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See a sample rate comparisonCPT 21813 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 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 23 - Emergency Room |
| Common Modifiers | None LT - Left side of body RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 21813 |
| Medicaid Fee Schedule | View Medicaid rates for 21813 |
National average reimbursement for CPT 21813 by major payers:
$1,352.60
$1,376.19
$1,355.84
$1,623.22
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CPT 21813
5 of 25 sample ratesHigher to lower in this preview
Methodist Healthcare System Of San Antonio, Ltd., L.L.P., Methodist Hospital
$5,225.00Published rateAmbulatory Surgery Associates, LLC, Brookside Surgery Center
Ambulatory Surgery Associates
$2,090.00Published rateGoldstep Ambulatory Surgery Center, LLC
Goldstep Ambulatory Surgery Center LLC
$1,445.00Published rateGlendora Ca Endoscopy Asc Lp, Glendora Digestive Disease Institute
$1,134.00Published rateCottonwood Day Surgery Center
Cottonwood Day Surgery Center, Inc.
$614.00Published rate
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See a sample payer proposalCPT 21813 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21813 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 21813 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 21813. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21813 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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