Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 21356 Fee Schedule
Last Verified: October 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.
Open Treatment Of Depressed Zy, Open Treatment Of Depressed Zygomatic Arch Fracture (Eggillies Approach) Open Treatment Of Depressed Zygomatic Arch Fracture (Eg
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 21356 |
| Medicaid Fee Schedule | View Medicaid rates for 21356 |
National average reimbursement for CPT 21356 by major payers:
$642.56
$659.54
$716.02
$645.06
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 21356.
CPT 21356
5 of 25 sample ratesHigher to lower in this preview
Beltway Surgery Centers, LLC, Beltway Surgery Center Springmill
$8,705.00Published ratePatient Partners LLC
$2,307.00Published rateNorth Palm Beach County Surgery Center LLC
$1,518.00Published rateSuncoast Specialty Surgery Center, Lllp
Suncoast Specialty Surgery Center Lllp
$890.00Published rateAngela Schapker
Deaconess Hospital Inc
$402.10Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 21356 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21356 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 21356 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 |
|---|---|---|
| 21355-CPT | Moderate | Percutaneous Treatment Of Fra, Percutaneous Treatment Of Fracture Of Malar Areaincludingzygomatic Arch And Malar Tripod With Ma Nipulation Percutaneous Treatment Of Fracture Ofmalar Area Including |
| 21356-CPT | Moderate | Open Treatment Of Depressed Zy, Open Treatment Of Depressed Zygomatic Arch Fracture (Eggillies Approach) Open Treatment Of Depressed Zygomatic Arch Fracture (Eg |
| 21360-CPT | Moderate | Open Treatment Of Depressed Ma, Open Treatment Of Depressed Malar Fracture Includingzygomatic Arch And Malar Tripod Open Treatmentof Depressed Malar Fracture Including |
| 21365-CPT | High | Opn Tx Complx Malar Fx, Open Treatment Of Complicated Eg Comminuted Or Involving Cranial Nerve Foramina Fracture S Of Malar Area Including Zygomatic Arch And Malar Tripod With Internal Fixation And Multiple Surgical Approaches |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21356. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21356 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 21356) and we'll show you how you compare in 15 minutes or less.