Involving Posterior Wall Frontal Sinus Fracture Via Coronal Or Multiple Approaches |
| 21345-CPT | Moderate | Closed Treatment Of Nasomaxill, Closed Treatment Of Nasomaxillary Complex Fracture(Lefortii Type) With Interdental Wire Fixation O R Fixation Of Denture Or Splint |
| 21346-CPT | High | Reposition Broken Bone In Face, Surgery To Repair A Fracture That Breaks The Cheekbone Below The Eye Socket And Runs Across The Bridge Of The Nose. Dental Wiring May Be Used To Bind The Jaw Shut And Stabilize The Bones. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21345. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21345 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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