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 21811 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.
Surgical Repair Of Broken Rib, Surgery To Repair And Stabilize One Or More Broken Ribs. The Bones May Be Held In Place For Healing With Pins Screws Wires Or An External Frame System. The Procedure Uses A Tiny Camera Inserted Into The Chest Cavity Through A Small Cut.
| 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 LT - Left side of body RT - Right side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 21811 |
| Medicaid Fee Schedule | View Medicaid rates for 21811 |
National average reimbursement for CPT 21811 by major payers:
$777.18
$835.60
$835.58
$967.37
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 21811.
CPT 21811
5 of 25 sample ratesHigher to lower in this preview
Lake Spivey Ambulatory Surgery Care, LLC, Spivey Station Surgery Center
Emory University
$4,041.00Published ratePhysicians Outpatient Surgery Center LLC
$1,995.00Published rateMed Atlantic Inc, Med Atlantic Inc Dba Urosurgical Ctr Of Richmond
$1,429.00Published rateAlta-Rose Surgery Center LLC
$1,060.00Published rateSuffolk Surgery Center LLC
$565.00Published 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 21811 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21811 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 21811 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 |
|---|---|---|
| 21750-CPT | Moderate | Closur Of Median Strnotomy Separat W//W/O Debrideme (S, Closure Of Median Sternotomy Separation With Or Without Debridement (S |
| 21811-CPT | Moderate | Surgical Repair Of Broken Rib, Surgery To Repair And Stabilize One Or More Broken Ribs. The Bones May Be Held In Place For Healing With Pins Screws Wires Or An External Frame System. The Procedure Uses A Tiny Camera Inserted Into The Chest Cavity Through A Small Cut. |
| 21812-CPT | Moderate | Surgical Repair Of Broken Rib, Surgery To Repair And Stabilize One Or More Broken Ribs. The Bones May Be Held In Place For Healing With Pins Screws Wires Or An External Frame System. The Procedure Uses A Tiny Camera Inserted Into The Chest Cavity Through A Small Cut. |
| 21813-CPT | High | Surgical Repair Of Broken Rib, Surgery To Repair And Stabilize One Or More Broken Ribs. The Bones May Be Held In Place For Healing With Pins Screws Wires Or An External Frame System. The Procedure Uses A Tiny Camera Inserted Into The Chest Cavity Through A Small Cut. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21811. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21811 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 21811) and we'll show you how you compare in 15 minutes or less.