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See a sample rate comparisonCPT 21451 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.
Closed Treatment Of Mandibular, Closed Treatment Of Mandibular Fracture With Manipulationclosed Treatment Of Mandibular Fracture With Manipulation
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21 - Inpatient Hospital 11 - Office |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 21451 |
| Medicaid Fee Schedule | View Medicaid rates for 21451 |
National average reimbursement for CPT 21451 by major payers:
$980.93
$978.20
$1,044.39
$1,223.93
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CPT 21451
5 of 25 sample ratesHigher to lower in this preview
St Vincent Hospital-Hospital Sisters-Third Order Of St Francis, Prevea Surgery Center
St Vincent Hospital-Hospital Sisters-Third Order Of St Francis
$3,481.00Published rateAdam Wadlington
Deaconess Hospital Inc
$1,328.60Published rateEndoscopic Ambulatory Specialty Center Of Bay Ridge Inc
Endoscopic Ambulatory Specialty Center Of Bay Ridge, Inc.
$940.00Published rateSnapfinger Vascular Access Center Asc LLC
$725.00Published rateLiberty Eye Surgical Center LLC
Liberty Eye Surgical Center, LLC
$394.00Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 21451 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21451 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 21451 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 |
|---|---|---|
| 21440-CPT | Moderate | Closed Treatment Of Mandibular, Closed Treatment Of Mandibular Or Maxillary Alveolar Ridgefracture (Separate Procedure) Closed Treatment Of Mandibular Or Maxillary Alveolar Ridge |
| 21451-CPT | Moderate | Closed Treatment Of Mandibular, Closed Treatment Of Mandibular Fracture With Manipulationclosed Treatment Of Mandibular Fracture With Manipulation |
| 21452-CPT | Moderate | Percutaneous Treatment Of Mand, Percutaneous Treatment Of Mandibular Fracture With Externalfixation Percutaneous Treatment Of Mandibular Fracture With External |
| 21453-CPT | High | Closed Treatment Of Mandibular, Closed Treatment Of Mandibular Fracture With Interdentalfixation Closed Treatment Of Mandibular Fracture With Interdental |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21451. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21451 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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