FeeBase
Log inGet started
Menu

CPT code 21127: Mandibular augmentation, with bone graft2026 Medicare rate & RVUs in Puerto Rico

Reports surgical augmentation of the mandibular body or angle using a bone graft to address deficient jaw size or contour.

CMS RVU26DEffective Oct 1, 2026One payment locality75 Medicare services in 2024

In Puerto Rico, Medicare pays $4,006.01 for 21127 in the office and $697.73 when it’s performed in a hospital or facility.

$4,006.01Office (non-facility)
$697.73Hospital or facility
+1.0%vs the national office rate ($3,968.03)

Check a contract rate as a % of Medicare · 21127 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 21127 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 21127 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 21127 covers

This procedure adds bone graft material to the mandibular body or angle to augment jaw size or contour. Oral and maxillofacial, plastic, or craniofacial surgeons may perform it as a reconstructive operation in a hospital or other surgical setting. The operative report should identify the mandibular site, the reason for augmentation, and the graft used and its placement.

Choose this code when the augmentation is performed with a bone graft, rather than prosthetic material or a chin osteotomy. The service has a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is 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 Puerto Rico compares for 21127

Across 109 of 109 payment localities, the office rate for 21127 runs from $3,449.69 in Arkansas to $5,545.32 in San Benito County, CA. Puerto Rico pays $4,006.01. The RVUs are the same everywhere; the geographic indexes change the dollars.

21127 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$4,006.01
  2. Los Angeles, CA · California$4,612.55+$606.54
  3. Washington, DC area · District of Columbia$4,621.08+$615.07
  4. Miami, FL · Florida$4,183.19+$177.18
  5. Chicago, IL · Illinois$4,048.57+$42.56
  6. Manhattan, NY · New York$4,590.83+$584.82
  7. Alaska · Alaska$4,378.33+$372.32

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

Every other payment area

21127 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$3,508.32$645.07
ArkansasArkansas$3,449.69$638.80
ArizonaArizona$3,852.33$681.49
Bakersfield, CACalifornia$4,295.15$708.73
Chico, CACalifornia$4,290.95$704.53
El Centro, CACalifornia$4,291.18$704.76
Fresno, CACalifornia$4,290.95$704.53
Hanford, CACalifornia$4,290.95$704.53

21127 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.

$3,449.69

$4,918.14

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

View every state and territory as a table
21127 office rate range by state
State / territoryOffice rate rangeLocalities
AK$4,378.331
AL$3,508.321
AR$3,449.691
AZ$3,852.331
CA$4,290.95–$5,545.3229
CO$4,187.771
CT$4,256.651
DC$4,621.081
DE$3,923.171
FL$3,836.66–$4,183.193
GA$3,597.16–$4,034.842
GU$4,430.231
HI$4,430.231
IA$3,641.131
ID$3,662.241
IL$3,688.23–$4,101.654
IN$3,687.461
KS$3,607.421
KY$3,573.761
LA$3,561.69–$3,766.872
MA$4,151.46–$4,661.722
MD$4,010.47–$4,621.083
ME$3,669.16–$3,919.252
MI$3,668.09–$3,876.802
MN$4,037.321
MO$3,481.55–$3,799.333
MS$3,467.121
MT$3,967.931
NC$3,715.661
ND$3,940.451
NE$3,668.381
NH$4,106.401
NJ$4,312.25–$4,559.342
NM$3,685.491
NV$3,963.791
NY$3,778.42–$4,698.355
OH$3,662.471
OK$3,581.411
OR$3,940.17–$4,352.952
PA$3,677.12–$4,128.452
PR$4,006.011
RI$4,086.751
SC$3,693.811
SD$3,937.201
TN$3,626.531
TX$3,648.25–$4,167.508
UT$3,752.301
VA$3,894.60–$4,621.082
VI$4,006.011
VT$3,909.931
WA$4,148.57–$4,778.022
WI$3,788.211
WV$3,527.381
WY$3,955.961

See 21127 in every payment locality

How the 21127 rate is calculated

Each of 21127’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 · 21127

RVUs × geographic indexes × conversion factor

Office or facility?

Work12.13

12.13 RVUs× 1.000 GPCI

Practice expense105.28

105.28 RVUs× 1.000 GPCI

Malpractice1.39

1.39 RVUs× 1.000 GPCI

Adjusted RVUs

118.8000

Conversion factor

$33.4009

Medicare rate

$3,968.03

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

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,882

Code
21127
Physician work
12.13
Practice expense
105.28
Malpractice
1.39

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 21127 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work12.13× 1.00012.1300
Practice expense105.28× 1.011106.4381
Malpractice1.39× 0.9851.3691
Total RVUs119.9372
Conversion factor× 33.4009

Office rate, Puerto Rico$4006.01

Office: (12.13 × 1 + 105.28 × 1.011 + 1.39 × 0.985) × $33.4009 = $4006.01

Facility: (12.13 × 1 + 7.31 × 1.011 + 1.39 × 0.985) × $33.4009 = $697.73

Open 21127 in the RVU calculator

Payment rules and modifiers for 21127

21127 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21127

Mandibular augmentation, with bone graft

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)1Permitted with supporting documentation.
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 · 21127

Mandibular augmentation, with bone graft

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

21127 without 51 · national office

$3,968.03

Mandibular augmentation, with bone graft

21127-51 · Second procedure: 50%

$1,984.02

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 21127

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

Codes related to 21127
CodeHow it relatesOffice range, Puerto Rico
Used instead
21125Mandibular augmentation, prosthetic materialMandibular augmentation using prosthetic material instead of a bone graft.$2,619.22
21120Chin augmentation, augmentation without sliding osteotomyGenioplasty augmentation addresses the chin rather than the mandibular body or angle.$720.69
21121Sliding genioplasty, single-piece osteotomyA sliding genioplasty repositions the chin rather than augmenting the mandibular body or angle with graft.$653.58

How 21127 has changed in Puerto Rico

21127 · Office / nonfacility

$4006.01

Effective 2026-10-01

The base rate is $189.00 higher than on 2025-10-01, moving from $3817.01 to $4006.01 (5.0%).

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

    $3817.01changed to$4006.01

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 12.44 changed to 12.13
    • Practice expense RVU 103.65 changed to 105.28
    • Malpractice RVU 1.21 changed to 1.39
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $4016.16changed to$3817.01

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 106.22 changed to 103.65
    • Malpractice RVU 1.27 changed to 1.21

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $3950.61changed to$4016.16

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $4118.92changed to$3950.61

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 107.10 changed to 106.22
    • Malpractice RVU 1.17 changed to 1.27
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $4090.52changed to$4118.92

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $4308.67changed to$4090.52

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 110.11 changed to 107.10
    • Malpractice RVU 1.09 changed to 1.17
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $4345.11changed to$4308.67

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 110.15 changed to 110.11
    • Malpractice RVU 1.07 changed to 1.09

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $4184.61changed to$4345.11

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 101.66 changed to 110.15
    • Malpractice RVU 1.05 changed to 1.07
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $4067.46changed to$4184.61

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 97.65 changed to 101.66
    • Malpractice RVU 2.11 changed to 1.05
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $3910.39changed to$4067.46

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 93.45 changed to 97.65
    • Malpractice RVU 2.10 changed to 2.11

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $3895.63changed to$3910.39

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 110.73 changed to 93.45
    • Malpractice RVU 2.06 changed to 2.10
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $3298.90changed to$3895.63

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 112.16 changed to 110.73
    • Malpractice RVU 2.13 changed to 2.06
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $3254.14changed to$3298.90

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 109.94 changed to 112.16
    • Malpractice RVU 2.09 changed to 2.13

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $3237.95changed to$3254.14

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $3110.87changed to$3237.95

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 106.92 changed to 109.94
    • Malpractice RVU 1.52 changed to 2.09
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $2874.96changed to$3110.87

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 105.70 changed to 106.92
    • Malpractice RVU 1.59 changed to 1.52
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $2874.96

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$4,006.01$697.73RVU26D
2026-07-01$4,006.01$697.73RVU26C
2026-04-01$4,006.01$697.73RVU26B
2026-01-01$4,006.01$697.73RVU26A
2025-10-01$3,817.01$762.65RVU25D
2025-07-01$3,817.01$762.65RVU25C
2025-04-01$3,817.01$762.65RVU25B
2025-01-01$3,817.01$762.65RVU25A
2024-10-01$4,016.16$773.05RVU24D
2024-07-01$4,016.16$773.05RVU24C
2024-04-01$4,016.16$773.05RVU24B
2024-03-09$4,016.16$773.05RVU24AR
2024-01-01$3,950.61$760.43RVU24A
2023-10-01$4,118.92$773.80RVU23D
2023-07-01$4,090.52$771.95RVU23C
2023-04-01$4,090.52$771.95RVU23B
2023-01-01$4,090.52$771.95RVU23A
2022-10-01$4,308.67$780.25RVU22D
2022-07-01$4,308.67$780.25RVU22C
2022-04-01$4,308.67$780.25RVU22B
2022-01-01$4,308.67$780.25RVU22A
2021-10-01$4,345.11$794.82RVU21D
2021-07-01$4,345.11$794.82RVU21C
2021-04-01$4,345.11$794.82RVU21B
2021-01-01$4,345.11$794.82RVU21A
2020-10-01$4,184.61$827.99RVU20D
2020-07-01$4,184.61$827.99RVU20C
2020-04-01$4,184.61$827.99RVU20B
2020-01-01$4,184.61$827.99RVU20A
2019-10-01$4,067.46$890.88RVU19D
2019-07-01$4,067.46$890.88RVU19C
2019-04-01$4,067.46$890.88RVU19B
2019-01-01$4,067.46$890.88RVU19A
2018-10-01$3,910.39$922.17RVU18D
2018-07-01$3,910.39$922.17RVU18C
2018-04-01$3,910.39$922.17RVU18B
2018-01-01$3,910.39$922.17RVU18AR1
2017-10-01$3,895.63$839.22RVU17D
2017-07-01$3,895.63$839.22RVU17C
2017-04-01$3,895.63$839.22RVU17B
2017-01-01$3,895.63$839.22RVU17A
2016-10-01$3,298.90$754.75RVU16D
2016-07-01$3,298.90$754.75RVU16C
2016-04-01$3,298.90$754.75RVU16B
2016-01-01$3,298.90$754.75RVU16A
2015-10-01$3,254.14$748.95RVU15D
2015-07-01$3,254.14$748.95RVU15C
2015-04-01$3,237.95$745.22RVU15B
2015-01-01$3,237.95$745.22RVU15A
2014-10-01$3,110.87$729.36RVU14D
2014-07-01$3,110.87$729.36RVU14C
2014-04-01$3,110.87$729.36RVU14B
2014-01-01$3,110.87$729.36RVU14A
2013-10-01$2,874.96$727.14RVU13D
2013-07-01$2,874.96$727.14RVU13C
2013-04-01$2,874.96$727.14RVU13B
2013-01-01$2,874.96$727.14RVU13AR

Price 21127 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

21127 billing questions

How do I distinguish this code from 21125?

Use 21127 for mandibular augmentation with a bone graft. Code 21125 describes augmentation using prosthetic material.

Is this the code for chin augmentation?

Not when the service is a genioplasty focused on the chin. Code 21120 is for genioplasty augmentation; 21127 concerns augmentation of the mandibular body or angle with a bone graft.

What should the operative report document?

Document the mandibular body or angle being augmented, the clinical reason for the augmentation, and the bone graft and its placement. These details support selection over prosthetic augmentation or a chin osteotomy.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

How is this handled with other procedures in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation.

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 21127PPRRVU2026_Oct_nonQPP.csv, line 1,882 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 21127 pays in Puerto Rico?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 21127 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Build my fee sheet