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See a sample rate comparisonCPT 21705 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.
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.
| 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 RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 21705 |
| Medicaid Fee Schedule | View Medicaid rates for 21705 |
National average reimbursement for CPT 21705 by major payers:
$723.61
$768.51
$773.56
$884.74
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CPT 21705
5 of 25 sample ratesHigher to lower in this preview
Thr/Stt Rockwall Asc, LLC
$8,818.00Published rateAdventhealth Surgery Center Wellswood LLC, Adventhealth Surgery Center Wellswood
Adventhealth Surgery Center Wellswood LLC
$6,087.00Published rateNorthwest Eyelid And Orbital Specialists Ps, Neos Surgery Center
Northwest Eyelid And Orbital Specialists Ps
$3,127.00Published rateImperial Health, LLP
$2,213.00Published rateSpokane Digestive Disease Center, P.S., South Asc
Spokane Digestive Disease Center P.S.
$857.00Published rate
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See a sample payer proposalCPT 21705 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21705 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 21705 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 21705. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21705 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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