$1,870.68
Use 21465 when the open repair is specifically for a mandibular condylar fracture. Code 21461 describes open mandibular fracture treatment without interdental fixation.
On this page
CMS RVU26D · Effective 2026-10-01
21465 in Austin
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$733.47
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Oral and maxillofacial surgery
About 21465: Open mandibular condylar fracture repair
Report 21465 for open surgical treatment of a fracture involving the mandibular condyle, the part of the jaw that forms the temporomandibular joint.
This service involves surgically exposing and realigning a fractured mandibular condyle, with fixation used when needed to stabilize the fragments. It is typically performed in an operating room by an oral and maxillofacial surgeon, or another surgeon qualified to treat facial fractures. The operative record should identify the condylar fracture and describe the open approach and treatment performed. A fracture managed without surgical exposure is not reported with this code.
Select 21465 for the open treatment of a condylar fracture, rather than a general mandibular fracture code or a code for closed management. Documentation should establish the fracture site and the surgical work; note fixation and any additional fracture procedures performed during the session. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeons are paid only with supporting documentation, and team surgery is not permitted.
CMS billing rules for 21465
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU12.79 · 59%
- Practice expense (office) RVU7.42 · 34%
- Malpractice RVU1.46 · 7%
27
Medicare services in 2024 · #5725 by national volume
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.
21465 compared with similar codes
Office rates for Austin, from the same CMS release.
$2,123.48
21462 describes open mandibular fracture treatment with interdental fixation. For an open condylar fracture, use the condylar-specific 21465.
No office rate
21454 describes open mandibular fracture treatment with external fixation. 21465 identifies open treatment of a condylar fracture.
No office rate
21470 is for complicated mandibular fracture treatment involving multiple approaches. 21465 identifies the condylar fracture service.
The same code, a different location
How does Austin compare?
21465 across payment areas
Same release and payment basis · bars start at $0
Austin · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Rest Of Texas
Texas · 21465
Office
Unavailable
Facility
$706.43
No comparable office rate is available.
Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)
California · 21465
Office
Unavailable
Facility
$770.28
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 21465
Office
Unavailable
Facility
$796.49
No comparable office rate is available.
Miami
Florida · 21465
Office
Unavailable
Facility
$808.52
No comparable office rate is available.
Chicago
Illinois · 21465
Office
Unavailable
Facility
$791.18
No comparable office rate is available.
Manhattan
New York · 21465
Office
Unavailable
Facility
$819.86
No comparable office rate is available.
Alaska*
Alaska · 21465
Office
Unavailable
Facility
$931.61
No comparable office rate is available.
Alabama
Alabama · 21465
Office
Unavailable
Facility
$671.65
No comparable office rate is available.
Arkansas
Arkansas · 21465
Office
Unavailable
Facility
$665.20
No comparable office rate is available.
Arizona
Arizona · 21465
Office
Unavailable
Facility
$709.09
No comparable office rate is available.
Bakersfield
California · 21465
Office
Unavailable
Facility
$736.64
No comparable office rate is available.
Chico
California · 21465
Office
Unavailable
Facility
$732.22
No comparable office rate is available.
El Centro
California · 21465
Office
Unavailable
Facility
$732.47
No comparable office rate is available.
Fresno
California · 21465
Office
Unavailable
Facility
$732.22
No comparable office rate is available.
Hanford-Corcoran
California · 21465
Office
Unavailable
Facility
$732.22
No comparable office rate is available.
Madera
California · 21465
Office
Unavailable
Facility
$732.22
No comparable office rate is available.
Merced
California · 21465
Office
Unavailable
Facility
$732.22
No comparable office rate is available.
Modesto
California · 21465
Office
Unavailable
Facility
$732.22
No comparable office rate is available.
Napa
California · 21465
Office
Unavailable
Facility
$805.53
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 21465
Office
Unavailable
Facility
$762.48
No comparable office rate is available.
Redding
California · 21465
Office
Unavailable
Facility
$732.22
No comparable office rate is available.
Rest Of California
California · 21465
Office
Unavailable
Facility
$732.22
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 21465
Office
Unavailable
Facility
$748.11
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 21465
Office
Unavailable
Facility
$756.95
No comparable office rate is available.
Salinas
California · 21465
Office
Unavailable
Facility
$753.82
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 21465
Office
Unavailable
Facility
$762.85
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 21465
Office
Unavailable
Facility
$839.61
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 21465
Office
Unavailable
Facility
$837.95
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 21465
Office
Unavailable
Facility
$857.71
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 21465
Office
Unavailable
Facility
$850.93
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 21465
Office
Unavailable
Facility
$742.88
No comparable office rate is available.
Santa Cruz-Watsonville
California · 21465
Office
Unavailable
Facility
$763.43
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 21465
Office
Unavailable
Facility
$754.27
No comparable office rate is available.
Santa Rosa-Petaluma
California · 21465
Office
Unavailable
Facility
$770.49
No comparable office rate is available.
Stockton
California · 21465
Office
Unavailable
Facility
$732.22
No comparable office rate is available.
Vallejo
California · 21465
Office
Unavailable
Facility
$803.14
No comparable office rate is available.
Visalia
California · 21465
Office
Unavailable
Facility
$732.22
No comparable office rate is available.
Yuba City
California · 21465
Office
Unavailable
Facility
$732.22
No comparable office rate is available.
Colorado
Colorado · 21465
Office
Unavailable
Facility
$734.11
No comparable office rate is available.
Connecticut
Connecticut · 21465
Office
Unavailable
Facility
$761.67
No comparable office rate is available.
Delaware
Delaware · 21465
Office
Unavailable
Facility
$718.03
No comparable office rate is available.
Fort Lauderdale
Florida · 21465
Office
Unavailable
Facility
$766.42
No comparable office rate is available.
Rest Of Florida
Florida · 21465
Office
Unavailable
Facility
$737.42
No comparable office rate is available.
Atlanta
Georgia · 21465
Office
Unavailable
Facility
$738.85
No comparable office rate is available.
Rest Of Georgia
Georgia · 21465
Office
Unavailable
Facility
$706.39
No comparable office rate is available.
Hawaii, Guam
Hawaii · 21465
Office
Unavailable
Facility
$737.22
No comparable office rate is available.
Iowa
Iowa · 21465
Office
Unavailable
Facility
$673.33
No comparable office rate is available.
Idaho
Idaho · 21465
Office
Unavailable
Facility
$678.27
No comparable office rate is available.
East St. Louis
Illinois · 21465
Office
Unavailable
Facility
$753.42
No comparable office rate is available.
Rest Of Illinois
Illinois · 21465
Office
Unavailable
Facility
$729.69
No comparable office rate is available.
Suburban Chicago
Illinois · 21465
Office
Unavailable
Facility
$771.13
No comparable office rate is available.
Indiana
Indiana · 21465
Office
Unavailable
Facility
$680.64
No comparable office rate is available.
Kansas
Kansas · 21465
Office
Unavailable
Facility
$675.82
No comparable office rate is available.
Kentucky
Kentucky · 21465
Office
Unavailable
Facility
$692.14
No comparable office rate is available.
New Orleans
Louisiana · 21465
Office
Unavailable
Facility
$715.81
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 21465
Office
Unavailable
Facility
$693.25
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 21465
Office
Unavailable
Facility
$784.03
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 21465
Office
Unavailable
Facility
$733.87
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 21465
Office
Unavailable
Facility
$760.28
No comparable office rate is available.
Rest Of Maryland
Maryland · 21465
Office
Unavailable
Facility
$727.04
No comparable office rate is available.
Rest Of Maine
Maine · 21465
Office
Unavailable
Facility
$685.54
No comparable office rate is available.
Southern Maine
Maine · 21465
Office
Unavailable
Facility
$703.57
No comparable office rate is available.
Detroit
Michigan · 21465
Office
Unavailable
Facility
$748.58
No comparable office rate is available.
Rest Of Michigan
Michigan · 21465
Office
Unavailable
Facility
$708.53
No comparable office rate is available.
Minnesota
Minnesota · 21465
Office
Unavailable
Facility
$696.65
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 21465
Office
Unavailable
Facility
$707.56
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 21465
Office
Unavailable
Facility
$712.00
No comparable office rate is available.
Rest Of Missouri
Missouri · 21465
Office
Unavailable
Facility
$688.33
No comparable office rate is available.
Mississippi
Mississippi · 21465
Office
Unavailable
Facility
$676.62
No comparable office rate is available.
Montana**
Montana · 21465
Office
Unavailable
Facility
$723.70
No comparable office rate is available.
North Carolina
North Carolina · 21465
Office
Unavailable
Facility
$689.59
No comparable office rate is available.
North Dakota**
North Dakota · 21465
Office
Unavailable
Facility
$694.83
No comparable office rate is available.
Nebraska
Nebraska · 21465
Office
Unavailable
Facility
$674.38
No comparable office rate is available.
New Hampshire
New Hampshire · 21465
Office
Unavailable
Facility
$727.86
No comparable office rate is available.
Northern Nj
New Jersey · 21465
Office
Unavailable
Facility
$793.68
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 21465
Office
Unavailable
Facility
$768.42
No comparable office rate is available.
New Mexico
New Mexico · 21465
Office
Unavailable
Facility
$713.03
No comparable office rate is available.
Nevada**
Nevada · 21465
Office
Unavailable
Facility
$715.90
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 21465
Office
Unavailable
Facility
$839.77
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 21465
Office
Unavailable
Facility
$776.81
No comparable office rate is available.
Queens
New York · 21465
Office
Unavailable
Facility
$817.80
No comparable office rate is available.
Rest Of New York
New York · 21465
Office
Unavailable
Facility
$696.92
No comparable office rate is available.
Ohio
Ohio · 21465
Office
Unavailable
Facility
$702.63
No comparable office rate is available.
Oklahoma
Oklahoma · 21465
Office
Unavailable
Facility
$686.40
No comparable office rate is available.
Portland
Oregon · 21465
Office
Unavailable
Facility
$745.66
No comparable office rate is available.
Rest Of Oregon
Oregon · 21465
Office
Unavailable
Facility
$708.32
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 21465
Office
Unavailable
Facility
$751.06
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 21465
Office
Unavailable
Facility
$700.79
No comparable office rate is available.
Puerto Rico
Puerto Rico · 21465
Office
Unavailable
Facility
$725.79
No comparable office rate is available.
Rhode Island
Rhode Island · 21465
Office
Unavailable
Facility
$734.83
No comparable office rate is available.
South Carolina
South Carolina · 21465
Office
Unavailable
Facility
$697.65
No comparable office rate is available.
South Dakota**
South Dakota · 21465
Office
Unavailable
Facility
$691.42
No comparable office rate is available.
Tennessee
Tennessee · 21465
Office
Unavailable
Facility
$678.67
No comparable office rate is available.
Utah
Utah · 21465
Office
Unavailable
Facility
$703.95
No comparable office rate is available.
Virginia
Virginia · 21465
Office
Unavailable
Facility
$705.25
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 21465
Office
Unavailable
Facility
$725.79
No comparable office rate is available.
Vermont
Vermont · 21465
Office
Unavailable
Facility
$697.23
No comparable office rate is available.
Rest Of Washington
Washington · 21465
Office
Unavailable
Facility
$730.83
No comparable office rate is available.
Seattle (King Cnty)
Washington · 21465
Office
Unavailable
Facility
$792.49
No comparable office rate is available.
Wisconsin
Wisconsin · 21465
Office
Unavailable
Facility
$679.64
No comparable office rate is available.
West Virginia
West Virginia · 21465
Office
Unavailable
Facility
$712.35
No comparable office rate is available.
Wyoming**
Wyoming · 21465
Office
Unavailable
Facility
$711.12
No comparable office rate is available.
See how rates vary across the country
21465 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
Austin is a Medicare payment area. Our Census mapping connects it to 31 cities and communities in Texas, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
- 21465 in Austin
Multiple payment areas
- 21465 in Barton Creek
- 21465 in Bee Cave
- 21465 in Briarcliff
- 21465 in Cedar Park
Multiple payment areas
- 21465 in Creedmoor
Multiple payment areas
- 21465 in Elgin
Multiple payment areas
- 21465 in Garfield
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 21465 in Austin. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$806.82
$733.47 × 110% = $806.82
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 21465 in Austin.
PPRRVU2026_Oct_nonQPP.csv
1,991
- Code
- 21465
- Physician work
- 12.79
- Practice expense
- 7.42
- Malpractice
- 1.46
GPCI2026.csv
96
- Locality
- Austin
- Physician work
- 1.002
- Practice expense
- 1.058
- Malpractice
- 0.886
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 12.79 | × 1.002 | 12.8156 |
| Practice expense | 7.42 | × 1.058 | 7.8504 |
| Malpractice | 1.46 | × 0.886 | 1.2936 |
| Total RVUs | 21.9595 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Austin$733.47
Open 21465 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 12.79 | 1.002 |
| Practice expense | 7.42 | 1.058 |
| Malpractice | 1.46 | 0.886 |
(12.79 × 1.002 + 7.42 × 1.058 + 1.46 × 0.886) × $33.4009 = $733.47
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
21465 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $733.47 | RVU26D |
| 2026-07-01 | Not available in this setting | $733.47 | RVU26C |
| 2026-04-01 | Not available in this setting | $733.47 | RVU26B |
| 2026-01-01 | Not available in this setting | $733.47 | RVU26A |
| 2025-10-01 | Not available in this setting | $802.35 | RVU25D |
| 2025-07-01 | Not available in this setting | $802.35 | RVU25C |
| 2025-04-01 | Not available in this setting | $802.35 | RVU25B |
| 2025-01-01 | Not available in this setting | $802.35 | RVU25A |
21465 billing questions
How does 21465 differ from 21461 or 21462?
21465 identifies open treatment of a mandibular condylar fracture. Codes 21461 and 21462 describe open mandibular fracture treatment without the condylar-specific designation; 21462 includes interdental fixation.
Can 21465 be reported for a fracture treated without open surgery?
No. Use a code for the applicable closed or percutaneous treatment when the fracture is managed without open surgical exposure.
How should bilateral condylar fractures be reported?
When the service is bilateral, report modifier 50; CMS pays the bilateral procedure at 150%.
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 billed?
Assistant-at-surgery payment may be available. Co-surgeons are paid only when supporting documentation is submitted; 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
1,98821454,,Optx mndblr fx xtrnl fixj,A,,7.18,5.49,NA,5.49,,0.82,13.49,13.49,0,090,0.10,0.69,0.21,2,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,98921461,,Optx mndblr fx wo ntrdntl,A,,9.08,43.24,,18.66,,1.31,53.63,29.05,0,090,0.10,0.69,0.21,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,99021462,,Optx mndblr fx w/ntrdntl,A,,10.73,48.58,,20.79,,1.61,60.92,33.13,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,99121465,,Optx mndblr cndylr fx,A,,12.79,7.42,NA,7.42,,1.46,21.67,21.67,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,99221470,,Optx complicated mndblr fx,A,,17.10,11.46,NA,11.46,,2.56,31.12,31.12,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,99321480,,Cltx tmprmand dislc 1st/sbsq,A,,0.59,4.43,,0.19,,0.13,5.15,0.91,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,99421485,,Cltx tmprmand dislc comp,A,,4.65,24.67,,17.77,,0.67,29.99,23.09,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780
9904412,TX,11,DALLAS,1.009,0.996,0.858