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Billing code 21340: Nasoethmoid fractureMedicare rate & RVUs

Reports percutaneous treatment of a nasoethmoid complex fracture when the surgeon manipulates the fracture through a percutaneous approach rather than open exposure.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $660.00 for 21340 nationally in a facility.

Medicare rate · 21340

Nasoethmoid fracture

Work RVUs
11.2
Total RVUs
19.76
Global days
090

National rate · 2026

$660.00

Facility setting, before claim adjustments.

See every locality for 21340 →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 21340 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 21340 covers

This code represents treatment of a fracture involving the nasoethmoid complex through a percutaneous approach, with fracture manipulation and stabilization as part of the treatment. It is distinct from open repair, which requires surgical exposure of the fracture. Otolaryngologists, facial plastic surgeons, plastic surgeons, and oral and maxillofacial surgeons may perform this work, often in an operating room after facial trauma such as a motor vehicle collision.

Choose the code based on the documented fracture site and treatment approach, not simply the presence of a nasal fracture. The operative report should identify the nasoethmoid injury and describe the percutaneous manipulation and stabilization performed. CMS assigns 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. Modifier 50 is inappropriate. An assistant is payable only when medical necessity is documented; 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 21340 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

21340 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$607.44
Alaska*Unavailable$837.65
ArizonaUnavailable$644.99
ArkansasUnavailable$600.96
AtlantaUnavailable$675.77
AustinUnavailable$667.97
BakersfieldUnavailable$668.04
Baltimore/Surr. CntysUnavailable$695.79
BeaumontUnavailable$635.30
BrazoriaUnavailable$648.93

21340 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
21340 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 21340 rate is calculated

Each of 21340’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 · 21340

RVUs × geographic indexes × conversion factor

Work11.20

11.20 RVUs× 1.000 GPCI

Practice expense6.93

6.93 RVUs× 1.000 GPCI

Malpractice1.63

1.63 RVUs× 1.000 GPCI

Adjusted RVUs

19.7600

Conversion factor

$33.4009

Medicare rate

$660.00

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 21340

21340 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21340

Nasoethmoid fracture

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)0Not paid without supporting documentation.
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 · 21340

Nasoethmoid fracture

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

21340 without 51 · national facility

$660.00

Nasoethmoid fracture

21340-51 · Second procedure: 50%

$330.00

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

21340 compared with similar codes

Compare codes · National

5 codes, side by side

  • 21340

    Nasoethmoid fracture11.2 wRVU

    Not priced

  • 21338

    Fracture repair6.7 wRVU

    Not priced

  • 21339

    Nasoethmoid repair8.29 wRVU

    Not priced

  • 21315

    Nasal fracture treatment0.94 wRVU

    $159.99

  • 21320

    Nasal fracture treatment1.55 wRVU

    $220.78

How to choose

21338Fracture repair
Both address nasoethmoid complex fractures, but 21338 is for open treatment without internal fixation; 21340 is for percutaneous treatment.
21339Nasoethmoid repair
21339 describes open treatment with internal fixation. Choose 21340 when the documented treatment is percutaneous rather than open.
21315Nasal fracture treatment
21315 concerns closed treatment of a nasal fracture. Use 21340 when the treated injury is a nasoethmoid complex fracture managed percutaneously.
21320Nasal fracture treatment
21320 is for closed nasal fracture treatment with manipulation and stabilization; 21340 identifies percutaneous treatment of a nasoethmoid complex fracture.

Codes related to 21340

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

Codes related to 21340
CodeHow it relatesNational office range
Used instead
21338Fracture repairOpen treatment of a nasoethmoid fracture without internal fixation.No office rate
21339Nasoethmoid repairOpen treatment of a nasoethmoid fracture with internal fixation.No office rate
21315Nasal fracture treatmentClosed treatment for a nasal fracture rather than a nasoethmoid complex injury.$140.02–$215.44
21320Nasal fracture treatmentClosed nasal fracture treatment involving manipulation and stabilization.$194.31–$294.22
21337Septal fractureClosed treatment for a fracture involving the nasal bones and septum.$376.23–$563.22
21346Midface fracture repairOpen treatment with fixation for a nasomaxillary fracture.No office rate

21340 billing questions

How does this differ from codes 21338 and 21339?

21340 describes percutaneous treatment of a nasoethmoid complex fracture. Codes 21338 and 21339 describe open treatment, with 21339 involving internal fixation.

Can this be reported for an isolated nasal bone fracture?

Use this code for a nasoethmoid complex fracture treated percutaneously, not merely because the nose is fractured. Codes 21315 and 21320 concern closed treatment of nasal fractures.

Is modifier 50 appropriate when both sides are involved?

No. CMS does not apply a bilateral adjustment to this code, and modifier 50 is inappropriate.

What postoperative care is included?

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

When can an assistant be reported?

CMS pays an assistant at surgery only when the record documents medical necessity. Co-surgeons and team surgery are not permitted.

How are other procedures in the same session paid?

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

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 21340PPRRVU2026_Oct_nonQPP.csv, line 1,952 (RVU26D)

Open CMS sourceHow we calculate rates

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