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Billing code 21344: Frontal sinus repairMedicare rate & RVUs

Open repair of a complicated frontal sinus fracture, reported for operative treatment of a complex fracture pattern involving the sinus or adjacent structures.

CMS RVU26DEffective Oct 1, 2026109 payment localities27 Medicare services in 2024

Medicare pays $1,215.46 for 21344 nationally in a facility.

Medicare rate · 21344

Frontal sinus repair

Swap in your local Medicare rate.

Work RVUs
21.03
Total RVUs
36.39
Global days
090

National rate · 2026

$1,215.46

Facility setting, before claim adjustments.

See every locality for 21344 → · 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 21344 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 21344 covers

Code 21344 represents open operative repair of a complex fracture involving the frontal sinus, the air space behind the forehead. Facial trauma, otolaryngology, oral and maxillofacial, or neurosurgical specialists may perform the repair in an operating room. The injury may involve sinus walls, the drainage pathway, or adjacent cranial structures and require surgical exposure and reconstruction. A posterior-table injury with intracranial risk is one representative complex pattern, but selection follows the documented fracture and operative treatment, not one finding alone.

Choose 21344 for open treatment of a complicated frontal sinus fracture; a depressed frontal sinus fracture treated openly may instead fit the distinct 21343 pathway. The operative report should identify the fracture pattern and involved structures, explain the open repair, and describe reduction, reconstruction, and fixation when performed. CMS assigns a 90-day major-surgery global period, including the day-before preoperative visit and 90 days of related postoperative care. For same-session multiple procedures, the highest-valued procedure is paid in full and additional procedures at 50%. Assistant-at-surgery payment and co-surgeons are permitted; 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 21344 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

21344 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,119.85
Alaska*Unavailable$1,547.65
ArizonaUnavailable$1,188.04
ArkansasUnavailable$1,108.08
AtlantaUnavailable$1,244.62
AustinUnavailable$1,229.10
BakersfieldUnavailable$1,228.44
Baltimore/Surr. CntysUnavailable$1,280.86
BeaumontUnavailable$1,171.22
BrazoriaUnavailable$1,194.97

21344 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
21344 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 21344 rate is calculated

Each of 21344’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 · 21344

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 21.03Practice expense 12.31Malpractice 3.05

36.3900 adjusted RVUs×$33.4009 conversion factor=$1,215.46

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

Payment rules and modifiers for 21344

21344 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21344

Frontal sinus repair

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)2Permitted.
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 · 21344

Frontal sinus repair

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

21344 without 51 · national facility

$1,215.46

Frontal sinus repair

21344-51 · Second procedure: 50%

$607.73

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

21344 compared with similar codes

Compare codes

21344 vs 21343 vs 21339 vs 21346 vs 21385: national Medicare rates

Swap in your local Medicare rate.

  • 21344
    Frontal sinus repair · 21.03 wRVU
    —
  • 21343
    Frontal sinus repair · 13.96 wRVU
    —
  • 21339
    Nasoethmoid repair · 8.29 wRVU
    —
  • 21346
    Midface fracture repair · 11.16 wRVU
    —
  • 21385
    Orbital fracture repair · 9.33 wRVU
    —

How to choose

21343Frontal sinus repair
Both address open frontal sinus fracture treatment. Use 21344 for a complicated fracture pattern; 21343 is for a depressed frontal sinus fracture.
21339Nasoethmoid repair
21339 treats an open nasoethmoid fracture with fixation. It is not the code for open repair of the frontal sinus fracture.
21346Midface fracture repair
21346 addresses open treatment of a nasomaxillary fracture with fixation, rather than a complicated frontal sinus fracture.
21385Orbital fracture repair
21385 describes open treatment of an orbital fracture through a transantral approach; 21344 addresses the frontal sinus fracture.

Codes related to 21344

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

Codes related to 21344
CodeHow it relatesNational office range
Used instead
21343Frontal sinus repairOpen treatment for a depressed frontal sinus fracture when the documented pattern fits that code.No office rate
Often billed with
21339Nasoethmoid repairMay accompany separate open treatment of a nasoethmoid fracture in combined craniofacial trauma.No office rate
21346Midface fracture repairMay accompany separate open treatment of a nasomaxillary fracture in combined facial trauma.No office rate
21385Orbital fracture repairMay accompany separate open treatment of an orbital fracture in combined craniofacial trauma.No office rate

21344 billing questions

How do I distinguish 21344 from 21343?

21344 is for open treatment of a complicated frontal sinus fracture. Code 21343 describes open treatment of a depressed frontal sinus fracture; choose based on the documented fracture pattern and operative service.

Does fixation support reporting 21344?

Fixation may be part of the open fracture repair. Document the fracture anatomy, operative approach, and reduction or fixation performed.

What postoperative care is included?

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

Can an assistant or co-surgeon be reported?

CMS indicates assistant-at-surgery payment may be made and permits co-surgeons. Team surgery is not permitted for this code.

Should modifier 50 be appended?

No. The descriptor and anatomy make modifier 50 inappropriate for this service.

How are other procedures in the same session paid?

Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and additional procedures are paid at 50%.

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 21344PPRRVU2026_Oct_nonQPP.csv, line 1,954 (RVU26D)

Open CMS sourceHow we calculate rates

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