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See a sample rate comparisonCPT 21436 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 Multiple Surgical Approaches Internal Fixation With Bone Grafting Includes Obtaining Graft
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21 - Inpatient Hospital 11 - Office |
| Common Modifiers | None 58 - Staged or related procedure during postoperative period 50 - Bilateral Procedure |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 21436 |
| Medicaid Fee Schedule | View Medicaid rates for 21436 |
National average reimbursement for CPT 21436 by major payers:
$2,372.18
$2,711.51
$2,743.29
$3,279.48
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CPT 21436
5 of 25 sample ratesHigher to lower in this preview
Community Endoscopy Center LLC
$10,317.00Published rateMao Leawood Surgery Center LLC
$3,700.00Published rateAmerican Access Care Of New Jersey, LLC, Azura Surgery Center Cherry Hill
American Access Care Of New Jersey LLC
$2,460.00Published rateCenter For Visual Surgical Excellence, LLC
Center For Visual Surgical Excellence LLC
$1,669.00Published rateMinimally Invasive Surgery Center, P.A.
$600.00Published rate
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See a sample payer proposalCPT 21436 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21436 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 21436 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 |
|---|---|---|
| 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 |
| 21435-CPT | High | Treat Craniofacial Fracture, Open Treatment Of Craniofacial Separation Lefort Iii Type Complicated Utilizing Internal And Or External Fixation Techniques Eg Head Cap Halo Device And Or Intermaxillary Fixation |
| 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 21436. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21436 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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