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See a sample rate comparisonCPT 21620 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Ostectomy Sternum Partial
| 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 51 - Multiple procedures AS - PA/NP/CNS assistant at surgery |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 21620 |
| Medicaid Fee Schedule | View Medicaid rates for 21620 |
National average reimbursement for CPT 21620 by major payers:
$618.88
$692.86
$721.04
$832.30
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CPT 21620
5 of 25 sample ratesHigher to lower in this preview
Advanced Endoscopy Center LLC
Advanced Endoscopy Center, LLC
$5,966.00Published rateSurgicare Of Freehold Limited Liability Company
$3,422.00Published rateWills Eye Surgery Center
Wilmington Ambulatory Surgical Center LLC
$2,530.00Published rateRand Surgical Pavillion Corp
$1,636.00Published rateCarolina Digestive Health Associates, PA, Carolina Digestive Endoscopy Center
Carolina Digestive Health Associates, PA
$519.00Published rate
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See a sample payer proposalCPT 21620 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21620 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 21620 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. |
| 21616-CPT | High | 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 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21620. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21620 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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