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See a sample rate comparisonCPT 21490 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.
Open Treat Tmj Dislocation
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 11 - Office |
| Common Modifiers | None LT - Left side of body 50 - Bilateral Procedure |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 21490 |
| Medicaid Fee Schedule | View Medicaid rates for 21490 |
National average reimbursement for CPT 21490 by major payers:
$1,155.15
$1,163.99
$1,137.09
$1,368.48
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CPT 21490
5 of 25 sample ratesHigher to lower in this preview
Hss Asc Of Manhattan LLC, Hss Asc Of Manhattan
$9,710.00Published rateWest Bend Surgery Center LLC
$5,094.00Published rateNacogdoches County Hospital District, Nacogdoches Memorial Hospital Day Surgery
Lion Star Nacogdoches Hospital, LLC Dba Nacogdoches Memorial Hospital
$2,211.00Published rateTriad Surgery Center LLC, Triad Eye Medical Clinic And Cataract Institute PLLC
$1,732.00Published rateSteven Cook
Deaconess Hospital Inc
$715.29Published rate
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See a sample payer proposalCPT 21490 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21490 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 21490 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 |
|---|---|---|
| 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 |
| 21497-CPT | Moderate | Interdental Wire Condition Not Frac |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21490. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21490 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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