HCPCS S0021 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 | • Temporary National Codes (Non-Medicare) • Non-Medicare Drug Codes |
| Common Place of Service | • None • 11 - Office • 20 - Urgent Care Facility |
| Complexity Level | Low |
National average reimbursement for HCPCS S0021 by major payers:
$33.03
$18.26
$16.05
$15.43
| 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 HCPCS S0021 | ||||||
United | S0021 | $18.00 | 1225257801 - LEIF MEYERS | 454551946 - (ID) TETON VALLEY HEALTH CARE INC | MI | Emergency Medicine Physician (207P00000X) |
United | S0021 | $18.21 | 1598793036 - DANIEL ZIMMERMAN | 861441258 | NC | Physician Assistant (363A00000X) |
United | S0021 | $18.00 | 1942629126 - AMBER VESTER | 931251530 | OR | Family Medicine Physician (207Q00000X) |
United | S0021 | $18.00 | 1285658625 - ANN BOWERS | 911579410 - (WA) PHYSICIANS IMMEDIATE CARE MEDICAL CENTERS PS | OR | Emergency Medicine Physician (207P00000X) |
United | S0021 | $18.00 | 1245391192 - JONELL BLASE | 930593500 - (OR) DOCTORS EMERGENCY ROOM CORP PC | OR | Family Nurse Practitioner (363LF0000X) |
United | S0021 | $18.00 | 1205022688 - JEANNE CULLEN | 201508867 | OR | Registered Dietitian (133V00000X) |
United | S0021 | $18.00 | 1720590987 - PAMELA COTTON | 930593500 - (OR) DOCTORS EMERGENCY ROOM CORP PC | OR | Family Nurse Practitioner (363LF0000X) |
United | S0021 | $18.00 | 1386909851 - KYLE KURZET | 930421470 - (OR) WILLAMETTE COMMUNITY HEALTH SOLUTIONS | OR | Family Medicine Physician (207Q00000X) |
United | S0021 | $18.00 | 1285658625 - ANN BOWERS | 911579410 - (WA) PHYSICIANS IMMEDIATE CARE MEDICAL CENTERS PS | OR | Emergency Medicine Physician (207P00000X) |
United | S0021 | $18.00 | 1598793036 - DANIEL ZIMMERMAN | 930593500 - (OR) DOCTORS EMERGENCY ROOM CORP PC | OK | Physician Assistant (363A00000X) |
United | S0021 | $18.00 | 1598359234 - ZACHERY EHRENFELT | 930421470 - (OR) WILLAMETTE COMMUNITY HEALTH SOLUTIONS | OR | Physical Therapist (225100000X) |
United | S0021 | $18.00 | 1124242086 - KATHY MELDRUM | 930421470 - (OR) WILLAMETTE COMMUNITY HEALTH SOLUTIONS | OR | Physical Therapist (225100000X) |
United | S0021 | $18.00 | 1376327809 - JULIA O'NEIL | 930421470 - (OR) WILLAMETTE COMMUNITY HEALTH SOLUTIONS | OR | Registered Dietitian (133V00000X) |
United | S0021 | $18.00 | 1750693552 - JUDITH EMMANERE | 930421470 - (OR) WILLAMETTE COMMUNITY HEALTH SOLUTIONS | OR | Hand Occupational Therapist (225XH1200X) |
United | S0021 | $18.00 | 1093741803 - CHARLES PEDERSON | 930593500 - (OR) DOCTORS EMERGENCY ROOM CORP PC | OR | Occupational Medicine Physician (2083X0100X) |
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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
HCPCS S0021 vs. Other Non-Medicare Drug Codes Codes
The HCPCS S0021 code is part of the Temporary National Codes (Non-Medicare) services used for Non-Medicare Drug Codes. 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 HCPCS S0021 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 |
|---|---|---|
| S0017-HCPCS | Low | Injection, aminocaproic acid, 5 grams |
| S0021-HCPCS | Low | Injection, cefoperazone sodium, 1 gram |
| S0023-HCPCS | Low | Injection, cimetidine hydrochloride, 300 mg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS S0021. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the S0021 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like HCPCS S0021) and we'll show you how you compare in 15 minutes or less.