CPT code 21194: Mandible reconstruction, with bone graft2026 Medicare rate & RVUs in Utah

In Utah, Medicare pays $1,241.13 for 21194 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 21194 nationwide

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

What 21194 covers

This service reconstructs a defect in the mandible using a bone graft to restore lower-jaw continuity or contour. Oral and maxillofacial surgeons and plastic surgeons may perform it for defects related to trauma, tumor removal, or congenital conditions. The procedure is generally performed in an operating room, with the operative report identifying the mandibular defect and describing the graft reconstruction.

Select this code when the documented reconstruction uses a bone graft; distinguish it from lower-jaw reconstruction without a graft and from variants defined by fixation or segmental work. The record should support the defect treated and the reconstructive technique performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur 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 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 Utah compares for 21194

Across 109 of 109 payment localities, the facility rate for 21194 runs from $1,164.06 in Arkansas to $1,619.10 in Alaska. Utah pays $1,241.13. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

21194 rates by state

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

See 21194 in every payment locality

How the 21194 rate is calculated

Each of 21194’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.

Payment rules and modifiers for 21194

21194 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

Codes related to 21194

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

How 21194 has changed in Utah

Price 21194 for an earlier date of service

Where the Utah rate applies

Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.

• Alpine
• Alta
• Altamont
• Alton
• Amalga
• American Fork
• Aneth
• Annabella

Browse all communities in Utah

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

Open CMS sourceHow we calculate rates