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Billing code 21122: Sliding genioplastyMedicare rate & RVUs

Reports chin reshaping or repositioning by sliding bone segments after two or more osteotomies of the mandibular chin.

CMS RVU26DEffective Oct 1, 2026109 payment localities13 Medicare services in 2024

Medicare pays $700.08 for 21122 nationally in a facility.

Medicare rate · 21122

Sliding genioplasty

Swap in your local Medicare rate.

Work RVUs
8.49
Total RVUs
20.96
Global days
090

National rate · 2026

$700.08

Facility setting, before claim adjustments.

See every locality for 21122 → · Billed by an NP, PA or therapist? →

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

On this page 10 sections
  1. Medicare rate
  2. What 21122 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 21122 covers

This operation reshapes or repositions the chin by making at least two cuts in the mandibular symphysis and moving the resulting bone segments. Oral and maxillofacial, plastic, or craniofacial surgeons may perform it to address chin shape or position, commonly in an operating room in a hospital or ambulatory surgery center. The defining feature is the multiple-cut sliding technique, rather than a single osteotomy or augmentation with an implant or graft.

Choose 21122 when the operative report supports two or more osteotomies for the sliding genioplasty. Document the cuts, movement and reshaping of the chin segments, and any grafting performed; a single osteotomy is reported with 21121, while interpositional bone graft augmentation is distinguished by 21123. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard reduction. Report this midline service without modifier 50. An assistant at surgery may be paid; 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.

Where 21122 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

21122 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$631.82
Alaska*Unavailable$841.99
ArizonaUnavailable$681.25
ArkansasUnavailable$623.32
AtlantaUnavailable$717.30
AustinUnavailable$715.79
BakersfieldUnavailable$719.92
Baltimore/Surr. CntysUnavailable$743.63
BeaumontUnavailable$663.59
BrazoriaUnavailable$687.54

21122 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
21122 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 21122 rate is calculated

Each of 21122’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 · 21122

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 8.49Practice expense 10.90Malpractice 1.57

20.9600 adjusted RVUs×$33.4009 conversion factor=$700.08

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 21122

21122 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21122

Sliding genioplasty

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)0Not permitted.
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 · 21122

Sliding genioplasty

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

21122 without 51 · national facility

$700.08

Sliding genioplasty

21122-51 · Second procedure: 50%

$350.04

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

21122 compared with similar codes

Compare codes

21122 vs 21121 vs 21123 vs 21120: national Medicare rates

Swap in your local Medicare rate.

  • 21122
    Sliding genioplasty · 8.49 wRVU
    —
  • 21121
    Sliding genioplasty · 7.61 wRVU
    $649.98
  • 21123
    Chin augmentation · 11.06 wRVU
    —
  • 21120
    Chin augmentation · 4.97 wRVU
    $715.45

How to choose

21121Sliding genioplasty
Use 21121 for a single sliding osteotomy. 21122 requires documentation of two or more osteotomies.
21123Chin augmentation
21123 describes sliding genioplasty with interpositional bone graft augmentation. 21122 is selected for multiple osteotomies without that graft-augmentation technique.
21120Chin augmentation
21120 is for chin augmentation with graft or prosthetic material. 21122 describes reshaping or repositioning through multiple sliding osteotomies.

Codes related to 21122

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

Codes related to 21122
CodeHow it relatesNational office range
Same family
21121Sliding genioplastySliding genioplasty with one osteotomy rather than two or more.$584.18–$826.56
21123Chin augmentationSliding genioplasty with interpositional bone graft augmentation.No office rate
Used instead
21120Chin augmentationChin augmentation using graft or prosthetic material rather than multiple sliding osteotomies.$627.40–$948.72

21122 billing questions

How is 21122 distinguished from 21121?

21122 represents a sliding genioplasty involving two or more osteotomies. Use 21121 when the documented technique uses a single osteotomy.

When is 21123 a better fit?

Use 21123 for sliding genioplasty with interpositional bone graft augmentation. The operative report should support that grafting technique, rather than multiple osteotomies alone.

Should modifier 50 be reported?

No. The chin procedure is midline, so report the service without modifier 50.

What postoperative care is included?

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

How are other procedures in the same session paid?

The highest-valued procedure is paid in full; other procedures performed in that session are subject to the standard multiple-procedure reduction.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeons and team surgery are not permitted for this code.

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 21122PPRRVU2026_Oct_nonQPP.csv, line 1,879 (RVU26D)

Open CMS sourceHow we calculate rates

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