CPT 21347 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 • GC - Service performed by resident under supervision • 51 - Multiple procedures |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 21347 |
National average reimbursement for CPT 21347 by major payers:
$1,365.52
$1,416.34
$1,464.30
$1,774.05
| 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 21347 | ||||||
United | 21347 | $3067.00 | 1629458427 - CLARKSVILLE SURGICENTER, LLC | 473830244 | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21347 | $7770.00 | 1366776106 - MEMORIAL HERMANN SURGERY CENTER RICHMOND, LLC, MEMORIAL HERMANN SURGERY CENTER RICHMOND | 270552583 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21347 | $2800.00 | 1992248512 - LUBBOCK VASCULAR ACCESS CENTER | 352344583 - (TX) LUBBOCK INTERVENTIONAL NEPHROLOGY ASSOCIATES PA | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21347 | $4016.00 | 1073944039 - THE POLYCLINIC, THE POLYCLINIC PLASTIC SURGERY CENTER | 910369070 - (WA) THE POLYCLINIC, PLLC | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21347 | $4074.00 | 1447489695 - AMBULATORY SURGERY CENTER AT VIRTUA WASHINGTON TOWNSHIP, L.L.C., VIRTUA CENTER FOR SURGERY | 208643005 - (NJ) AMBULATORY SURGERY CENTER AT VIRTUA WASHINGTON TOWNSHIP, LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21347 | $1266.00 | 1487239059 - AAU GREENBELT ASC LLC | 862166420 - (MD) AAU GREENBELT ASC LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21347 | $1400.00 | 1710203427 - HARLINGEN SURGICAL CENTER, LLC, VALLEY EYE SURGERY CENTER | 270561821 - (TX) HARLINGEN SURGICAL CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21347 | $673.00 | 1528134293 - MARYLAND AESTHETIC AND RECONSTRUCTIVE AMBULATORY SURGICAL CENTER LLC | 522277480 - (MD) MARYLAND AESTHETIC AND RECONSTRUCTIVE AMBULATORY SURGICAL CENTER LLC | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21347 | $1016.00 | 1972541415 - OCEAN ENDOSURGERY CENTER LLC, OCEAN ENDOSURGERY CENTER | 223564617 - (NJ) OCEAN ENDOSURGERY CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21347 | $1550.00 | 1376115816 - BARNET DULANEY PERKINS EYE CENTER, PC, AMERICAN VISION PARTNERS | 562589722 - BARNET DULANEY PERKINS EYE CENTER PLLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21347 | $2500.00 | 1962869826 - ENDOTECH, LLC | 472926864 - (AZ) ENDOTECH LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21347 | $5201.00 | 1861041139 - KADLEC REGIONAL MEDICAL CENTER, KADLEC AMBULATORY ENDOSCOPY CENTER, LEE CAMPUS | 910655392 - KADLEC REGIONAL MEDICAL CENTER | WA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21347 | $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 | 21347 | $2369.00 | 1730409400 - EYE BONE, LLC, CHARDON SURGERY CENTER | 204691851 - (OH) EYE BONE, LLC DBA CHARDON SURGERY CENTER | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21347 | $2619.00 | 1184844607 - SPECIALTY CARE AND SURGERY CENTER | 954176904 - (CA) PAULA R. DHANDA, MD | CA | 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 21347 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21347 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 21347 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 |
|---|---|---|
| 21344-CPT | High | Open Treatment Of Complicated (Eg, Comminuted Or Involving Posterior Wall) Frontal Sinus Fracture, Via Coronal Or Multiple Approaches |
| 21345-CPT | Moderate | Closed Treatment Of Nasomaxillary Complex Fracture (Lefort Ii Type), With Interdental Wire Fixation Or Fixation Of Denture Or Splint |
| 21346-CPT | High | Red Fx Open-Lefort Type 2 |
| 21347-CPT | High | Open Lefort Ii Multi Ope Approach |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21347. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21347 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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