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Billing code 21347: Nasomaxillary fracture repairMedicare rate & RVUs

Reports open repair of a LeFort II-pattern nasomaxillary fracture when the surgeon uses multiple surgical approaches to expose and reduce the fracture.

CMS RVU26DEffective Oct 1, 2026109 payment localities55 Medicare services in 2024

Medicare pays $939.23 for 21347 nationally in a facility.

Medicare rate · 21347

Nasomaxillary fracture repair

Swap in your local Medicare rate.

Work RVUs
13.19
Total RVUs
28.12
Global days
090

National rate · 2026

$939.23

Facility setting, before claim adjustments.

See every locality for 21347 → · 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 21347 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 21347 covers

This service is open surgical repair of a LeFort II-pattern fracture involving the central midface, including the nasal and maxillary structures. The surgeon exposes and reduces the fracture through multiple operative approaches. Oral and maxillofacial surgeons, facial plastic surgeons, and otolaryngologists may perform the repair, commonly in a hospital operating room after significant facial trauma.

Choose this code when the operative report supports the fracture pattern and use of multiple approaches; the number of approaches, not simply the number of fracture lines, distinguishes it from related repair codes. Document the injury, reduction, and approaches used. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. 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.

Where 21347 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

21347 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$857.08
Alaska*Unavailable$1,158.96
ArizonaUnavailable$916.53
ArkansasUnavailable$846.86
AtlantaUnavailable$960.40
AustinUnavailable$958.01
BakersfieldUnavailable$964.25
Baltimore/Surr. CntysUnavailable$993.20
BeaumontUnavailable$895.57
BrazoriaUnavailable$924.74

21347 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
21347 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 21347 rate is calculated

Each of 21347’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 · 21347

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 13.19Practice expense 13.01Malpractice 1.92

28.1200 adjusted RVUs×$33.4009 conversion factor=$939.23

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

Payment rules and modifiers for 21347

21347 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21347

Nasomaxillary fracture 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)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 · 21347

Nasomaxillary fracture 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

21347 without 51 · national facility

$939.23

Nasomaxillary fracture repair

21347-51 · Second procedure: 50%

$469.62

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

21347 compared with similar codes

Compare codes

21347 vs 21346 vs 21348 vs 21345: national Medicare rates

Swap in your local Medicare rate.

  • 21347
    Nasomaxillary fracture repair · 13.19 wRVU
    —
  • 21346
    Midface fracture repair · 11.16 wRVU
    —
  • 21348
    Facial fracture repair · 17.08 wRVU
    —
  • 21345
    Midface fracture · 8.83 wRVU
    $799.28

How to choose

21346Midface fracture repair
Use 21347 when multiple operative approaches are used. Code 21346 describes open nasomaxillary fracture repair with fixation.
21348Facial fracture repair
Code 21348 is the related open repair when bone grafting distinguishes the service; 21347 is identified by multiple approaches.
21345Midface fracture
Code 21345 describes closed treatment of a nasomaxillary fracture. Use 21347 for the documented open repair with multiple approaches.

Codes related to 21347

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

Codes related to 21347
CodeHow it relatesNational office range
Same family
21346Midface fracture repairRelated open nasomaxillary fracture repair distinguished by fixation.No office rate
21348Facial fracture repairRelated open nasomaxillary fracture repair distinguished by bone grafting.No office rate
Used instead
21345Midface fractureClosed treatment for a nasomaxillary fracture when open repair is not performed.$713.35–$1,015.61

21347 billing questions

How is 21347 distinguished from 21346?

21347 is selected when the open repair uses multiple surgical approaches. Code 21346 describes a related open repair with fixation; follow the specific operative service documented.

Does multiple approaches mean multiple fracture lines?

No. The distinction is the use of multiple operative approaches to expose and repair the nasomaxillary fracture, not merely the presence of multiple fracture lines.

Can modifier 50 be reported when both sides are involved?

No. CMS identifies bilateral adjustment as inappropriate for this code, even when the injury involves both sides.

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?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

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 21347PPRRVU2026_Oct_nonQPP.csv, line 1,957 (RVU26D)

Open CMS sourceHow we calculate rates

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