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CPT 21408 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.

Open Orbit Fract W Bone Graft
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Musculoskeletal System

Common Place of Service

21 - Inpatient Hospital

24 - Ambulatory Surgical Center

Common Modifiers

None

RT - Right side of body

LT - Left side of body

Complexity LevelHigh
Medicare Fee ScheduleView Medicare rates for 21408

National average reimbursement for CPT 21408 by major payers:

bcbs

$1,197.28

uhc

$1,209.32

aetna

$1,224.20

cigna

$1,502.15

Preview provider-level rates for...
For billing codeCPT 21408
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 21408

United
21408$5249.001396174454 - SURGERY CENTER OF SCOTTSDALE LLC731553441 - (AZ) SURGERY CENTER OF SCOTTSDALE LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
21408$1230.001023256187 - TAMPA SURGERY CENTER LLC264008716 - (FL) TAMPA SURGERY CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
21408$6846.001346403854 - THE EMORY CLINIC INC, EMORY ORTHOPAEDIC SURGERY CENTER582030692 - EMORY UNIVERSITYGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
21408$5433.001912933680 - SOUTHWESTERN AMBULATORY SURGERY CENTER, LLC562422009 - (PA) SOUTHWESTERN AMBULATORY SURGERY CENTERPAAmbulatory Surgical Clinic/Center (261QA1903X)
United
21408$2500.001568079788 - DIALYSIS ACCESS CENTER OF CINCINNATI, INC.815023998 - (OH) DIALYSIS ACCESS CENTER OF CINCINNATI INCOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
21408$14525.001881678662 - SURGERY AFFILIATE OF EL PASO, LLC, FOUNDATION SURGERY AFFILIATE OF EL PASO, LLC742797719 - (TX) SURGERY AFFILIATE OF EL PASO LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
21408$6506.001740371665 - SUMMIT SURGICAL ASSOCIATES LLC, SUMMIT SURGICAL CENTER954810282 - (CA) SUMMIT SURGICALCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
21408$2693.001861449571 - KIRURGS, LLC, SURGEONS' SURGICAL CENTER522018568 - (MD) SURGEONS SURGICAL CENTER, LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
21408$6724.001699702050 - VIRGINIA MASON MEDICAL CENTER, VIRGINIA MASON BELLEVUE ASC910565539 - (WA) VIRGINIA MASON MEDICAL CENTERWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
21408$678.001689657058 - CENTER FOR ADVANCED EYE SURGERY, LTD341866635 - (OH) CENTER FOR ADVANCED EYE SURGERY LTDOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
21408$830.001275178444 - KENOSHA DIGESTIVE HEALTH CENTER LLC842167873 - (WI) KENOSHA DIGESTIVE HEALTH CENTER LLCWIAmbulatory Surgical Clinic/Center (261QA1903X)
United
21408$2375.001417987595 - ENDOSCOPY CENTER OF NORTH BALTIMORE412081861MDAmbulatory Surgical Clinic/Center (261QA1903X)
United
21408$960.001265462881 - WOOSTER OPHTHALMOLOGISTS, INC., EYE SURGERY CENTER OF WOOSTER341338984 - (OH) WOOSTER OPHTHALMOLOGISTS, INC.OHAmbulatory Surgical Clinic/Center (261QA1903X)
United
21408$1088.001760445928 - ARIZONA ENDOSCOPY CENTER, LLC860908400 - (AZ) ARIZONA ENDOSCOPY CENTER LLCAZAmbulatory Surgical Clinic/Center (261QA1903X)
United
21408$2251.001750521720 - SPOKANE VALLEY EAR NOSE & THROAT PS, SPOKANE VALLEY AMBULATORY SURGERY CENTER911072626 - (WA) SPOKANE VALLEY EAR, NOSE & THROAT, P.S.WAAmbulatory 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 21408 vs. Other Surgical Procedures on the Musculoskeletal System Codes

The CPT 21408 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 21408 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
21400-CPTModerateClose Orbit Fract Wo Manip
21401-CPTModerateRed Fx-Orbit Other
21406-CPTModerateOpen Treat Orbit Frac Wo/Implant
21408-CPTHighOpen Orbit Fract W Bone Graft

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21408. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 21408 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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