Billing code 21497: Interdental wiringMedicare rate & RVUs
Interdental wiring stabilizes the jaws through dental fixation for a documented nonfracture indication, rather than as part of coded fracture treatment.
Medicare pays $717.12 for 21497 nationally in the office and $561.80 in a hospital or facility. Local office rates run $631.55–$968.83.
Medicare rate · 21497
Interdental wiring
- Work RVUs
- 4.52
- Total RVUs
- 21.47
- Global days
- 090
National rate · 2026
$717.12
Office setting, before claim adjustments.
See every locality for 21497 →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 21497 covers
This service involves placing wire between teeth to hold the jaws in a stable position for a nonfracture indication. It is generally performed by an oral and maxillofacial surgeon, often in a facility setting. The clinical record should identify why interdental stabilization is needed and describe the wiring performed; the indication should not be a fracture treated under a fracture-specific code.
Report the service when the documented work is interdental wiring for a nonfracture condition, not merely because wires are present as part of another procedure. The 90-day global period includes the day-before preoperative visit and related postoperative care during that period. 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. Modifier 50 is not appropriate for this code. Assistant-at-surgery payment requires documented medical necessity; 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 21497 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
$631.55 to $968.83
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $641.19 | $505.29 |
| Alaska* | $820.82 | $655.41 |
| Arizona | $697.68 | $547.18 |
| Arkansas | $631.55 | $498.13 |
| Atlanta | $729.72 | $571.92 |
| Austin | $747.38 | $583.06 |
| Bakersfield | $766.20 | $595.98 |
| Baltimore/Surr. Cntys | $763.60 | $596.95 |
| Beaumont | $666.48 | $525.15 |
| Brazoria | $709.71 | $555.79 |
| Chicago | $742.55 | $586.46 |
| Chico | $764.68 | $594.46 |
| Colorado | $750.44 | $585.18 |
| Connecticut | $765.95 | $598.68 |
| Dallas | $713.91 | $559.21 |
| Dc + Md/Va Suburbs | $824.96 | $642.00 |
| Delaware | $709.59 | $556.14 |
| Detroit | $709.34 | $559.47 |
| East St. Louis | $690.10 | $547.21 |
| El Centro | $764.77 | $594.54 |
| Fort Lauderdale | $737.75 | $580.42 |
| Fort Worth | $708.63 | $555.49 |
| Fresno | $764.68 | $594.46 |
| Galveston | $711.61 | $557.38 |
| Hanford-Corcoran | $764.68 | $594.46 |
| Hawaii, Guam | $785.36 | $608.77 |
| Houston | $720.76 | $566.53 |
| Idaho | $664.36 | $521.47 |
| Indiana | $668.42 | $524.45 |
| Iowa | $660.34 | $518.23 |
| Kansas | $656.09 | $515.68 |
| Kentucky | $654.71 | $516.64 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $818.24 | $634.51 |
| Madera | $764.68 | $594.46 |
| Manhattan | $825.58 | $645.10 |
| Merced | $764.68 | $594.46 |
| Metropolitan Boston | $828.06 | $642.62 |
| Metropolitan Kansas City | $683.22 | $537.38 |
| Metropolitan Philadelphia | $745.59 | $583.90 |
| Metropolitan St. Louis | $690.78 | $542.92 |
| Miami | $765.18 | $603.50 |
| Minnesota | $721.29 | $561.48 |
| Mississippi | $636.39 | $502.66 |
| Modesto | $764.68 | $594.46 |
| Montana** | $717.08 | $561.77 |
| Napa | $893.14 | $688.43 |
| Nebraska | $664.42 | $521.07 |
| Nevada** | $714.88 | $559.41 |
| New Hampshire | $737.56 | $575.87 |
| New Mexico | $674.87 | $532.45 |
| New Orleans | $686.97 | $540.82 |
| North Carolina | $674.28 | $529.37 |
| North Dakota** | $707.20 | $551.88 |
| Northern Nj | $815.68 | $635.51 |
| Nyc Suburbs/Long Island | $844.94 | $660.27 |
| Ohio | $669.45 | $527.65 |
| Oklahoma | $654.60 | $515.91 |
| Oxnard-Thousand Oaks-Ventura | $815.05 | $631.47 |
| Portland | $776.25 | $603.69 |
| Poughkpsie/N Nyc Suburbs | $779.62 | $609.55 |
| Puerto Rico | $722.91 | $565.89 |
| Queens | $834.16 | $650.58 |
| Redding | $764.68 | $594.46 |
| Rest Of California | $764.68 | $594.46 |
| Rest Of Florida | $701.34 | $552.86 |
| Rest Of Georgia | $660.98 | $522.44 |
| Rest Of Illinois | $678.72 | $536.92 |
| Rest Of Louisiana | $653.23 | $515.78 |
| Rest Of Maine | $666.85 | $523.96 |
| Rest Of Maryland | $723.85 | $566.67 |
| Rest Of Massachusetts | $745.26 | $581.72 |
| Rest Of Michigan | $671.47 | $529.67 |
| Rest Of Missouri | $640.86 | $506.98 |
| Rest Of New Jersey | $775.33 | $605.72 |
| Rest Of New York | $684.69 | $537.14 |
| Rest Of Oregon | $709.96 | $555.27 |
| Rest Of Pennsylvania | $671.14 | $528.57 |
| Rest Of Texas | $687.48 | $540.08 |
| Rest Of Washington | $744.21 | $580.66 |
| Rhode Island | $736.31 | $575.87 |
| Riverside-San Bernardino-Ontario | $770.13 | $599.90 |
| Sacramento-Roseville-Folsom | $804.36 | $623.73 |
| Salinas | $801.41 | $621.40 |
| San Diego-Chula Vista-Carlsbad | $821.69 | $635.93 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $947.70 | $728.70 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $947.13 | $728.14 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $968.83 | $744.87 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $966.51 | $742.55 |
| San Luis Obispo-Paso Robles | $788.31 | $611.40 |
| Santa Cruz-Watsonville | $830.67 | $641.96 |
| Santa Maria-Santa Barbara | $804.80 | $623.71 |
| Santa Rosa-Petaluma | $839.17 | $648.45 |
| Seattle (King Cnty) | $846.33 | $655.76 |
| South Carolina | $672.85 | $529.34 |
| South Dakota** | $706.03 | $550.71 |
| Southern Maine | $706.01 | $552.09 |
| Stockton | $764.68 | $594.46 |
| Suburban Chicago | $745.90 | $586.39 |
| Tennessee | $659.39 | $518.20 |
| Utah | $682.45 | $536.45 |
| Vallejo | $892.32 | $687.61 |
| Vermont | $703.37 | $549.61 |
| Virgin Islands | $722.91 | $565.89 |
| Virginia | $702.87 | $550.19 |
| Visalia | $764.68 | $594.46 |
| West Virginia | $652.34 | $517.37 |
| Wisconsin | $682.48 | $533.69 |
| Wyoming** | $712.78 | $557.46 |
| Yuba City | $764.68 | $594.46 |
21497 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.
$631.55
$866.76
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 | $820.82 | 1 |
| AL | $641.19 | 1 |
| AR | $631.55 | 1 |
| AZ | $697.68 | 1 |
| CA | $764.68–$968.83 | 29 |
| CO | $750.44 | 1 |
| CT | $765.95 | 1 |
| DC | $824.96 | 1 |
| DE | $709.59 | 1 |
| FL | $701.34–$765.18 | 3 |
| GA | $660.98–$729.72 | 2 |
| GU | $785.36 | 1 |
| HI | $785.36 | 1 |
| IA | $660.34 | 1 |
| ID | $664.36 | 1 |
| IL | $678.72–$745.90 | 4 |
| IN | $668.42 | 1 |
| KS | $656.09 | 1 |
| KY | $654.71 | 1 |
| LA | $653.23–$686.97 | 2 |
| MA | $745.26–$828.06 | 2 |
| MD | $723.85–$824.96 | 3 |
| ME | $666.85–$706.01 | 2 |
| MI | $671.47–$709.34 | 2 |
| MN | $721.29 | 1 |
| MO | $640.86–$690.78 | 3 |
| MS | $636.39 | 1 |
| MT | $717.08 | 1 |
| NC | $674.28 | 1 |
| ND | $707.20 | 1 |
| NE | $664.42 | 1 |
| NH | $737.56 | 1 |
| NJ | $775.33–$815.68 | 2 |
| NM | $674.87 | 1 |
| NV | $714.88 | 1 |
| NY | $684.69–$844.94 | 5 |
| OH | $669.45 | 1 |
| OK | $654.60 | 1 |
| OR | $709.96–$776.25 | 2 |
| PA | $671.14–$745.59 | 2 |
| PR | $722.91 | 1 |
| RI | $736.31 | 1 |
| SC | $672.85 | 1 |
| SD | $706.03 | 1 |
| TN | $659.39 | 1 |
| TX | $666.48–$747.38 | 8 |
| UT | $682.45 | 1 |
| VA | $702.87–$824.96 | 2 |
| VI | $722.91 | 1 |
| VT | $703.37 | 1 |
| WA | $744.21–$846.33 | 2 |
| WI | $682.48 | 1 |
| WV | $652.34 | 1 |
| WY | $712.78 | 1 |
How the 21497 rate is calculated
Each of 21497’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 · 21497
RVUs × geographic indexes × conversion factor
Work4.52
4.52 RVUs× 1.000 GPCI
Practice expense16.45
16.45 RVUs× 1.000 GPCI
Malpractice0.50
0.50 RVUs× 1.000 GPCI
Adjusted RVUs
21.4700
Conversion factor
$33.4009
Medicare rate
$717.12
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 21497
21497 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21497
Interdental wiring
| 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) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| 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 · 21497
Interdental wiring
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
21497 without 51 · national office
$717.12
Interdental wiring
21497-51 · Second procedure: 50%
$358.56
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%).
21497 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 21453Mandibular fracture care
- Use 21453 for closed treatment of a mandibular fracture with interdental fixation. Use 21497 for interdental wiring when the indication is not a fracture.
- 21462Mandibular fracture repair
- Use 21462 for open treatment of a mandibular fracture with interdental fixation. This code describes nonfracture interdental wiring instead.
- 21499Unlisted muscskel px head
- Use 21499 only when no listed code describes the service. Code 21497 specifically describes interdental wiring for a nonfracture indication.
21497 billing questions
How is this distinguished from mandibular fracture treatment?
This code is for interdental wiring with a nonfracture indication. When the wiring is part of treatment for a mandibular fracture, select the fracture-specific code that matches the treatment approach.
What documentation supports reporting this code?
Document the nonfracture indication, the need for interdental stabilization, and the wiring work performed. The record should make clear that the service is not being reported as fracture treatment.
Can the wiring be separately reported with another operation?
The code represents the interdental wiring service itself. Report another procedure only when its distinct work is documented and separate reporting is supported by the applicable coding rules.
Can modifier 50 be used when both sides are treated?
No. CMS identifies bilateral adjustment as inappropriate for this code; report the service without modifier 50.
When is an assistant-at-surgery payment allowed?
CMS permits assistant-at-surgery payment only when medical necessity is documented. Co-surgeon and team-surgery payment are not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
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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