CPT 21602 Fee Schedule
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.
| 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 • 62 - Co-Surgeons • GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 21602 |
National average reimbursement for CPT 21602 by major payers:
$1,995.98
$2,199.27
$2,162.30
$2,601.74
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 21602 | ||||||
United | 21602 | $5122.00 | 1003103474 - NEW ALBANY SURGERY CENTER, LLC | 451617821 - (OH) NEW ALBANY SURGERY CENTER, LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21602 | $3134.00 | 1619643608 - CARDIOVASCULAR ASC LLC | 462883732 - (FL) CARDIOVASCULAR ASC LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21602 | $5330.00 | 1205875283 - RWJ ENDOSURGICAL CENTER LLC | 900872940 - (NJ) RWJ ENDOSURGICAL CENTER LLC | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21602 | $4816.00 | 1750491205 - ENT SURGERY CENTER OF ATLANTA,LLC | 200075229 - (GA) ENT SURGERY CENTER OF ATLANTALLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21602 | $9182.00 | 1184922353 - PEARLAND SURGERY CENTER, LLC | 270289493 - (TX) PEARLAND SURGERY CENTER, LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21602 | $6087.00 | 1043803877 - PALM BEACH INTERNATIONAL SURGERY CENTER LLC, PALM BEACH INTERNATIONAL SURGERY CENTER AT THE PALEY INSTITUTE | 384092545 - (FL) PALM BEACH INTERNATIONAL SURGERY CENTER LLC | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21602 | $9182.00 | 1518344043 - MEMORIAL HERMANN SURGERY CENTER KIRBY, LLC, MEMORIAL HERMANN SURGERY CENTER KIRBY GLEN | 364801162 | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21602 | $1032.00 | 1023103769 - OAK LAWN ENDOSCOPY LLC | 462381028 | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21602 | $6914.00 | 1336148360 - BOULDER COMMUNITY MUSCULOSKELETAL SURGERY CENTER, LLC, BOULDER SURGERY CENTER | 201391702 - (CO) BOULDER COMMUNITY MUSCULOSKELETAL SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21602 | $2058.00 | 1306320338 - ALABAMA EYE SURGERY CENTER LLC | 814662532 - (AL) ALABAMA EYE SURGERY CENTER LLC | AL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21602 | $3000.00 | 1861663098 - ASCENT SURGERY CENTER, LLC | 262011928 - (CO) ASCENT SURGERY CENTER LLC | CO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21602 | $2459.00 | 1255345229 - BEACON ORTHOPAEDICS SURGERY CENTER, LLC, SUMMIT SURGERY CENTER | 311800570 - (OH) BEACON ORTHOPAEDICS SURGERY CENTER LLC | OH | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21602 | $4445.00 | 1508942996 - PHYSICIANS SURGERY SERVICES LP, ADVANCED SURGERY CENTER | 201074818 - (CA) PHYSICIAN SURGERY SERVICES L.P. | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21602 | $2911.00 | 1083873277 - VENTURE AMBULATORY SURGERY CENTER LLC | 743257508 | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21602 | $3400.00 | 1053385856 - JACKSON OPHTHALMOLOGY ASC LLC, PHYSICIANS SURGERY CENTER | 752842260 - (TN) JACKSON OPHTHALMOLOGY ASC, LLC DBA PHYSICIANS SUR | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 21602 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21602 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 21602 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 |
|---|---|---|
| 21555-CPT | Moderate | Removal Of (Less Than 3 Centimeters) Tissue Growth Beneath The Skin Of Neck Or Front Of Chest |
| 21556-CPT | Moderate | Excision, Tumor, Soft Tissue Of Neck Or Anterior Thorax, Subfascial (Eg, Intramuscular); Less Than 5 Cm |
| 21600-CPT | Moderate | Excision Rib Partial |
| 21602-CPT | High | Excision Of Chest Wall Tumor Involving Rib(S) With Plastic Reconstruction; Without Mediastinal Lymphadenectomy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21602. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21602 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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