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 21610 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.
Costotransversectomy (Sep Proc)
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 21 - Inpatient Hospital 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None AS - PA/NP/CNS assistant at surgery 51 - Multiple procedures |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 21610 |
| Medicaid Fee Schedule | View Medicaid rates for 21610 |
National average reimbursement for CPT 21610 by major payers:
$1,618.18
$1,567.12
$1,607.39
$1,874.29
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 21610.
CPT 21610
5 of 25 sample ratesHigher to lower in this preview
The Endoscopy Center At St. Francis, LLC
The Endoscopy Center At St Francis LLC
$11,198.00Published rateCedar Park Surgery Center, LLC
Cedar Park Surgery Center LLC
$2,585.00Published rateSurgcenter Of Bel Air
Surgcenter Of Bel Air, LLC
$2,117.00Published rateLangley Holdings, LLC
$1,300.00Published rateCentral Florida Eye Institute Pl
$617.00Published 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 21610 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21610 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 21610 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 |
|---|---|---|
| 21610-CPT | High | Costotransversectomy (Sep Proc) |
| 21615-CPT | Moderate | Surgery To Remove A Rib, Surgery To Remove The First Rib. If There Is An Extra Rib Above The First Rib In The Neck (Cervical Rib) It Will Be Removed As Well. |
| 21620-CPT | Moderate | Ostectomy Sternum Partial |
| 21630-CPT | High | Resect Sternum Radical-Tumor |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21610. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21610 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 21610) and we'll show you how you compare in 15 minutes or less.