CPT code 21198: Jaw reconstruction, segmental lower jaw2026 Medicare rate & RVUs in Montana

In Montana, Medicare pays $908.70 for 21198 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 21198 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 21198 covers

This operation reconstructs a segment of the mandible to restore jaw continuity or contour. Oral and maxillofacial surgeons and other reconstructive surgeons may perform it in a hospital operating room for a defect related to trauma, tumor removal, or another condition requiring segmental repair. The operative report should identify the mandibular segment reconstructed and describe the work performed; the code is not selected merely because the procedure involves the lower jaw.

Report the code when the documented operation is segmental mandibular reconstruction, distinguishing it from the separate lower-jaw reconstruction approaches represented by 21193–21196 and from advancement under 21199. The procedure 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 multiple-procedure reduction. An assistant at surgery 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 Montana compares for 21198

Across 109 of 109 payment localities, the facility rate for 21198 runs from $829.75 in Arkansas to $1,156.00 in Alaska. Montana pays $908.70. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

21198 rates by state

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

See 21198 in every payment locality

How the 21198 rate is calculated

Each of 21198’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 21198

21198 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 21198

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

How 21198 has changed in Montana

Price 21198 for an earlier date of service

Where the Montana rate applies

Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.

• Absarokee
• Acton
• Alberton
• Alder
• Alzada
• Amsterdam
• Anaconda-Deer Lodge County
• Antelope

Browse all communities in Montana

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