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See a sample rate comparisonCPT 21433 Fee Schedule
Last Verified: October 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.
Treat Craniofacial Fracture, Open Treatment Of Craniofacial Separation Lefort Iii Type Complicated Eg Comminuted Or Involving Cranial Nerve Foramina Multiple Surgical Approaches
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | None GC - Service performed by resident under supervision AG - Primary physician |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 21433 |
| Medicaid Fee Schedule | View Medicaid rates for 21433 |
National average reimbursement for CPT 21433 by major payers:
$2,205.29
$2,332.73
$2,367.23
$2,815.44
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CPT 21433
5 of 25 sample ratesHigher to lower in this preview
Indianapolis Endoscopy Center LLP
$10,317.00Published rateSurgery Center Of Gilbert LLC, Surgery Center Of Gilbert
Surgery Center Of Gilbert, LLC
$4,044.00Published rateClarksville Surgicenter, LLC
$2,668.00Published rateArturo Betancourt, M.D., P.A., Baltimore Washington Eye Center
Arturo Betancourt, Md, PA
$1,446.00Published rateTri-State Gastroenterology Associates, Psc, Tri-State Digestive Disorder Center
Tri-State Gastroenterology Associates, Psc
$732.00Published rate
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See a sample payer proposalCPT 21433 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21433 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 21433 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 |
|---|---|---|
| 21431-CPT | Moderate | Closed Treatment Of Craniofaci, Closed Treatment Of Craniofacial Separation (Lefort Iiitype) Using Interdental Wire Fixation Of Denture Or Splint Closed Treatment Of Craniofacial Separation (Lefort Iii |
| 21432-CPT | Moderate | Open Treatment Of Craniofacial, Open Treatment Of Craniofacial Separation (Lefort Iii Type)With Wiring Andor Internal Fixation Open Treatment Of Craniofacial Separation (Lefort Iii Type) |
| 21433-CPT | High | Treat Craniofacial Fracture, Open Treatment Of Craniofacial Separation Lefort Iii Type Complicated Eg Comminuted Or Involving Cranial Nerve Foramina Multiple Surgical Approaches |
| 21436-CPT | High | Treat Craniofacial Fracture, Open Treatment Of Craniofacial Separation Lefort Iii Type Complicated Multiple Surgical Approaches Internal Fixation With Bone Grafting Includes Obtaining Graft |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21433. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21433 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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