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See a sample rate comparisonCPT 21825 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.
Open Treatment Of Sternum Frac, Open Treatment Of Sternum Fracture With Or Withoutskeletal Fixation Open Treatment Of Sternum Frac Ture With Or Without Skeletal
| 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 AS - PA/NP/CNS assistant at surgery 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 21825 |
| Medicaid Fee Schedule | View Medicaid rates for 21825 |
National average reimbursement for CPT 21825 by major payers:
$698.40
$745.95
$780.44
$906.04
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CPT 21825
5 of 25 sample ratesHigher to lower in this preview
Piedmont Asc LLC
$7,229.00Published rateCentral Jersey Ambulatory Surgical Center, LLC
Central Jersey Ambulatory Surgical Center LLC
$5,484.00Published rateUniversity Of Miami, Umiami Medicine - Ophthalmology (Naples Bascom Palmer - Asc)
University Of Miami
$3,820.00Published rateSouthwest Endoscopy Ltd
$2,382.00Published rateWashburn Surgery Center, LLC
Washburn Surgery Center LLC
$819.00Published rate
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See a sample payer proposalCPT 21825 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21825 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 21825 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 |
|---|---|---|
| 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. |
| 21820-CPT | Low | Red Fx-Sternum Closed |
| 21825-CPT | Moderate | Open Treatment Of Sternum Frac, Open Treatment Of Sternum Fracture With Or Withoutskeletal Fixation Open Treatment Of Sternum Frac Ture With Or Without Skeletal |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21825. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21825 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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