CPT 21337Surgery

Closed tx septal&nose fx

CPT code 21337 covers the closed (non-surgical) treatment of a broken nose and nasal septum, where the doctor manually realigns the bones without making incisions or using internal fixation devices.

Showing rates for

National Average

Base Medicare rate

$406.27

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

3.39

PE RVU (NF)

8.65

MP RVU

0.52

Total RVU

12.56

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

Loading bundling edits…

Billing tips

Bill in non-facility setting when performing in office or clinic to capture full $406.27 versus $298.56 facility rate
Impact: $107.71 higher reimbursement (36% increase) when performed in non-facility setting
Do not bill 21337 with 21335 (closed treatment nasal bone fracture without septal involvement); 21337 is the comprehensive code when both structures are treated
Impact: Prevents unbundling denials and potential recoupment of $298-406 per claim
Document septal involvement explicitly with pre- and post-reduction assessment of septal position and airway patency to justify 21337 over simpler nasal codes
Impact: 21337 pays approximately $100-150 more than 21335; lack of septal documentation triggers downcoding
Perform and bill within 14 days of injury; after this window, procedure may require 21338 (open treatment) or be considered cosmetic rhinoplasty
Impact: Prevents complete denial and reclassification as non-covered cosmetic procedure
When performed under anesthesia, ensure anesthesia provider bills appropriately (not included in 21337); typical anesthesia time 15-30 minutes
Impact: Ensures anesthesia revenue is not lost; typically adds $150-300 in facility anesthesia charges
Bill evaluation and management (E/M) separately with modifier 25 only when significant, separately identifiable service beyond fracture assessment is documented
Impact: Can add $75-150 for appropriate level E/M, but high audit risk if not clearly documented as separate

Live Field Datano reports yet

Real billers contribute denial patterns and appeal strategies for this code. Once 5+ reports come in, you’ll see live aggregated data here — the only place this exists, free.

Working with CPT 21337?

Get the free Revenue Protection Toolkit — the denial triggers, modifier pitfalls, and bundling conflicts that quietly cost you reimbursement. Instant download.

Help build the field knowledge

MedPayIQ gets smarter as billers contribute. If you've had this code denied, share what happened so others learn from it. Anonymous, no patient info.

Related actions

Frequently asked questions

What is the 2025 Medicare reimbursement rate for CPT code 21337?

The 2025 Medicare national average reimbursement for CPT 21337 is $406.27 in non-facility settings and $298.56 in facility settings, based on 12.56 total RVUs and the 32.3465 conversion factor from CMS Physician Fee Schedule RVU25A.

What is the difference between CPT 21337 and 21335?

CPT 21335 covers closed treatment of nasal bone fracture only, while CPT 21337 includes treatment of both nasal bone AND septal fractures. Code 21337 requires documentation of septal involvement and manipulation, and reimburses approximately $100-150 more than 21335.

Can I bill an E/M code with CPT 21337 on the same day?

Yes, you can bill a separate E/M service with modifier 25 on the same day as 21337, but only when the E/M represents a significant, separately identifiable service beyond the routine evaluation included in the fracture treatment decision. Documentation must clearly support the separate nature of the E/M service to avoid bundling denials.

What is the global period for CPT 21337?

CPT 21337 has a 10-day global period, meaning routine follow-up care within 10 days post-procedure is included in the reimbursement. Any unrelated services during this period require modifier 79, and related procedures require modifier 78 with appropriate documentation.

How many RVUs is CPT code 21337 worth in 2025?

CPT 21337 has 12.56 total RVUs in 2025, comprised of 3.39 work RVUs, 8.65 non-facility practice expense RVUs (5.32 facility), and 0.52 malpractice RVUs according to CMS RVU25A data.

What documentation is required to bill CPT 21337 instead of 21335?

To justify CPT 21337, documentation must explicitly describe septal fracture or displacement, detail the septal manipulation or reduction performed (not just nasal bone), and include both pre- and post-reduction assessment of septal position. Without clear septal documentation, payers will downcode to 21335.

How long after injury can you bill CPT 21337 for nasal fracture reduction?

CPT 21337 is typically appropriate within 7-14 days of injury, when closed reduction is still feasible before significant callus formation. After 2-3 weeks, the procedure may require open treatment (21338) or be denied as cosmetic. When billing beyond 14 days, detailed documentation explaining the delayed treatment timeline is essential to avoid medical necessity denials.