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 21743 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.
Repair Sternum Nuss W Scope, Reconstructive Repair Of Pectus Excavatum Or Carinatum Minimally Invasive Approach Nuss Procedure With Thoracoscopy
| 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 22 - Increased Procedural Services 80 - Assistant surgeon |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 21743 |
| Medicaid Fee Schedule | View Medicaid rates for 21743 |
National average reimbursement for CPT 21743 by major payers:
$2,030.89
$1,780.11
$2,012.67
$2,800.14
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 21743.
CPT 21743
5 of 25 sample ratesHigher to lower in this preview
River Valley Asc LLC, River Valley Asc, LLC
River Valley Asc LLC
$5,922.00Published rateIllinois Sports Medicine & Orthopedic Surgery Center, LLC
Illinois Sports Medicine And Orthopedic Surgery Center, LLC
$3,860.00Published rateIndiana Vascular Surgery Center LLC
$2,528.00Published rateHamilton Endoscopy And Surgery Center, LLC
Hamilton Endoscopy & Surgery Center, LLC
$1,196.00Published rateEndosurg Outpatient Center LLC
$625.00Published 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 21743 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21743 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 21743 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 |
|---|---|---|
| 21627-CPT | Moderate | Sternal Debridement |
| 21740-CPT | High | Chest Reconstructive Surgery, Surgery To Correct Bone Growth That Has Resulted In The Breastbone Caving Inward Or Pushing Outward. |
| 21742-CPT | High | Repair Stern Nuss W O Scope, Reconstructive Repair Of Pectus Excavatum Or Carinatum Minimally Invasive Approach Nuss Procedure Without Thoracoscopy |
| 21743-CPT | High | Repair Sternum Nuss W Scope, Reconstructive Repair Of Pectus Excavatum Or Carinatum Minimally Invasive Approach Nuss Procedure With Thoracoscopy |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21743. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21743 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 21743) and we'll show you how you compare in 15 minutes or less.