CPT code 21196: Mandibular reconstruction, with fixation2026 Medicare rate & RVUs in Utah

In Utah, Medicare pays $1,255.39 for 21196 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 21196 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 21196 covers

Code 21196 represents operative reconstruction of the mandibular rami, body, or angle with fixation to stabilize the reconstructed jaw. Oral and maxillofacial, plastic, or craniofacial surgeons may perform the procedure in a hospital or ambulatory surgery setting to address mandibular defects or deformity after trauma, tumor removal, or a congenital condition. The operative report should identify the reconstructed area, the clinical reason for reconstruction, the technique, and the fixation used; document grafting when relevant to choosing among mandibular reconstruction codes.

CMS 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 multiple procedure reduction. The code is priced as bilateral, so modifier 50 does not increase payment. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team-surgery payment 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 Utah compares for 21196

Across 109 of 109 payment localities, the facility rate for 21196 runs from $1,175.55 in Arkansas to $1,625.35 in Alaska. Utah pays $1,255.39. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

21196 rates by state

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

See 21196 in every payment locality

How the 21196 rate is calculated

Each of 21196’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 21196

21196 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 21196

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

How 21196 has changed in Utah

Price 21196 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