CPT 21933 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Surgery • Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • AS - PA/NP/CNS assistant at surgery • RT - Right side of body |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 21933 |
National average reimbursement for CPT 21933 by major payers:
$1,039.54
$1,015.19
$1,045.61
$1,250.25
| 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 21933 | ||||||
United | 21933 | $3150.00 | 1124083076 - NORTH GARLAND SURGERY CENTER LLP, BAYLOR SCOTT & WHITE SURGICARE - NORTH GARLAND | 562399993 - (TX) NORTH GARLAND SURGERY CENTER LLP | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21933 | $2621.00 | 1396342481 - PIEDMONT ASC LLC | 851448653 | NC | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21933 | $5447.00 | 1700341468 - PORT WARWICK SURGERY CENTER, LLC | 832749039 - (VA) PORT WARWICK SURGERY CENTER LLC | VA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21933 | $1947.00 | 1538146931 - WILLAMETTE SURGERY CENTER LLC | 260018738 - (OR) WILLAMETTE SURGERY CENTER, P.C. | OR | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21933 | $410.00 | 1255311635 - MELBOURNE ASC LP, THE SURGERY CENTER OF MELBOURNE | 621625311 - (FL) MELBOURNE ASC LP | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21933 | $8705.00 | 1386159853 - BELTWAY SURGERY CENTERS, LLC, EAGLE HIGHLANDS SURGERY CENTER | 352072586 | IN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21933 | $1090.00 | 1871260554 - JOHNS HOPKINS SURGERY CENTERS SERIES | 208707724 - (MD) JOHNS HOPKINS SURGERY CENTER SERIES | MD | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21933 | $1200.00 | 1023542339 - BATON ROUGE VASCULAR ACCESS ASC LLC | 814685509 - (LA) BATON ROUGE VASCULAR ACCESS ASC LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21933 | $1652.00 | 1609815075 - ORTHOATLANTA SURGERY CENTER OF FAYETTEVILLE, LLC | 202961633 - (GA) ORTHOATLANTA SURGERY CENTER OF FAYETTEVILLE LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21933 | $1701.00 | 1659360071 - EAST TENNESSEE AMBULATORY SURGERY CENTER LLC | 621787537 - (TN) EAST TENNESSEE AMBULATORY SURGERY CENTER | TN | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21933 | $900.00 | 1508531641 - ALLIANCE SURGERY CENTER AT SANDY SPRINGS LLC | 871977629 - (GA) ALLIANCE SURGERY CENTER AT SANDY SPRINGS LLC | GA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21933 | $7169.00 | 1346235058 - EAST MEQUON SURGERY CENTER LLC | 861075286 - (WI) EAST MEQUON SURGERY CENTER LLC | WI | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21933 | $551.00 | 1366710741 - THE EYE PHYSICIANS OF PINELLAS, PA, LARGO AMBULATORY SURGERY CENTER | 593400241 - (FL) THE EYE PHYSICIANS OF PINELLAS, P.A. | FL | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21933 | $1550.00 | 1841840758 - GULFSTREAM PARC ASC LLC | 843025864 - (TX) GULFSTREAM PARC ASC LLC | TX | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 21933 | $684.00 | 1619920501 - CENTER FOR DIGESTIVE HEALTH | 364532301 - (IL) THE CENTER FOR DIGESTIVE HEALTH, LLC | IL | 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 21933 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 21933 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 21933 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 |
|---|---|---|
| 21933-CPT | High | Exc Tumor Soft Tiss Back Flank Subfascial 5 Cm |
| 21935-CPT | High | Radical Resection Of Tumor (Eg Sarcoma) Soft Tissue Of Back Or Flank; Less Than 5 Cm (Revised 01/01/2014) |
| 21936-CPT | High | Radical Resection Of Tumor (Eg Sarcoma) Soft Tissue Of Back Or Flank; 5 Cm Or Greater (Revised 01/01/2014) |
| 22010-CPT | High | Bx Spinal Sft Tissues;Superf-21920 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 21933. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 21933 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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