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See a sample rate comparisonCPT 21462 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.
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.
| 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 LT - Left side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 21462 |
| Medicaid Fee Schedule | View Medicaid rates for 21462 |
National average reimbursement for CPT 21462 by major payers:
$2,363.58
$2,737.02
$2,881.98
$1,879.83
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CPT 21462
5 of 25 sample ratesHigher to lower in this preview
Beltway Surgery Centers, L.L.C.
$11,291.00Published rateTampa Surgical Center LLC
$2,800.00Published rateGalea Center, LLC., Galea Center For Advanced Surgery
Galea Center LLC
$1,850.00Published rateBean Center For Foot Surgery Inc, Sierra Center For Foot Surgery
Bean Center For Foot Surgery Inc
$1,198.00Published ratePomerado Outpatient Surgical Center L P, Palomar Surgical Center Escondido
Pomerado Outpatient Surgical Center L P
$576.00Published rate
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See a sample payer proposalCPT 21462 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21462 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 21462 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 |
|---|---|---|
| 21461-CPT | High | Open Treatment Of Mandibular F, Open Treatment Of Mandibular Fracture Without Interdentalfixation Open Treatment Of Mandibular Fracture Without Interdental |
| 21462-CPT | High | 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. |
| 21465-CPT | High | 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. |
| 21470-CPT | High | Open Treatment Of Complicated, Open Treatment Of Complicated Mandibular Fracture Bymultiple Surgical Approaches Including Internal Fixation Interdental Fixation Andor Wiring Of Dentures Or Splints |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21462. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21462 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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