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Billing code 21193: Mandibular reconstructionMedicare rate & RVUs

Reports operative reconstruction of the lower jaw when the documented procedure is performed without a bone graft.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $1,108.58 for 21193 nationally in a facility.

Medicare rate · 21193

Mandibular reconstruction

Work RVUs
18.43
Total RVUs
33.19
Global days
090

National rate · 2026

$1,108.58

Facility setting, before claim adjustments.

See every locality for 21193 →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 21193 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 21193 covers

billing code 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

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

109 of 109 payment localities

21193 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,019.29
Alaska*Unavailable$1,402.40
ArizonaUnavailable$1,083.18
ArkansasUnavailable$1,008.27
AtlantaUnavailable$1,134.87
AustinUnavailable$1,123.00
BakersfieldUnavailable$1,124.01
Baltimore/Surr. CntysUnavailable$1,169.09
BeaumontUnavailable$1,065.91
BrazoriaUnavailable$1,090.18

21193 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
21193 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 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

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)2Already bilateral by definition: paid once at 100%.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
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 · 21193

Mandibular reconstruction

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.

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

21193 without 51 · national facility

$1,108.58

Mandibular reconstruction

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%).

When to use modifier 51

21193 compared with similar codes

Compare codes · National

5 codes, side by side

  • 21193

    Mandibular reconstruction18.43 wRVU

    Not priced

  • 21194

    Mandible reconstruction21.27 wRVU

    Not priced

  • 21195

    Jaw reconstruction18.68 wRVU

    Not priced

  • 21196

    Mandibular reconstruction20.31 wRVU

    Not priced

  • 21199

    Mandibular reconstruction16.31 wRVU

    Not priced

How to choose

21194Mandible reconstruction
Use 21194 when the lower-jaw reconstruction includes a bone graft; 21193 is the no-graft variant.
21195Jaw reconstruction
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 reconstruction
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 reconstruction
21199 identifies lower-jaw reconstruction involving advancement; 21193 is distinguished by reconstruction without a bone graft.

Codes related to 21193

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

Codes related to 21193
CodeHow it relatesNational office range
Same family
21194Mandible reconstructionLower-jaw reconstruction variant that includes a bone graft.No office rate
21195Jaw reconstructionLower-jaw reconstruction variant identified by the absence of fixation.No office rate
21196Mandibular reconstructionLower-jaw reconstruction variant identified by fixation.No office rate
21198Jaw reconstructionRelated lower-jaw reconstruction code for a segmental procedure.No office rate
21199Mandibular reconstructionRelated lower-jaw reconstruction code involving advancement.No office rate

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

Show the CMS file lines behind this rate
RVUs for 21193PPRRVU2026_Oct_nonQPP.csv, line 1,907 (RVU26D)

Open CMS sourceHow we calculate rates

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