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CPT 21387 Fee Schedule

Last Verified: January 2026

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.

Red Fx Open-Blowout Combined
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Musculoskeletal System

Common Place of Service

21 - Inpatient Hospital

22 - On Campus Outpatient Hospital

Common Modifiers

None

LT - Left side of body

RT - Right side of body

Complexity LevelHigh
Medicare Fee ScheduleView Medicare rates for 21387

National average reimbursement for CPT 21387 by major payers:

bcbs

$1,066.61

uhc

$1,026.87

aetna

$1,041.45

cigna

$1,274.61

Preview provider-level rates for...
For billing codeCPT 21387
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 21387

United
21387$5249.001801146535 - SURGCENTER AT PARADISE VALLEY, LLC, SURGCENTER AT PIMA CROSSING455364868 - (AZ) SURGCENTER AT PARADISE VALLEYAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
21387$4110.001306217039 - FIRST HILL SURGERY CENTER LLC472066485 - (WA) FIRST HILL SURGERY CENTER LLCWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
21387$2051.001558053868 - LORAIN AMHERST SURGERY CENTER LLC853470191 - (OH) LORAIN AMHERST SURGERY CENTER LLCOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
21387$5354.001346383155 - BRIARCLIFF AMBULATORY SURGERY CENTER LP, BRIARCLIFF SURGERY CENTER202852584 - (MO) BRIARCLIFF AMBULATORY SURGERY CENTER LPMOAmbulatory Surgical Clinic/Center (261QA1903X)
United
21387$3730.001528104080 - SURGICAL CENTER AT CEDAR KNOLLS LLC202158771 - (NJ) SURGICAL CENTER AT CEDAR KNOLLSNJAmbulatory Surgical Clinic/Center (261QA1903X)
United
21387$400.001417949280 - CLEARWATER AMBULATORY SURGICAL CENTERS INC, CLEARWATER ENDOSCOPY CENTER593044282 - (FL) CLEARWATER AMBULATORY SURGICAL CENTERS INCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
21387$1198.001467557678 - BEAN CENTER FOR FOOT SURGERY INC, SIERRA CENTER FOR FOOT SURGERY880309955 - (NV) BEAN CENTER FOR FOOT SURGERY INCNVAmbulatory Surgical Clinic/Center (261QA1903X)
United
21387$2550.001508840893 - PARKWAY SURGERY CENTER621799370 - (SC) PARKWAY SURGERY CENTER, LLCSCAmbulatory Surgical Clinic/Center (261QA1903X)
United
21387$5433.001851396014 - ARC WORCESTER CENTER, L.P.621772057 - (MA) ARC WORCESTER CENTER LPMAAmbulatory Surgical Clinic/Center (261QA1903X)
United
21387$5966.001962405803 - MID RIVERS AMBULATORY SURGERY CENTER LP, MID RIVERS SURGERY CENTER203833902 - (MO) MID RIVERS AMBULATORY SURGERY CENTER LPMOAmbulatory Surgical Clinic/Center (261QA1903X)
United
21387$2731.001427690775 - CARDIAC AND VASCULAR INSTITUTE AMBULATORY SURGERY CENTER, LLC851809741 - (FL) CARDIAC AND VASCULAR INSTITUTE AMBULATORY SURGERY CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
21387$5354.001386277069 - SOUTHWEST ENDOSCOPY LLC843623972AZAmbulatory Surgical Clinic/Center (261QA1903X)
United
21387$1618.001114491073 - ASC DEVELOPMENT COMPANY LLC203405773 - (MD) ASC DEVELOPMENT COMPANY LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
21387$5354.001063947422 - SILVER CROSS AMBULATORY SURGERY CENTER, LLC, SILVER CROSS SURGERY CENTER371852055 - (IL) SILVER CROSS AMBULATORY SURGERY CENTER LLCILAmbulatory Surgical Clinic/Center (261QA1903X)
United
21387$4781.001255577045 - MAPLE LAWN SURGERY CENTER262739529 - (MD) MAPLE LAWN SURGERY CENTER, LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 21387 vs. Other Surgical Procedures on the Musculoskeletal System Codes

The CPT 21387 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 21387 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.

CodeComplexityDescription
21385-CPTModerateRed Fx Open-Caldwell Luc
21386-CPTModerateOpen Treat Blowout Frac Periorbital
21387-CPTHighRed Fx Open-Blowout Combined
21390-CPTHighOpen Treat Blowout Frac W/Implant

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21387. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 21387 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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