CPT 21172

Musculoskeletal

Current code36 hospitals with prices

This name is the CMS category the code belongs to (CMS's Restructured BETOS Classification System), shared with similar codes. The official CPT description belongs to the American Medical Association and isn't shown.

What Washington hospitals publish for this code

Medicaid managed care: Rate for an Apple Health managed-care plan. Applies only to members of that plan.

Prices for CPT 21172 by hospital
HospitalMedicaid managed care rates (lowest – highest)Cash priceList price (before discounts)
Legacy Salmon Creek Medical CenterVancouverFile dated 2026-04-01—$1,369 – $3,911Doctor’s fee: $2,542 – $3,911$2,106 – $6,017Doctor’s fee: $3,911 – $6,017
Seattle Children's HospitalSeattle$1,250 – $1,3359 plans$8,945$8,945
Virginia Mason Medical CenterSeattle—$6,523$12,791

Lowest and highest amounts each hospital lists for this code during a hospital stay, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.

Doctor's fee, Seattle (King County)
$2,242 in a hospital or surgery center
Doctor's fee, rest of Washington
$2,050 in a hospital or surgery center
Hospital outpatient payment (national)
$6,048 (APC 5165)
Surgery center payment (national)
$3,026

How hospitals also write this code

Some price files write it differently. These are counted as CPT 21172:

  • 21172P (with a letter after it, P; 2 price lines)
  • 21172T (with a letter after it, T; 1 price line)