CPT code 21122: Sliding genioplasty, two or more osteotomies2026 Medicare rate & RVUs in Missouri
Reports chin reshaping or repositioning by sliding bone segments after two or more osteotomies of the mandibular chin.
CMS doesn’t publish an office rate for 21122 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 21122 covers
This operation reshapes or repositions the chin by making at least two cuts in the mandibular symphysis and moving the resulting bone segments. Oral and maxillofacial, plastic, or craniofacial surgeons may perform it to address chin shape or position, commonly in an operating room in a hospital or ambulatory surgery center. The defining feature is the multiple-cut sliding technique, rather than a single osteotomy or augmentation with an implant or graft.
Choose 21122 when the operative report supports two or more osteotomies for the sliding genioplasty. Document the cuts, movement and reshaping of the chin segments, and any grafting performed; a single osteotomy is reported with 21121, while interpositional bone graft augmentation is distinguished by 21123. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard reduction. Report this midline service without modifier 50. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.
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.
Where 21122 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $676.67 |
| Metropolitan St. Louis, MO | Unavailable | $682.71 |
| Rest of Missouri | Unavailable | $648.48 |
How the 21122 rate is calculated
Each of 21122’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 · 21122
RVUs × geographic indexes × conversion factor
Work8.49
8.49 RVUs× 1.000 GPCI
Practice expense10.90
10.90 RVUs× 1.000 GPCI
Malpractice1.57
1.57 RVUs× 1.000 GPCI
Adjusted RVUs
20.9600
Conversion factor
$33.4009
Medicare rate
$700.08
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 21122
21122 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21122
Sliding genioplasty, two or more osteotomies
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 21122
Sliding genioplasty, two or more osteotomies
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
21122 without 51 · national facility
$700.08
Sliding genioplasty, two or more osteotomies
21122-51 · Second procedure: 50%
$350.04
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%).
21122 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 21121Sliding genioplastySingle-piece osteotomy
- Use 21121 for a single sliding osteotomy. 21122 requires documentation of two or more osteotomies.
- 21123Chin augmentationSliding osteotomy with graft
- 21123 describes sliding genioplasty with interpositional bone graft augmentation. 21122 is selected for multiple osteotomies without that graft-augmentation technique.
- 21120Chin augmentationAugmentation without sliding osteotomy
- 21120 is for chin augmentation with graft or prosthetic material. 21122 describes reshaping or repositioning through multiple sliding osteotomies.
21122 billing questions
How is 21122 distinguished from 21121?
21122 represents a sliding genioplasty involving two or more osteotomies. Use 21121 when the documented technique uses a single osteotomy.
When is 21123 a better fit?
Use 21123 for sliding genioplasty with interpositional bone graft augmentation. The operative report should support that grafting technique, rather than multiple osteotomies alone.
Should modifier 50 be reported?
No. The chin procedure is midline, so report the service without modifier 50.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures performed in that session are subject to the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons and team surgery are not permitted for this code.
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
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