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CPT code 21121: Sliding genioplasty, single-piece osteotomy2026 Medicare rate & RVUs in Nevada

Reports a single-piece chin osteotomy repositioned to correct chin projection, asymmetry, or contour by moving the bone segment.

CMS RVU26DEffective Oct 1, 2026One payment locality

In Nevada, Medicare pays $645.50 for 21121 in the office and $482.34 when it’s performed in a hospital or facility.

$645.50Office (non-facility)
$482.34Hospital or facility
−0.7%vs the national office rate ($649.98)

Check a contract rate as a % of Medicare · 21121 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 21121 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Nevada
  2. What 21121 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 21121 covers

This operation reshapes the chin by cutting the mandibular symphysis as one segment, moving that segment to a planned position, and securing it. Oral and maxillofacial surgeons and plastic surgeons perform it in an operating room for concerns such as chin retrusion, excess projection, asymmetry, or vertical contour. It may be performed alone or as part of orthognathic reconstruction.

Choose 21121 when the operative report documents one sliding bone segment; a multisegment osteotomy or added augmentation changes the code selection. Document the osteotomy configuration, direction of movement, fixation, and any graft or implant work. CMS assigns a 90-day major-surgery global: the day-before preoperative visit and related postoperative care through day 90 are included. For multiple procedures in one session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. CMS permits assistant-at-surgery payment, but not co-surgeon or team-surgery payment. The midline chin procedure is reported without modifier 50; bilateral adjustment is inappropriate.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Nevada compares for 21121

Across 109 of 109 payment localities, the office rate for 21121 runs from $584.18 in Arkansas to $826.56 in San Benito County, CA. Nevada pays $645.50. The RVUs are the same everywhere; the geographic indexes change the dollars.

21121 in Nevada vs other payment areas
  1. Nevada · this page$645.50
  2. Los Angeles, CA · California$717.75+$72.25
  3. Washington, DC area · District of Columbia$732.27+$86.77
  4. Miami, FL · Florida$709.45+$63.95
  5. Chicago, IL · Illinois$691.23+$45.73
  6. Manhattan, NY · New York$742.69+$97.19
  7. Alaska · Alaska$787.86+$142.36

Other areas in Nevada first, then benchmark localities. Bars start at $0.

Every other payment area

21121 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$591.53$448.91
ArkansasArkansas$584.18$444.16
ArizonaArizona$634.43$476.48
Bakersfield, CACalifornia$678.66$500.01
Chico, CACalifornia$676.03$497.38
El Centro, CACalifornia$676.17$497.53
Fresno, CACalifornia$676.03$497.38
Hanford, CACalifornia$676.03$497.38

21121 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$584.18

$787.86

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
21121 office rate range by state
State / territoryOffice rate rangeLocalities
AK$787.861
AL$591.531
AR$584.181
AZ$634.431
CA$676.03–$826.5629
CO$670.141
CT$689.411
DC$732.271
DE$643.921
FL$648.46–$709.453
GA$615.95–$662.452
GU$687.991
HI$687.991
IA$601.291
ID$605.331
IL$634.44–$691.234
IN$608.271
KS$600.361
KY$606.801
LA$606.59–$632.302
MA$667.59–$728.352
MD$654.54–$732.273
ME$609.66–$635.962
MI$621.82–$657.082
MN$640.161
MO$598.62–$632.443
MS$591.421
MT$649.921
NC$614.921
ND$632.721
NE$603.671
NH$661.391
NJ$696.71–$726.652
NM$625.381
NV$645.501
NY$623.01–$760.475
OH$618.311
OK$604.261
OR$639.88–$687.322
PA$618.31–$675.202
PR$653.581
RI$663.781
SC$617.751
SD$630.691
TN$603.151
TX$614.91–$668.458
UT$625.011
VA$635.20–$732.272
VI$653.581
VT$631.961
WA$665.78–$740.622
WI$614.471
WV$614.461
WY$642.431

See 21121 in every payment locality

How the 21121 rate is calculated

Each of 21121’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 21121

RVUs × geographic indexes × conversion factor

Office or facility?

Work7.61

7.61 RVUs× 1.000 GPCI

Practice expense10.98

10.98 RVUs× 1.000 GPCI

Malpractice0.87

0.87 RVUs× 1.000 GPCI

Adjusted RVUs

19.4600

Conversion factor

$33.4009

Medicare rate

$649.98

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Nevada inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,878

Code
21121
Physician work
7.61
Practice expense
10.98
Malpractice
0.87

GPCI2026.csv

73

Locality
Nevada
Physician work
1.000
Practice expense
1.001
Malpractice
0.833
Office calculation for 21121 in Nevada
ComponentRVULocality factorAdjusted
Physician work7.61× 1.0007.6100
Practice expense10.98× 1.00110.9910
Malpractice0.87× 0.8330.7247
Total RVUs19.3257
Conversion factor× 33.4009

Office rate, Nevada$645.50

Office: (7.61 × 1 + 10.98 × 1.001 + 0.87 × 0.833) × $33.4009 = $645.50

Facility: (7.61 × 1 + 6.1 × 1.001 + 0.87 × 0.833) × $33.4009 = $482.34

Open 21121 in the RVU calculator

Payment rules and modifiers for 21121

21121 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21121

Sliding genioplasty, single-piece osteotomy

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 21121

Sliding genioplasty, single-piece osteotomy

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

21121 without 51 · national office

$649.98

Sliding genioplasty, single-piece osteotomy

21121-51 · Second procedure: 50%

$324.99

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 21121

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 21121
CodeHow it relatesOffice range, Nevada
Used instead
21120Chin augmentation, augmentation without sliding osteotomyUsed for chin augmentation rather than a sliding osteotomy.$710.83
Same family
21122Sliding genioplasty, two or more osteotomiesSliding genioplasty involving two or more bone segments.No office rate
21123Chin augmentation, sliding osteotomy with graftSliding genioplasty that includes augmentation.No office rate

How 21121 has changed in Nevada

21121 · Office / nonfacility

$645.50

Effective 2026-10-01

The base rate is $26.89 higher than on 2025-10-01, moving from $618.61 to $645.50 (4.3%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $618.61changed to$645.50

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 7.81 changed to 7.61
    • Practice expense RVU 10.69 changed to 10.98
    • Malpractice RVU 0.74 changed to 0.87
    • Practice expense GPCI 1.000 changed to 1.001
    • Malpractice GPCI 0.844 changed to 0.833

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $628.57changed to$618.61

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 10.44 changed to 10.69
    • Malpractice RVU 0.75 changed to 0.74

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $618.31changed to$628.57

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $643.94changed to$618.31

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 10.38 changed to 10.44
    • Malpractice RVU 0.74 changed to 0.75
    • Malpractice GPCI 1.098 changed to 0.844

  5. January 1, 2023

    RVU23A

    $659.52changed to$643.94

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 10.29 changed to 10.38
    • Malpractice RVU 0.68 changed to 0.74
    • Work GPCI 1.005 changed to 1.000
    • Malpractice GPCI 1.351 changed to 1.098

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $682.18changed to$659.52

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 10.81 changed to 10.29
    • Malpractice RVU 0.66 changed to 0.68

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $705.71changed to$682.18

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 10.99 changed to 10.81
    • Malpractice RVU 0.64 changed to 0.66
    • Work GPCI 1.004 changed to 1.005
    • Malpractice GPCI 1.130 changed to 1.351

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $758.49changed to$705.71

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 11.82 changed to 10.99
    • Malpractice RVU 1.32 changed to 0.64
    • Work GPCI 1.002 changed to 1.004
    • Practice expense GPCI 1.017 changed to 1.000
    • Malpractice GPCI 0.909 changed to 1.130

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $796.84changed to$758.49

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 12.89 changed to 11.82

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $848.04changed to$796.84

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 14.08 changed to 12.89
    • Malpractice RVU 1.30 changed to 1.32
    • Work GPCI 1.004 changed to 1.002
    • Practice expense GPCI 1.034 changed to 1.017
    • Malpractice GPCI 0.946 changed to 0.909

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $864.40changed to$848.04

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 14.26 changed to 14.08
    • Malpractice RVU 1.33 changed to 1.30
    • Work GPCI 1.005 changed to 1.004
    • Practice expense GPCI 1.051 changed to 1.034
    • Malpractice GPCI 0.982 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $855.11changed to$864.40

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 13.95 changed to 14.26
    • Malpractice RVU 1.31 changed to 1.33

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $850.85changed to$855.11

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $809.75changed to$850.85

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 13.47 changed to 13.95
    • Malpractice RVU 0.52 changed to 1.31
    • Work GPCI 1.001 changed to 1.005
    • Practice expense GPCI 1.055 changed to 1.051
    • Malpractice GPCI 1.107 changed to 0.982

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $822.18changed to$809.75

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 14.83 changed to 13.47
    • Malpractice RVU 0.54 changed to 0.52
    • Work GPCI 1.000 changed to 1.001
    • Practice expense GPCI 1.058 changed to 1.055
    • Malpractice GPCI 1.232 changed to 1.107

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$822.18

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$645.50$482.34RVU26D
2026-07-01$645.50$482.34RVU26C
2026-04-01$645.50$482.34RVU26B
2026-01-01$645.50$482.34RVU26A
2025-10-01$618.61$519.31RVU25D
2025-07-01$618.61$519.31RVU25C
2025-04-01$618.61$519.31RVU25B
2025-01-01$618.61$519.31RVU25A
2024-10-01$628.57$525.38RVU24D
2024-07-01$628.57$525.38RVU24C
2024-04-01$628.57$525.38RVU24B
2024-03-09$628.57$525.38RVU24AR
2024-01-01$618.31$516.80RVU24A
2023-10-01$643.94$538.55RVU23D
2023-07-01$643.94$538.55RVU23C
2023-04-01$643.94$538.55RVU23B
2023-01-01$643.94$538.55RVU23A
2022-10-01$659.52$550.85RVU22D
2022-07-01$659.52$550.85RVU22C
2022-04-01$659.52$550.85RVU22B
2022-01-01$659.52$550.85RVU22A
2021-10-01$682.18$569.83RVU21D
2021-07-01$682.18$569.83RVU21C
2021-04-01$682.18$569.83RVU21B
2021-01-01$682.18$569.83RVU21A
2020-10-01$705.71$596.72RVU20D
2020-07-01$705.71$596.72RVU20C
2020-04-01$705.71$596.72RVU20B
2020-01-01$705.71$596.72RVU20A
2019-10-01$758.49$645.97RVU19D
2019-07-01$758.49$645.97RVU19C
2019-04-01$758.49$645.97RVU19B
2019-01-01$758.49$645.97RVU19A
2018-10-01$796.84$679.68RVU18D
2018-07-01$796.84$679.68RVU18C
2018-04-01$796.84$679.68RVU18B
2018-01-01$796.84$679.68RVU18AR1
2017-10-01$848.04$708.88RVU17D
2017-07-01$848.04$708.88RVU17C
2017-04-01$848.04$708.88RVU17B
2017-01-01$848.04$708.88RVU17A
2016-10-01$864.40$720.28RVU16D
2016-07-01$864.40$720.28RVU16C
2016-04-01$864.40$720.28RVU16B
2016-01-01$864.40$720.28RVU16A
2015-10-01$855.11$710.84RVU15D
2015-07-01$855.11$710.84RVU15C
2015-04-01$850.85$707.30RVU15B
2015-01-01$850.85$707.30RVU15A
2014-10-01$809.75$671.43RVU14D
2014-07-01$809.75$671.43RVU14C
2014-04-01$809.75$671.43RVU14B
2014-01-01$809.75$671.43RVU14A
2013-10-01$822.18$674.96RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 21121 for an earlier date of service

Where the Nevada rate applies

Nevada is a Medicare payment area, not a city. Our Census mapping connects it to 138 cities and communities in Nevada. Some span more than one payment area; confirm with the service ZIP.

  • Alamo
  • Amargosa Valley
  • Austin
  • Baker
  • Battle Mountain
  • Beatty
  • Beaverdam
  • Bennett Springs

Browse all communities in Nevada

21121 billing questions

How does 21121 differ from 21122?

21121 describes a sliding genioplasty using one bone segment. Use 21122 when the osteotomy divides the chin into two or more segments.

When is 21123 used instead?

Use 21123 when augmentation is performed with the sliding osteotomy. The operative report should identify the augmentation material or graft work.

Can modifier 50 be reported?

No. The chin is a midline site for this procedure, and CMS identifies modifier 50 as inappropriate.

Can an assistant surgeon be paid?

CMS permits assistant-at-surgery payment for 21121. Co-surgeon and team-surgery payment are not permitted for this code.

What postoperative care is included?

The 90-day global includes the day-before preoperative visit and related postoperative care through day 90.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 21121PPRRVU2026_Oct_nonQPP.csv, line 1,878 (RVU26D)
Geographic factors for NevadaGPCI2026.csv, line 73 (RVU26D)

Open CMS sourceHow we calculate rates

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