CPT 21750 Fee Schedule
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.
| 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 • 58 - Staged or related procedure during postoperative period • AS - PA/NP/CNS assistant at surgery |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 21750 |
National average reimbursement for CPT 21750 by major payers:
$858.29
$938.74
$999.14
$1,136.44
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 21750 | ||||||
United | 21750 | $4444.00 | 1710037452 - ILLINOIS SPORTS MEDICINE & ORTHOPEDIC SURGERY CENTER, LLC | 201054630 - (IL) ILLINOIS SPORTS MEDICINE AND ORTHOPEDIC SURGERY CENTER, LLC | IL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21750 | $14053.00 | 1659839686 - AURORA SURGERY CENTERS, LLC | 811401714 - (WI) AURORA SURGERY CENTERS LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21750 | $5981.00 | 1427422799 - WEBSTER AMBULATORY SUGERY CENTER LP, SUNSET HILLS SURGERY CENTER | 205953387 | MO | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21750 | $1691.00 | 1033210760 - CARLISLE ENDOSCOPY CENTER, LTD. | 251871866 - (PA) CARLISLE ENDOSCOPY CENTER LTD | PA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21750 | $2788.00 | 1194970418 - PACIFIC CATARACT AND LASER INSTITUTE INC PC | 911394965 - PACIFIC CATARACT AND LASER INSTITUTE, INC., PC | NM | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21750 | $8818.00 | 1487399168 - WILLOW PARK ENDOSCOPY CENTER, LLC | 881643733 - (TX) WILLOW PARK ENDOSCOPY CENTER LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21750 | $900.00 | 1598189342 - MEI SURGERY CENTER LLC, MICHIGAN EYE SURGERY CENTER | 461591012 - (MI) MEI SURGERY CENTER LLC | MI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21750 | $17168.00 | 1326046822 - SOUTH EMERSON SURGERY CENTER, LLC | 352087260 - (IN) SOUTH EMERSON SURGERY CENTER, LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21750 | $2560.00 | 1588224802 - FLOWOOD SURGERY CENTER LLC | 842131306 - (MS) FLOWOOD SURGERY CENTER LLC | MS | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21750 | $4170.00 | 1861782591 - CENTER FOR AMBULATORY AND MINIMALLY INVASIVE SURGERY LLC, CAMIS | 270907140 - (NJ) CENTER FOR AMBULATORY AND MINI | NJ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21750 | $11344.00 | 1760035158 - LEIGH ORTHOPEDIC SURGERY CENTER, LLC | 832402528 - (VA) LEIGH ORTHOPEDIC SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21750 | $4724.00 | 1558832741 - GRAND AVENUE SURGERY CENTER, LLC | 831834803 - (CA) GRAND AVENUE SURGERY CENTER LLC | CA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21750 | $1050.00 | 1164871075 - CENTRAL ARIZONA GI & LIVER INSTITUTE LLC | 812583508 | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21750 | $6365.00 | 1699777540 - PHYSICIANS SURGERY CENTER OF TEMPE, LLC, PHYSICIANS SURGERY CENTER OF TEMPE | 731538769 - (AZ) PHYSICIANS SURGERY CENTER OF TEMPE LLC | AZ | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21750 | $5012.00 | 1295381572 - SOUTH SUBURBAN SURGICAL SUITES, LLC, SOUTH SUBURBAN SURGICAL SUITES | 842207819 - (IN) SOUTH SUBURBAN SURGICAL SUITES LLC | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 21750 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21750 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 21750 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 |
|---|---|---|
| 21602-CPT | High | Excision Of Chest Wall Tumor Involving Rib(S) With Plastic Reconstruction; Without Mediastinal Lymphadenectomy |
| 21603-CPT | High | Excision Of Chest Wall Tumor Involving Rib(S) With Plastic Reconstruction; With Mediastinal Lymphadenectomy |
| 21750-CPT | Moderate | Close Sternotomy Separation W/Wo Debride |
| 21811-CPT | Moderate | Once Per Dos Open Treatment Of Rib Fracture W/Internal Fixation, Includes Thoracoscopic Visualization When Performed; Unilateral 1-2 Ribs |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21750. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21750 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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