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See a sample rate comparisonCPT 21685 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.
Surgical Correction Of Airway, Surgery To Pull Hyoid Bone (C-Shaped Bone In Upper Neck) Forward. Procedure Is Done To Relieve Airway That Gets Blocked During Sleep.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None 51 - Multiple procedures AS - PA/NP/CNS assistant at surgery GC - Service performed by resident under supervision |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 21685 |
| Medicaid Fee Schedule | View Medicaid rates for 21685 |
National average reimbursement for CPT 21685 by major payers:
$1,262.64
$1,321.16
$1,354.37
$1,615.86
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CPT 21685
5 of 25 sample ratesHigher to lower in this preview
Beltway Surgery Centers, L.L.C.
$8,705.00Published rateCrown Point Surgery Center, LLC, Crown Point Surgery Center
Crown Point Surgery Center, LLC
$2,388.00Published rateDtc Surgery Center, LLC, Occ Surgery Center At Inverness
Dtc Surgery Center LLC
$1,682.00Published rateEndotech, LLC
Endotech LLC
$1,150.00Published rateWestglen Endoscopy Center LLC, Westglen Endoscopy Center
Westglen Endoscopy Center LLC
$622.00Published rate
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See a sample payer proposalCPT 21685 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21685 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 21685 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 |
|---|---|---|
| 21685-CPT | High | Surgical Correction Of Airway, Surgery To Pull Hyoid Bone (C-Shaped Bone In Upper Neck) Forward. Procedure Is Done To Relieve Airway That Gets Blocked During Sleep. |
| 21700-CPT | Moderate | Surgery On The Chest Muscle, Surgery To Divide The Chest Muscle For Treatment Of Thoracic Outlet Syndrome. This Condition Affects The Nerves In The Neck And Arms. |
| 21705-CPT | Moderate | Surgery On The Chest Muscle, Surgery To Divide The Chest Muscle For Treatment Of Thoracic Outlet Syndrome. This Condition Affects The Nerves In The Neck And Arms. |
| 21720-CPT | Moderate | Divisi Of Sternocleidomasto For Torticollis Open Opera; W/O, Division Of Sternocleidomastoid For Torticollis Open Operation; Witho |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21685. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21685 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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