CPT code 21125: Mandibular augmentation, prosthetic material2026 Medicare rate & RVUs in Redding, CA
Reports mandibular augmentation using prosthetic material to enlarge or restore jaw contour, rather than augmentation with bone graft or repositioning by osteotomy.
In Redding, CA, Medicare pays $2,794.34 for 21125 in the office and $613.27 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 21125 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 21125 covers
Mandibular augmentation with a prosthetic implant enlarges or restores jaw contour by placing alloplastic material along a deficient segment of the mandible. It is distinct from bone-graft augmentation and from an osteotomy that repositions native jaw segments. Oral and maxillofacial surgeons and plastic surgeons typically perform the procedure in an operating room for reconstructive or contour-correction needs, using an implant selected for the documented mandibular deficiency.
Report 21125 when the operative service augments the mandible with prosthetic material. The note should identify the treated mandibular area, the indication, the implant and its placement, and the work performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care through day 90. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; 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.
How Redding, CA compares for 21125
Across 109 of 109 payment localities, the office rate for 21125 runs from $2,265.30 in Arkansas to $3,589.45 in San Benito County, CA. Redding, CA pays $2,794.34. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Redding, CA · this page$2,794.34
- Bakersfield, CA · California$2,798.00+$3.66
- Chico, CA · California$2,794.34
- El Centro, CA · California$2,794.54+$0.20
- Fresno, CA · California$2,794.34
- Hanford, CA · California$2,794.34
- Los Angeles, CA · California$2,999.66+$205.32
Other areas in California first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| Madera, CACalifornia | $2,794.34 | $613.27 |
| Merced, CACalifornia | $2,794.34 | $613.27 |
| Modesto, CACalifornia | $2,794.34 | $613.27 |
| Napa, CACalifornia | $3,298.56 | $675.70 |
| Oxnard, CACalifornia | $2,991.22 | $639.01 |
| Rest of CaliforniaCalifornia | $2,794.34 | $613.27 |
| Riverside, CACalifornia | $2,807.51 | $626.44 |
| Sacramento, CACalifornia | $2,948.66 | $634.26 |
| Salinas, CACalifornia | $2,938.08 | $631.64 |
| San Diego, CACalifornia | $3,019.50 | $639.43 |
| Marin County, CACalifornia | $3,510.55 | $704.61 |
| San Francisco, CACalifornia | $3,509.18 | $703.24 |
| San Benito County, CACalifornia | $3,589.45 | $719.83 |
| Santa Clara County, CACalifornia | $3,583.83 | $714.21 |
| San Luis Obispo, CACalifornia | $2,889.09 | $622.45 |
| Santa Cruz, CACalifornia | $3,057.96 | $640.08 |
| Santa Maria, CACalifornia | $2,952.45 | $632.08 |
| Santa Rosa, CACalifornia | $3,089.77 | $646.02 |
| Stockton, CACalifornia | $2,794.34 | $613.27 |
| Vallejo, CACalifornia | $3,296.58 | $673.72 |
| Visalia, CACalifornia | $2,794.34 | $613.27 |
| Yuba City, CACalifornia | $2,794.34 | $613.27 |
| Washington, DC areaDistrict of Columbia | $3,011.36 | $667.11 |
| Miami, FLFlorida | $2,747.72 | $676.10 |
| Chicago, ILIllinois | $2,661.40 | $661.42 |
| Manhattan, NYNew York | $2,998.74 | $686.33 |
| AlaskaAlaska | $2,896.52 | $777.14 |
| AlabamaAlabama | $2,302.61 | $561.34 |
| ArkansasArkansas | $2,265.30 | $555.86 |
| ArizonaArizona | $2,521.46 | $593.12 |
| ColoradoColorado | $2,731.97 | $614.59 |
| ConnecticutConnecticut | $2,780.77 | $637.51 |
| DelawareDelaware | $2,566.82 | $600.67 |
| Fort Lauderdale, FLFlorida | $2,656.88 | $640.99 |
| Rest of FloridaFlorida | $2,518.96 | $616.50 |
| Atlanta, GAGeorgia | $2,640.02 | $618.15 |
| Rest of GeorgiaGeorgia | $2,365.37 | $590.27 |
| Hawaii, Guam, HIHawaii | $2,880.44 | $617.78 |
| IowaIowa | $2,383.92 | $563.05 |
| IdahoIdaho | $2,398.01 | $567.19 |
| East St. Louis, ILIllinois | $2,460.29 | $629.46 |
| Rest of IllinoisIllinois | $2,426.64 | $609.74 |
| Suburban Chicago, ILIllinois | $2,688.74 | $644.98 |
| IndianaIndiana | $2,413.96 | $569.20 |
| KansasKansas | $2,364.01 | $565.02 |
| KentuckyKentucky | $2,347.56 | $578.43 |
| New Orleans, LALouisiana | $2,471.08 | $598.46 |
| Rest of LouisianaLouisiana | $2,340.49 | $579.32 |
| Metropolitan Boston, MAMassachusetts | $3,033.03 | $656.94 |
| Rest of MassachusettsMassachusetts | $2,709.79 | $614.29 |
| Baltimore area, MDMaryland | $2,771.64 | $636.34 |
| Rest of MarylandMaryland | $2,622.23 | $608.32 |
| Rest of MaineMaine | $2,404.03 | $573.21 |
| Southern Maine, MEMaine | $2,560.84 | $588.72 |
| Detroit, MIMichigan | $2,546.19 | $625.81 |
| Rest of MichiganMichigan | $2,409.10 | $592.20 |
| MinnesotaMinnesota | $2,631.03 | $583.30 |
| Metropolitan Kansas City, MOMissouri | $2,460.24 | $591.61 |
| Metropolitan St. Louis, MOMissouri | $2,489.90 | $595.39 |
| Rest of MissouriMissouri | $2,290.46 | $575.05 |
| MississippiMississippi | $2,278.76 | $565.34 |
| MontanaMontana | $2,595.50 | $605.48 |
| North CarolinaNorth Carolina | $2,433.36 | $576.67 |
| North DakotaNorth Dakota | $2,571.58 | $581.55 |
| NebraskaNebraska | $2,400.78 | $563.99 |
| New HampshireNew Hampshire | $2,680.87 | $609.26 |
| Northern New JerseyNew Jersey | $2,973.04 | $664.61 |
| Rest of New JerseyNew Jersey | $2,816.29 | $643.18 |
| New MexicoNew Mexico | $2,420.82 | $595.97 |
| NevadaNevada | $2,591.04 | $599.02 |
| NYC suburbs and Long Island, NYNew York | $3,069.18 | $703.04 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $2,829.23 | $650.15 |
| Queens, NYNew York | $3,036.99 | $684.78 |
| Rest of New YorkNew York | $2,473.41 | $582.88 |
| OhioOhio | $2,404.21 | $587.31 |
| OklahomaOklahoma | $2,350.80 | $573.71 |
| Portland, OROregon | $2,835.45 | $624.53 |
| Rest of OregonOregon | $2,574.77 | $592.70 |
| Metropolitan Philadelphia, PAPennsylvania | $2,700.06 | $628.44 |
| Rest of PennsylvaniaPennsylvania | $2,412.68 | $585.83 |
| Puerto RicoPuerto Rico | $2,619.22 | $607.30 |
| Rhode IslandRhode Island | $2,670.62 | $614.92 |
| South CarolinaSouth Carolina | $2,422.06 | $583.28 |
| South DakotaSouth Dakota | $2,568.75 | $578.72 |
| TennesseeTennessee | $2,376.36 | $567.42 |
| Austin, TXTexas | $2,719.48 | $614.03 |
| Beaumont, TXTexas | $2,394.40 | $583.48 |
| Brazoria, TXTexas | $2,569.68 | $597.56 |
| Dallas, TXTexas | $2,584.20 | $602.13 |
| Fort Worth, TXTexas | $2,562.69 | $600.52 |
| Galveston, TXTexas | $2,576.02 | $599.93 |
| Houston, TXTexas | $2,598.17 | $622.07 |
| Rest of TexasTexas | $2,479.29 | $590.75 |
| UtahUtah | $2,459.25 | $588.63 |
| VirginiaVirginia | $2,546.24 | $590.05 |
| Virgin Islands, VIUnited States Virgin Islands | $2,619.22 | $607.30 |
| VermontVermont | $2,553.58 | $583.46 |
| Rest of WashingtonWashington | $2,707.28 | $611.78 |
| King County, WAWashington | $3,105.96 | $664.20 |
| WisconsinWisconsin | $2,475.07 | $568.63 |
| West VirginiaWest Virginia | $2,324.35 | $595.02 |
| WyomingWyoming | $2,585.08 | $595.05 |
21125 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$2,265.30
$3,191.90
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $2,896.52 | 1 |
| AL | $2,302.61 | 1 |
| AR | $2,265.30 | 1 |
| AZ | $2,521.46 | 1 |
| CA | $2,794.34–$3,589.45 | 29 |
| CO | $2,731.97 | 1 |
| CT | $2,780.77 | 1 |
| DC | $3,011.36 | 1 |
| DE | $2,566.82 | 1 |
| FL | $2,518.96–$2,747.72 | 3 |
| GA | $2,365.37–$2,640.02 | 2 |
| GU | $2,880.44 | 1 |
| HI | $2,880.44 | 1 |
| IA | $2,383.92 | 1 |
| ID | $2,398.01 | 1 |
| IL | $2,426.64–$2,688.74 | 4 |
| IN | $2,413.96 | 1 |
| KS | $2,364.01 | 1 |
| KY | $2,347.56 | 1 |
| LA | $2,340.49–$2,471.08 | 2 |
| MA | $2,709.79–$3,033.03 | 2 |
| MD | $2,622.23–$3,011.36 | 3 |
| ME | $2,404.03–$2,560.84 | 2 |
| MI | $2,409.10–$2,546.19 | 2 |
| MN | $2,631.03 | 1 |
| MO | $2,290.46–$2,489.90 | 3 |
| MS | $2,278.76 | 1 |
| MT | $2,595.50 | 1 |
| NC | $2,433.36 | 1 |
| ND | $2,571.58 | 1 |
| NE | $2,400.78 | 1 |
| NH | $2,680.87 | 1 |
| NJ | $2,816.29–$2,973.04 | 2 |
| NM | $2,420.82 | 1 |
| NV | $2,591.04 | 1 |
| NY | $2,473.41–$3,069.18 | 5 |
| OH | $2,404.21 | 1 |
| OK | $2,350.80 | 1 |
| OR | $2,574.77–$2,835.45 | 2 |
| PA | $2,412.68–$2,700.06 | 2 |
| PR | $2,619.22 | 1 |
| RI | $2,670.62 | 1 |
| SC | $2,422.06 | 1 |
| SD | $2,568.75 | 1 |
| TN | $2,376.36 | 1 |
| TX | $2,394.40–$2,719.48 | 8 |
| UT | $2,459.25 | 1 |
| VA | $2,546.24–$3,011.36 | 2 |
| VI | $2,619.22 | 1 |
| VT | $2,553.58 | 1 |
| WA | $2,707.28–$3,105.96 | 2 |
| WI | $2,475.07 | 1 |
| WV | $2,324.35 | 1 |
| WY | $2,585.08 | 1 |
How the 21125 rate is calculated
Each of 21125’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 · 21125
RVUs × geographic indexes × conversion factor
Work10.53
10.53 RVUs× 1.000 GPCI
Practice expense65.97
65.97 RVUs× 1.000 GPCI
Malpractice1.21
1.21 RVUs× 1.000 GPCI
Adjusted RVUs
77.7100
Conversion factor
$33.4009
Medicare rate
$2,595.58
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Redding, CA inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
1,881
- Code
- 21125
- Physician work
- 10.53
- Practice expense
- 65.97
- Malpractice
- 1.21
GPCI2026.csv
19
- Locality
- Redding, CA
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.53 | × 1.017 | 10.7090 |
| Practice expense | 65.97 | × 1.096 | 72.3031 |
| Malpractice | 1.21 | × 0.536 | 0.6486 |
| Total RVUs | 83.6607 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Redding, CA$2794.34
Office: (10.53 × 1.017 + 65.97 × 1.096 + 1.21 × 0.536) × $33.4009 = $2794.34
Facility: (10.53 × 1.017 + 6.39 × 1.096 + 1.21 × 0.536) × $33.4009 = $613.27
Payment rules and modifiers for 21125
21125 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21125
Mandibular augmentation, prosthetic material
| 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 · 21125
Mandibular augmentation, prosthetic material
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
21125 without 51 · national office
$2,595.58
Mandibular augmentation, prosthetic material
21125-51 · Second procedure: 50%
$1,297.79
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%).
How 21125 has changed in Redding, CA
21125 · Office / nonfacility
$2794.34
Effective 2026-10-01
The base rate is $146.37 higher than on 2025-10-01, moving from $2647.97 to $2794.34 (5.5%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$2647.97changed to$2794.34
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 10.80 changed to 10.53
- Practice expense RVU 64.35 changed to 65.97
- Malpractice RVU 1.03 changed to 1.21
- Work GPCI 1.014 changed to 1.017
- Practice expense GPCI 1.093 changed to 1.096
- Malpractice GPCI 0.560 changed to 0.536
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$2771.40changed to$2647.97
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 65.61 changed to 64.35
- Malpractice RVU 1.06 changed to 1.03
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$2726.17changed to$2771.40
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$2848.41changed to$2726.17
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 67.14 changed to 65.61
- Malpractice RVU 1.01 changed to 1.06
- Work GPCI 1.021 changed to 1.014
- Practice expense GPCI 1.079 changed to 1.093
- Malpractice GPCI 0.579 changed to 0.560
January 1, 2023
RVU23A
$2943.55changed to$2848.41
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 68.92 changed to 67.14
- Malpractice RVU 0.95 changed to 1.01
- Work GPCI 1.027 changed to 1.021
- Practice expense GPCI 1.065 changed to 1.079
- Malpractice GPCI 0.597 changed to 0.579
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$3068.99changed to$2943.55
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 71.65 changed to 68.92
- Malpractice RVU 0.93 changed to 0.95
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$3089.62changed to$3068.99
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 69.18 changed to 71.65
- Malpractice RVU 0.91 changed to 0.93
- Work GPCI 1.024 changed to 1.027
- Practice expense GPCI 1.070 changed to 1.065
- Malpractice GPCI 0.580 changed to 0.597
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$3152.39changed to$3089.62
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 70.23 changed to 69.18
- Malpractice RVU 1.83 changed to 0.91
- Work GPCI 1.020 changed to 1.024
- Practice expense GPCI 1.074 changed to 1.070
- Malpractice GPCI 0.562 changed to 0.580
Held through RVU20B, RVU20C, RVU20D.
July 1, 2019
RVU19C
$3150.57changed to$3152.39
- Malpractice RVU 1.74 changed to 1.83
Held through RVU19D.
January 1, 2019
RVU19A
$3209.44changed to$3150.57
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 71.80 changed to 70.23
- Malpractice RVU 1.82 changed to 1.74
Held through RVU19B.
January 1, 2018
RVU18AR1
$3495.54changed to$3209.44
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 79.12 changed to 71.80
- Malpractice RVU 1.59 changed to 1.82
- Work GPCI 1.024 changed to 1.020
- Practice expense GPCI 1.079 changed to 1.074
- Malpractice GPCI 0.610 changed to 0.562
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
No ratechanged to$3495.54
Held through RVU17B, RVU17C, RVU17D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $2,794.34 | $613.27 | RVU26D |
| 2026-07-01 | $2,794.34 | $613.27 | RVU26C |
| 2026-04-01 | $2,794.34 | $613.27 | RVU26B |
| 2026-01-01 | $2,794.34 | $613.27 | RVU26A |
| 2025-10-01 | $2,647.97 | $674.82 | RVU25D |
| 2025-07-01 | $2,647.97 | $674.82 | RVU25C |
| 2025-04-01 | $2,647.97 | $674.82 | RVU25B |
| 2025-01-01 | $2,647.97 | $674.82 | RVU25A |
| 2024-10-01 | $2,771.40 | $680.82 | RVU24D |
| 2024-07-01 | $2,771.40 | $680.82 | RVU24C |
| 2024-04-01 | $2,771.40 | $680.82 | RVU24B |
| 2024-03-09 | $2,771.40 | $680.82 | RVU24AR |
| 2024-01-01 | $2,726.17 | $669.71 | RVU24A |
| 2023-10-01 | $2,848.41 | $687.83 | RVU23D |
| 2023-07-01 | $2,848.41 | $687.83 | RVU23C |
| 2023-04-01 | $2,848.41 | $687.83 | RVU23B |
| 2023-01-01 | $2,848.41 | $687.83 | RVU23A |
| 2022-10-01 | $2,943.55 | $693.52 | RVU22D |
| 2022-07-01 | $2,943.55 | $693.52 | RVU22C |
| 2022-04-01 | $2,943.55 | $693.52 | RVU22B |
| 2022-01-01 | $2,943.55 | $693.52 | RVU22A |
| 2021-10-01 | $3,068.99 | $707.77 | RVU21D |
| 2021-07-01 | $3,068.99 | $707.77 | RVU21C |
| 2021-04-01 | $3,068.99 | $707.77 | RVU21B |
| 2021-01-01 | $3,068.99 | $707.77 | RVU21A |
| 2020-10-01 | $3,089.62 | $733.66 | RVU20D |
| 2020-07-01 | $3,089.62 | $733.66 | RVU20C |
| 2020-04-01 | $3,089.62 | $733.66 | RVU20B |
| 2020-01-01 | $3,089.62 | $733.66 | RVU20A |
| 2019-10-01 | $3,152.39 | $774.68 | RVU19D |
| 2019-07-01 | $3,152.39 | $774.68 | RVU19C |
| 2019-04-01 | $3,150.57 | $772.86 | RVU19B |
| 2019-01-01 | $3,150.57 | $772.86 | RVU19A |
| 2018-10-01 | $3,209.44 | $803.02 | RVU18D |
| 2018-07-01 | $3,209.44 | $803.02 | RVU18C |
| 2018-04-01 | $3,209.44 | $803.02 | RVU18B |
| 2018-01-01 | $3,209.44 | $803.02 | RVU18AR1 |
| 2017-10-01 | $3,495.54 | $774.03 | RVU17D |
| 2017-07-01 | $3,495.54 | $774.03 | RVU17C |
| 2017-04-01 | $3,495.54 | $774.03 | RVU17B |
| 2017-01-01 | $3,495.54 | $774.03 | RVU17A |
| 2016-10-01 | Rate data unavailable | Rate data unavailable | RVU16D |
| 2016-07-01 | Rate data unavailable | Rate data unavailable | RVU16C |
| 2016-04-01 | Rate data unavailable | Rate data unavailable | RVU16B |
| 2016-01-01 | Rate data unavailable | Rate data unavailable | RVU16A |
| 2015-10-01 | Rate data unavailable | Rate data unavailable | RVU15D |
| 2015-07-01 | Rate data unavailable | Rate data unavailable | RVU15C |
| 2015-04-01 | Rate data unavailable | Rate data unavailable | RVU15B |
| 2015-01-01 | Rate data unavailable | Rate data unavailable | RVU15A |
| 2014-10-01 | Rate data unavailable | Rate data unavailable | RVU14D |
| 2014-07-01 | Rate data unavailable | Rate data unavailable | RVU14C |
| 2014-04-01 | Rate data unavailable | Rate data unavailable | RVU14B |
| 2014-01-01 | Rate data unavailable | Rate data unavailable | RVU14A |
| 2013-10-01 | Rate data unavailable | Rate data unavailable | RVU13D |
| 2013-07-01 | Rate data unavailable | Rate data unavailable | RVU13C |
| 2013-04-01 | Rate data unavailable | Rate data unavailable | RVU13B |
| 2013-01-01 | Rate data unavailable | Rate data unavailable | RVU13AR |
Where the Redding, CA rate applies
Redding, CA is a Medicare payment area, not a city. Our Census mapping connects it to 32 cities and communities in California. Some span more than one payment area; confirm with the service ZIP.
- Redding
- Anderson
- Bella Vista
- Big Bend
- Burney
- Cassel
- Castella
- Centerville
21125 billing questions
How does 21125 differ from 21127?
21125 describes mandibular augmentation with prosthetic material. 21127 is the related augmentation code for bone grafting.
When is 21120 a better fit?
Use 21120 for augmentation performed as a genioplasty, such as chin augmentation. Use 21125 when the documented service is mandibular augmentation with prosthetic material.
Can 21125 be reported with modifier 50?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What postoperative care is included?
The 90-day global includes the day-before preoperative visit and related postoperative care through the 90-day period.
Can an assistant surgeon be paid for 21125?
CMS indicates that assistant-at-surgery payment may be made. Co-surgeons and team surgery are not permitted.
What documentation supports 21125?
Document the mandibular area treated, the indication for augmentation, the prosthetic material and its placement, and the operative work performed.
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
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Fee sheets · Coming soon
Put 21125 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
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