CPT code 21193: Mandibular reconstruction, without bone graft2026 Medicare rate & RVUs in Texas
Reports operative reconstruction of the lower jaw when the documented procedure is performed without a bone graft.
CMS doesn’t publish an office rate for 21193 in Texas.
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 21193 covers
CPT 21193 covers operative reconstruction of the lower jaw without a bone graft. Oral and maxillofacial, plastic, or craniofacial surgeons may perform this work to restore mandibular form or function after a defect or deformity. The operative report should identify the mandibular reconstruction performed and establish that a bone graft was not used as part of that reconstruction.
Choose this code based on the documented procedure and graft use, not simply the diagnosis or the fact that the mandible is involved. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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. The code is priced as bilateral, so modifier 50 does not increase payment. Assistant-at-surgery services may be paid; co-surgeons require 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.
Where 21193 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $1,123.00 |
| Beaumont, TX | Unavailable | $1,065.91 |
| Brazoria, TX | Unavailable | $1,090.18 |
| Dallas, TX | Unavailable | $1,099.79 |
| Fort Worth, TX | Unavailable | $1,096.92 |
| Galveston, TX | Unavailable | $1,095.28 |
| Houston, TX | Unavailable | $1,144.33 |
| Rest of Texas | Unavailable | $1,079.32 |
How the 21193 rate is calculated
Each of 21193’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 · 21193
RVUs × geographic indexes × conversion factor
Work18.43
18.43 RVUs× 1.000 GPCI
Practice expense12.08
12.08 RVUs× 1.000 GPCI
Malpractice2.68
2.68 RVUs× 1.000 GPCI
Adjusted RVUs
33.1900
Conversion factor
$33.4009
Medicare rate
$1,108.58
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 21193
21193 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21193
Mandibular reconstruction, without bone graft
| 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) | 2 | Already bilateral by definition: paid once at 100%. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 21193
Mandibular reconstruction, without 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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
21193 without 51 · national facility
$1,108.58
Mandibular reconstruction, without bone graft
21193-51 · Second procedure: 50%
$554.29
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%).
21193 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 21194Mandible reconstructionWith bone graft
- Use 21194 when the lower-jaw reconstruction includes a bone graft; 21193 is the no-graft variant.
- 21195Jaw reconstructionWithout fixation
- This lower-jaw reconstruction variant is specified as without fixation. Select based on the operative technique documented rather than treating it as interchangeable with 21193.
- 21196Mandibular reconstructionWith fixation
- This lower-jaw reconstruction variant is specified as with fixation. The operative report's description of the procedure determines whether it fits instead of 21193.
- 21199Mandibular reconstructionWith advancement
- 21199 identifies lower-jaw reconstruction involving advancement; 21193 is distinguished by reconstruction without a bone graft.
21193 billing questions
How do I distinguish 21193 from 21194?
The key distinction is whether a bone graft is used in the lower-jaw reconstruction. Use 21193 for reconstruction without a graft and 21194 when the reconstruction includes a graft.
Does modifier 50 increase payment for 21193?
No. CMS prices 21193 as bilateral, so modifier 50 does not increase payment.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeons are paid only when supporting documentation is provided.
How does payment work when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction.
What documentation supports selecting 21193?
The operative report should describe the lower-jaw reconstruction and make clear that no bone graft was used as part of it.
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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