Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 21452 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.
Percutaneous Treatment Of Mand, Percutaneous Treatment Of Mandibular Fracture With Externalfixation Percutaneous Treatment Of Mandibular Fracture With External
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None GC - Service performed by resident under supervision 51 - Multiple procedures AG - Primary physician LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 21452 |
| Medicaid Fee Schedule | View Medicaid rates for 21452 |
National average reimbursement for CPT 21452 by major payers:
$854.98
$861.68
$955.53
$728.89
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 21452.
CPT 21452
5 of 25 sample ratesHigher to lower in this preview
Seashore Surgical Institute, LLC
Seashore Surgical Institute
$2,629.00Published rateUh North Ridgeville Endoscopy Center LLC
$1,441.00Published rateMurrells Inlet Asc LLC, Carolina Coast Surgery Center
Murrells Inlet Asc, LLC Dba Carolina Coast Surgery Center
$726.00Published rateTriad Surgery Center, LLC, Triad Eye Institute
Triad Eye Institute, PLLC
$560.00Published rateArrowhead Surgery Center LLC
$347.00Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 21452 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21452 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 21452 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 |
|---|---|---|
| 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 |
| 21454-CPT | Moderate | Surgery To Repair Broken Jaw, Surgery To Repair A Broken Jaw Bone. A Mouth Splint Or Dental Wiring May Be Used To Bind The Jaw Shut And Stabilize The Bones. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21452. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21452 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 21452) and we'll show you how you compare in 15 minutes or less.