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 21485 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.
Fracture Treatment, Closed Treatment Of Temporomandibular Dislocation Initial Or Subsequent Complicated (Eg Recurrent Requiring Intermaxillary Fixation Or Splinting) Initial Or Subsequent
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 11 - Office 21 - Inpatient Hospital |
| Common Modifiers | None 50 - Bilateral Procedure RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 21485 |
| Medicaid Fee Schedule | View Medicaid rates for 21485 |
National average reimbursement for CPT 21485 by major payers:
$1,182.17
$1,024.69
$1,138.97
$1,389.63
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 21485.
CPT 21485
5 of 25 sample ratesHigher to lower in this preview
Texas Health Presbyterian Hospital Dallas
$2,761.00Published rateMonocacy Surgery Center LLC
Monocacy Surgery Center
$1,233.00Published rateNorthwest Surgery Center, LLC
$867.00Published rateKuresmart Pain Management Surgery Center, Clearway Surgery Center Of Dundalk
Kuresmart Pain Management Surgery Center
$611.00Published rateSurgery Center At Gateway LLC
$370.00Published 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 21485 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21485 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 21485 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 |
| 21480-CPT | Low | Closed Treatment Of Temporoman, Closed Treatment Of Temporomandibular Dislocationinitialor Subsequent Closed Treatment Of Temporo Mandibular Dislocation Initial |
| 21485-CPT | High | Fracture Treatment, Closed Treatment Of Temporomandibular Dislocation Initial Or Subsequent Complicated (Eg Recurrent Requiring Intermaxillary Fixation Or Splinting) Initial Or Subsequent |
| 21490-CPT | High | Open Treat Tmj Dislocation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21485. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21485 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 21485) and we'll show you how you compare in 15 minutes or less.