Billing code 21461: Mandibular fracture repairMedicare rate & RVUs
Reports operative reduction and stabilization of a mandibular fracture when the surgeon treats it openly without using interdental fixation.
Medicare pays $1,791.29 for 21461 nationally in the office and $970.30 in a hospital or facility. Local office rates run $1,566.43–$2,442.71.
Medicare rate · 21461
Mandibular fracture repair
- Work RVUs
- 9.08
- Total RVUs
- 53.63
- Global days
- 090
National rate · 2026
$1,791.29
Office setting, before claim adjustments.
See every locality for 21461 →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
What 21461 covers
This service covers operative exposure, alignment, and stabilization of a fractured mandible without fastening the teeth or dental arches together for fixation. Oral and maxillofacial surgeons, otolaryngologists, and plastic surgeons may perform it in an operating room, commonly for fractures requiring open reduction and stabilization. Plate-and-screw fixation may be used; the key distinction from the related interdental-fixation code is that fixation between the teeth is not used.
Select the code from the operative report’s fracture treatment and fixation method, not simply from the fracture diagnosis. Document the mandibular fracture site and pattern, the open approach, reduction and stabilization performed, and whether interdental fixation was used. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are subject to the standard reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted; 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 21461 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$1566.43 to $2442.71
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $1,591.77 | $873.40 |
| Alaska* | $2,017.16 | $1,142.80 |
| Arizona | $1,740.22 | $944.67 |
| Arkansas | $1,566.43 | $861.20 |
| Atlanta | $1,824.10 | $989.97 |
| Austin | $1,870.68 | $1,002.06 |
| Bakersfield | $1,918.59 | $1,018.78 |
| Baltimore/Surr. Cntys | $1,911.94 | $1,031.02 |
| Beaumont | $1,658.20 | $911.10 |
| Brazoria | $1,771.09 | $957.49 |
| Chicago | $1,857.30 | $1,032.20 |
| Chico | $1,914.79 | $1,014.98 |
| Colorado | $1,877.78 | $1,004.24 |
| Connecticut | $1,917.75 | $1,033.54 |
| Dallas | $1,782.03 | $964.32 |
| Dc + Md/Va Suburbs | $2,069.69 | $1,102.56 |
| Delaware | $1,771.06 | $959.91 |
| Detroit | $1,770.76 | $978.50 |
| East St. Louis | $1,720.12 | $964.80 |
| El Centro | $1,915.01 | $1,015.20 |
| Fort Lauderdale | $1,845.42 | $1,013.75 |
| Fort Worth | $1,768.16 | $958.66 |
| Fresno | $1,914.79 | $1,014.98 |
| Galveston | $1,776.08 | $960.83 |
| Hanford-Corcoran | $1,914.79 | $1,014.98 |
| Hawaii, Guam | $1,970.73 | $1,037.26 |
| Houston | $1,800.06 | $984.81 |
| Idaho | $1,652.69 | $897.38 |
| Indiana | $1,663.37 | $902.31 |
| Iowa | $1,642.14 | $890.93 |
| Kansas | $1,630.94 | $888.76 |
| Kentucky | $1,627.26 | $897.40 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $2,053.32 | $1,082.09 |
| Madera | $1,914.79 | $1,014.98 |
| Manhattan | $2,070.31 | $1,116.31 |
| Merced | $1,914.79 | $1,014.98 |
| Metropolitan Boston | $2,079.10 | $1,098.83 |
| Metropolitan Kansas City | $1,702.18 | $931.27 |
| Metropolitan Philadelphia | $1,864.41 | $1,009.75 |
| Metropolitan St. Louis | $1,722.05 | $940.47 |
| Miami | $1,917.41 | $1,062.75 |
| Minnesota | $1,802.37 | $957.57 |
| Mississippi | $1,579.12 | $872.24 |
| Modesto | $1,914.79 | $1,014.98 |
| Montana** | $1,791.20 | $970.21 |
| Napa | $2,248.14 | $1,166.07 |
| Nebraska | $1,652.87 | $895.09 |
| Nevada** | $1,785.43 | $963.61 |
| New Hampshire | $1,845.04 | $990.38 |
| New Mexico | $1,680.21 | $927.36 |
| New Orleans | $1,712.03 | $939.47 |
| North Carolina | $1,678.73 | $912.74 |
| North Dakota** | $1,765.30 | $944.31 |
| Northern Nj | $2,044.45 | $1,092.10 |
| Nyc Suburbs/Long Island | $2,121.16 | $1,145.00 |
| Ohio | $1,665.99 | $916.42 |
| Oklahoma | $1,627.00 | $893.85 |
| Oxnard-Thousand Oaks-Ventura | $2,046.14 | $1,075.73 |
| Portland | $1,945.25 | $1,033.13 |
| Poughkpsie/N Nyc Suburbs | $1,951.33 | $1,052.34 |
| Puerto Rico | $1,806.52 | $976.50 |
| Queens | $2,092.89 | $1,122.48 |
| Redding | $1,914.79 | $1,014.98 |
| Rest Of California | $1,914.79 | $1,014.98 |
| Rest Of Florida | $1,749.75 | $964.88 |
| Rest Of Georgia | $1,643.71 | $911.38 |
| Rest Of Illinois | $1,690.27 | $940.71 |
| Rest Of Louisiana | $1,623.36 | $896.78 |
| Rest Of Maine | $1,659.21 | $903.90 |
| Rest Of Maryland | $1,808.07 | $977.22 |
| Rest Of Massachusetts | $1,863.81 | $999.30 |
| Rest Of Michigan | $1,671.28 | $921.72 |
| Rest Of Missouri | $1,590.85 | $883.15 |
| Rest Of New Jersey | $1,940.54 | $1,044.01 |
| Rest Of New York | $1,706.08 | $926.14 |
| Rest Of Oregon | $1,772.52 | $954.81 |
| Rest Of Pennsylvania | $1,670.45 | $916.78 |
| Rest Of Texas | $1,713.39 | $934.27 |
| Rest Of Washington | $1,861.32 | $996.81 |
| Rhode Island | $1,839.99 | $991.90 |
| Riverside-San Bernardino-Ontario | $1,928.97 | $1,029.16 |
| Sacramento-Roseville-Folsom | $2,017.32 | $1,062.50 |
| Salinas | $2,010.03 | $1,058.49 |
| San Diego-Chula Vista-Carlsbad | $2,063.42 | $1,081.51 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $2,388.57 | $1,230.97 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $2,387.09 | $1,229.49 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $2,442.71 | $1,258.84 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $2,436.63 | $1,252.75 |
| San Luis Obispo-Paso Robles | $1,976.90 | $1,041.78 |
| Santa Cruz-Watsonville | $2,087.87 | $1,090.36 |
| Santa Maria-Santa Barbara | $2,019.23 | $1,061.95 |
| Santa Rosa-Petaluma | $2,109.38 | $1,101.20 |
| Seattle (King Cnty) | $2,126.29 | $1,118.93 |
| South Carolina | $1,674.96 | $916.37 |
| South Dakota** | $1,762.24 | $941.24 |
| Southern Maine | $1,762.15 | $948.54 |
| Stockton | $1,914.79 | $1,014.98 |
| Suburban Chicago | $1,866.19 | $1,023.03 |
| Tennessee | $1,639.60 | $893.32 |
| Utah | $1,700.17 | $928.44 |
| Vallejo | $2,246.00 | $1,163.93 |
| Vermont | $1,755.23 | $942.45 |
| Virgin Islands | $1,806.52 | $976.50 |
| Virginia | $1,753.87 | $946.84 |
| Visalia | $1,914.79 | $1,014.98 |
| West Virginia | $1,620.95 | $907.51 |
| Wisconsin | $1,700.35 | $913.84 |
| Wyoming** | $1,779.91 | $958.92 |
| Yuba City | $1,914.79 | $1,014.98 |
21461 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$1,566.43
$2,178.75
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $2,017.16 | 1 |
| AL | $1,591.77 | 1 |
| AR | $1,566.43 | 1 |
| AZ | $1,740.22 | 1 |
| CA | $1,914.79–$2,442.71 | 29 |
| CO | $1,877.78 | 1 |
| CT | $1,917.75 | 1 |
| DC | $2,069.69 | 1 |
| DE | $1,771.06 | 1 |
| FL | $1,749.75–$1,917.41 | 3 |
| GA | $1,643.71–$1,824.10 | 2 |
| GU | $1,970.73 | 1 |
| HI | $1,970.73 | 1 |
| IA | $1,642.14 | 1 |
| ID | $1,652.69 | 1 |
| IL | $1,690.27–$1,866.19 | 4 |
| IN | $1,663.37 | 1 |
| KS | $1,630.94 | 1 |
| KY | $1,627.26 | 1 |
| LA | $1,623.36–$1,712.03 | 2 |
| MA | $1,863.81–$2,079.10 | 2 |
| MD | $1,808.07–$2,069.69 | 3 |
| ME | $1,659.21–$1,762.15 | 2 |
| MI | $1,671.28–$1,770.76 | 2 |
| MN | $1,802.37 | 1 |
| MO | $1,590.85–$1,722.05 | 3 |
| MS | $1,579.12 | 1 |
| MT | $1,791.20 | 1 |
| NC | $1,678.73 | 1 |
| ND | $1,765.30 | 1 |
| NE | $1,652.87 | 1 |
| NH | $1,845.04 | 1 |
| NJ | $1,940.54–$2,044.45 | 2 |
| NM | $1,680.21 | 1 |
| NV | $1,785.43 | 1 |
| NY | $1,706.08–$2,121.16 | 5 |
| OH | $1,665.99 | 1 |
| OK | $1,627.00 | 1 |
| OR | $1,772.52–$1,945.25 | 2 |
| PA | $1,670.45–$1,864.41 | 2 |
| PR | $1,806.52 | 1 |
| RI | $1,839.99 | 1 |
| SC | $1,674.96 | 1 |
| SD | $1,762.24 | 1 |
| TN | $1,639.60 | 1 |
| TX | $1,658.20–$1,870.68 | 8 |
| UT | $1,700.17 | 1 |
| VA | $1,753.87–$2,069.69 | 2 |
| VI | $1,806.52 | 1 |
| VT | $1,755.23 | 1 |
| WA | $1,861.32–$2,126.29 | 2 |
| WI | $1,700.35 | 1 |
| WV | $1,620.95 | 1 |
| WY | $1,779.91 | 1 |
How the 21461 rate is calculated
Each of 21461’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 · 21461
RVUs × geographic indexes × conversion factor
Work9.08
9.08 RVUs× 1.000 GPCI
Practice expense43.24
43.24 RVUs× 1.000 GPCI
Malpractice1.31
1.31 RVUs× 1.000 GPCI
Adjusted RVUs
53.6300
Conversion factor
$33.4009
Medicare rate
$1,791.29
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 21461
21461 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21461
Mandibular fracture repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 21461
Mandibular 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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
21461 without 51 · national office
$1,791.29
Mandibular fracture repair
21461-51 · Second procedure: 50%
$895.65
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%).
21461 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 21462Mandibular fracture repair
- Both describe open treatment of mandibular fractures. Choose 21462 when interdental fixation is used; 21461 is for treatment without it.
- 21453Mandibular fracture care
- 21453 describes closed treatment with interdental fixation. This code describes open treatment without interdental fixation.
- 21454Mandibular fracture repair
- 21454 is the open-treatment option when external fixation is used. This code is for open treatment without interdental fixation.
- 21470Mandibular fracture repair
- 21470 describes open treatment of a complicated mandibular fracture; 21461 is for open treatment without interdental fixation when the complicated-fracture code is not indicated.
21461 billing questions
How does this differ from 21462?
21461 describes open mandibular fracture treatment without interdental fixation. Use 21462 when interdental fixation is part of the open treatment.
Can the surgeon use plates and screws with this code?
Yes. The distinguishing point is that fixation between the teeth is not used; document the stabilization method in the operative report.
How does this differ from 21453?
21453 is for closed treatment with interdental fixation. This code represents open treatment without interdental fixation.
Is modifier 50 appropriate for fractures on both sides?
No. CMS identifies bilateral adjustment as inapplicable to this code; modifier 50 is inappropriate.
Can an assistant surgeon or co-surgeon be paid?
Medicare does not pay an assistant at surgery for this code. Co-surgeon payment is limited to cases supported by 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
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