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See a sample rate comparisonCPT 21346 Fee Schedule
Medicare rates as of October 2026
CPT 21346 is classified under Surgery, in the Surgical Procedures on the Musculoskeletal System subgroup.
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.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21Inpatient Hospital 22On Campus Outpatient Hospital |
| Common Modifiers | GCService performed by resident under supervision 51Multiple procedures |
| 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 | $913.85 national non-facility rate (2026)View Medicare rates for 21346 |
| Medicaid Fee Schedule | $741.305 median of the 8 states in the free previewView Medicaid rates for 21346 |
National average reimbursement for CPT 21346 by major payers:
$1,157.55
BCBS / Anthem
$1,265.65
UnitedHealthcare
$1,354.29
Aetna
$1,619.48
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 21346.
CPT 21346
5 of 25 sample ratesHigher to lower in this preview
Crown Point Surgical Suites, LLC
Crown Point Surgical Suites LLC
$3,829.00Published rateHuebner Creek Surgery Center, PLLC
Huebner Ambulatory Surgery Center LLC
$2,250.00Published rateO'Fallon Surgical Center, LLC, Physicians Surgical Center
$1,377.00Published rateSt Luke'S Surgery Center, LLC
A Positive Focus Counseling LLC
$932.00Published rateSally K Balin Ambulatory Surgical Center Inc
Sally K Balin Ambulatory Surgical Center Inc.
$380.00Published rate
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See a sample payer proposalCPT 21346 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The table lists codes related to 21346. Select one to see its fee schedule.
| Code | Description |
|---|---|
| 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 |
| 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 |
| 21346-CPT | 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. |
| 21347-CPT | 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 21346. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21346 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 21346 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns CPT 21346 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 21346 in an ambulatory surgery center?
CMS lists CPT 21346 with ASC payment indicator G2: Paid separately, from the OPPS relative weight.
Which revenue codes are billed with CPT 21346?
Hospital price transparency files list CPT 21346 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.