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CMS RVU26D · Effective 2026-10-01

21121 in Chico

Office / nonfacility

$676.03

Base rate per service

Facility setting

$497.38

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 21121: Single-piece sliding genioplasty

Reports a single-piece chin osteotomy repositioned to correct chin projection, asymmetry, or contour by moving the bone segment.

This operation reshapes the chin by cutting the mandibular symphysis as one segment, moving that segment to a planned position, and securing it. Oral and maxillofacial surgeons and plastic surgeons perform it in an operating room for concerns such as chin retrusion, excess projection, asymmetry, or vertical contour. It may be performed alone or as part of orthognathic reconstruction.

Choose 21121 when the operative report documents one sliding bone segment; a multisegment osteotomy or added augmentation changes the code selection. Document the osteotomy configuration, direction of movement, fixation, and any graft or implant work. CMS assigns a 90-day major-surgery global: the day-before preoperative visit and related postoperative care through day 90 are included. For multiple procedures in one session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. CMS permits assistant-at-surgery payment, but not co-surgeon or team-surgery payment. The midline chin procedure is reported without modifier 50; bilateral adjustment is inappropriate.

CMS billing rules for 21121

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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
Assistant at surgery
Assistant at surgery may be paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU7.61 · 39%
  • Practice expense (office) RVU10.98 · 56%
  • Malpractice RVU0.87 · 4%

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.

21121 compared with similar codes

Office rates for Chico, from the same CMS release.

21120

Chin augmentation

Augmentation without sliding osteotomy

$753.81

21120 describes augmentation of the chin. Choose 21121 when the surgeon repositions a single osteotomized bone segment instead.

21122

Sliding genioplasty

Two or more osteotomies

No office rate

21122 is for a sliding osteotomy divided into two or more segments; 21121 is the single-segment procedure.

21123

Chin augmentation

Sliding osteotomy with graft

No office rate

21123 includes augmentation with the sliding osteotomy. Use 21121 when the documented procedure is a single-piece sliding osteotomy without that augmentation.

The same code, a different location

How does Chico compare?

In Bakersfield, the office rate for 21121 is $678.66—$2.63 higher than the $676.03 rate in Chico. Both use the same code, release and participation basis.

21121 across payment areas

Same release and payment basis · bars start at $0

  1. Chico · This locality

    $676.03

  2. Bakersfield

    $678.66

    $2.63 higher than Chico

  3. El Centro

    $676.17

    $0.14 higher than Chico

  4. Fresno

    $676.03

    The same base rate than Chico

  5. Hanford-Corcoran

    $676.03

    The same base rate than Chico

  6. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $717.75

    $41.72 higher than Chico

  7. Madera

    $676.03

    The same base rate than Chico

Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 21121 ranges from $584.18 in Arkansas to $826.56 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

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

  • Merced

    California · 21121

    Office

    $676.03

    Facility

    $497.38

    The same base rate than Chico for the office setting.

  • Modesto

    California · 21121

    Office

    $676.03

    Facility

    $497.38

    The same base rate than Chico for the office setting.

  • Napa

    California · 21121

    Office

    $768.32

    Facility

    $553.49

    $92.29 higher than Chico for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 21121

    Office

    $712.89

    Facility

    $520.23

    $36.86 higher than Chico for the office setting.

  • Redding

    California · 21121

    Office

    $676.03

    Facility

    $497.38

    The same base rate than Chico for the office setting.

  • Rest Of California

    California · 21121

    Office

    $676.03

    Facility

    $497.38

    The same base rate than Chico for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 21121

    Office

    $685.49

    Facility

    $506.85

    $9.46 higher than Chico for the office setting.

  • Sacramento-Roseville-Folsom

    California · 21121

    Office

    $705.43

    Facility

    $515.86

    $29.40 higher than Chico for the office setting.

  • Salinas

    California · 21121

    Office

    $702.69

    Facility

    $513.78

    $26.66 higher than Chico for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 21121

    Office

    $716.18

    Facility

    $521.24

    $40.15 higher than Chico for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 21121

    Office

    $808.77

    Facility

    $578.95

    $132.74 higher than Chico for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 21121

    Office

    $807.78

    Facility

    $577.96

    $131.75 higher than Chico for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 21121

    Office

    $826.56

    Facility

    $591.52

    $150.53 higher than Chico for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 21121

    Office

    $822.52

    Facility

    $587.48

    $146.49 higher than Chico for the office setting.

  • San Luis Obispo-Paso Robles

    California · 21121

    Office

    $691.80

    Facility

    $506.14

    $15.77 higher than Chico for the office setting.

  • Santa Cruz-Watsonville

    California · 21121

    Office

    $720.69

    Facility

    $522.64

    $44.66 higher than Chico for the office setting.

  • Santa Maria-Santa Barbara

    California · 21121

    Office

    $704.49

    Facility

    $514.44

    $28.46 higher than Chico for the office setting.

  • Santa Rosa-Petaluma

    California · 21121

    Office

    $727.74

    Facility

    $527.58

    $51.71 higher than Chico for the office setting.

  • Stockton

    California · 21121

    Office

    $676.03

    Facility

    $497.38

    The same base rate than Chico for the office setting.

  • Vallejo

    California · 21121

    Office

    $766.90

    Facility

    $552.07

    $90.87 higher than Chico for the office setting.

  • Visalia

    California · 21121

    Office

    $676.03

    Facility

    $497.38

    The same base rate than Chico for the office setting.

  • Yuba City

    California · 21121

    Office

    $676.03

    Facility

    $497.38

    The same base rate than Chico for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 21121

    Office

    $732.27

    Facility

    $540.26

    $56.24 higher than Chico for the office setting.

  • Miami

    Florida · 21121

    Office

    $709.45

    Facility

    $539.77

    $33.42 higher than Chico for the office setting.

  • Chicago

    Illinois · 21121

    Office

    $691.23

    Facility

    $527.41

    $15.20 higher than Chico for the office setting.

  • Manhattan

    New York · 21121

    Office

    $742.69

    Facility

    $553.29

    $66.66 higher than Chico for the office setting.

  • Alaska*

    Alaska · 21121

    Office

    $787.86

    Facility

    $614.27

    $111.83 higher than Chico for the office setting.

  • Alabama

    Alabama · 21121

    Office

    $591.53

    Facility

    $448.91

    $84.50 lower than Chico for the office setting.

  • Arkansas

    Arkansas · 21121

    Office

    $584.18

    Facility

    $444.16

    $91.85 lower than Chico for the office setting.

  • Arizona

    Arizona · 21121

    Office

    $634.43

    Facility

    $476.48

    $41.60 lower than Chico for the office setting.

  • Colorado

    Colorado · 21121

    Office

    $670.14

    Facility

    $496.71

    $5.89 lower than Chico for the office setting.

  • Connecticut

    Connecticut · 21121

    Office

    $689.41

    Facility

    $513.86

    $13.38 higher than Chico for the office setting.

  • Delaware

    Delaware · 21121

    Office

    $643.92

    Facility

    $482.88

    $32.11 lower than Chico for the office setting.

  • Fort Lauderdale

    Florida · 21121

    Office

    $678.23

    Facility

    $513.11

    $2.20 higher than Chico for the office setting.

  • Rest Of Florida

    Florida · 21121

    Office

    $648.46

    Facility

    $492.64

    $27.57 lower than Chico for the office setting.

  • Atlanta

    Georgia · 21121

    Office

    $662.45

    Facility

    $496.85

    $13.58 lower than Chico for the office setting.

  • Rest Of Georgia

    Georgia · 21121

    Office

    $615.95

    Facility

    $470.56

    $60.08 lower than Chico for the office setting.

  • Hawaii, Guam

    Hawaii · 21121

    Office

    $687.99

    Facility

    $502.66

    $11.96 higher than Chico for the office setting.

  • Iowa

    Iowa · 21121

    Office

    $601.29

    Facility

    $452.14

    $74.74 lower than Chico for the office setting.

  • Idaho

    Idaho · 21121

    Office

    $605.33

    Facility

    $455.37

    $70.70 lower than Chico for the office setting.

  • East St. Louis

    Illinois · 21121

    Office

    $650.11

    Facility

    $500.15

    $25.92 lower than Chico for the office setting.

  • Rest Of Illinois

    Illinois · 21121

    Office

    $634.44

    Facility

    $485.62

    $41.59 lower than Chico for the office setting.

  • Suburban Chicago

    Illinois · 21121

    Office

    $684.10

    Facility

    $516.70

    $8.07 higher than Chico for the office setting.

  • Indiana

    Indiana · 21121

    Office

    $608.27

    Facility

    $457.18

    $67.76 lower than Chico for the office setting.

  • Kansas

    Kansas · 21121

    Office

    $600.36

    Facility

    $453.01

    $75.67 lower than Chico for the office setting.

  • Kentucky

    Kentucky · 21121

    Office

    $606.80

    Facility

    $461.90

    $69.23 lower than Chico for the office setting.

  • New Orleans

    Louisiana · 21121

    Office

    $632.30

    Facility

    $478.92

    $43.73 lower than Chico for the office setting.

  • Rest Of Louisiana

    Louisiana · 21121

    Office

    $606.59

    Facility

    $462.33

    $69.44 lower than Chico for the office setting.

  • Metropolitan Boston

    Massachusetts · 21121

    Office

    $728.35

    Facility

    $533.74

    $52.32 higher than Chico for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 21121

    Office

    $667.59

    Facility

    $495.95

    $8.44 lower than Chico for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 21121

    Office

    $687.71

    Facility

    $512.81

    $11.68 higher than Chico for the office setting.

  • Rest Of Maryland

    Maryland · 21121

    Office

    $654.54

    Facility

    $489.59

    $21.49 lower than Chico for the office setting.

  • Rest Of Maine

    Maine · 21121

    Office

    $609.66

    Facility

    $459.70

    $66.37 lower than Chico for the office setting.

  • Southern Maine

    Maine · 21121

    Office

    $635.96

    Facility

    $474.43

    $40.07 lower than Chico for the office setting.

  • Detroit

    Michigan · 21121

    Office

    $657.08

    Facility

    $499.79

    $18.95 lower than Chico for the office setting.

  • Rest Of Michigan

    Michigan · 21121

    Office

    $621.82

    Facility

    $473.01

    $54.21 lower than Chico for the office setting.

  • Minnesota

    Minnesota · 21121

    Office

    $640.16

    Facility

    $472.44

    $35.87 lower than Chico for the office setting.

  • Metropolitan Kansas City

    Missouri · 21121

    Office

    $626.94

    Facility

    $473.89

    $49.09 lower than Chico for the office setting.

  • Metropolitan St. Louis

    Missouri · 21121

    Office

    $632.44

    Facility

    $477.26

    $43.59 lower than Chico for the office setting.

  • Rest Of Missouri

    Missouri · 21121

    Office

    $598.62

    Facility

    $458.11

    $77.41 lower than Chico for the office setting.

  • Mississippi

    Mississippi · 21121

    Office

    $591.42

    Facility

    $451.08

    $84.61 lower than Chico for the office setting.

  • Montana**

    Montana · 21121

    Office

    $649.92

    Facility

    $486.93

    $26.11 lower than Chico for the office setting.

  • North Carolina

    North Carolina · 21121

    Office

    $614.92

    Facility

    $462.84

    $61.11 lower than Chico for the office setting.

  • North Dakota**

    North Dakota · 21121

    Office

    $632.72

    Facility

    $469.72

    $43.31 lower than Chico for the office setting.

  • Nebraska

    Nebraska · 21121

    Office

    $603.67

    Facility

    $453.22

    $72.36 lower than Chico for the office setting.

  • New Hampshire

    New Hampshire · 21121

    Office

    $661.39

    Facility

    $491.71

    $14.64 lower than Chico for the office setting.

  • Northern Nj

    New Jersey · 21121

    Office

    $726.65

    Facility

    $537.57

    $50.62 higher than Chico for the office setting.

  • Rest Of New Jersey

    New Jersey · 21121

    Office

    $696.71

    Facility

    $518.72

    $20.68 higher than Chico for the office setting.

  • New Mexico

    New Mexico · 21121

    Office

    $625.38

    Facility

    $475.92

    $50.65 lower than Chico for the office setting.

  • Nevada**

    Nevada · 21121

    Office

    $645.50

    Facility

    $482.34

    $30.53 lower than Chico for the office setting.

  • Nyc Suburbs/Long Island

    New York · 21121

    Office

    $760.47

    Facility

    $566.66

    $84.44 higher than Chico for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 21121

    Office

    $702.36

    Facility

    $523.88

    $26.33 higher than Chico for the office setting.

  • Queens

    New York · 21121

    Office

    $745.84

    Facility

    $553.18

    $69.81 higher than Chico for the office setting.

  • Rest Of New York

    New York · 21121

    Office

    $623.01

    Facility

    $468.17

    $53.02 lower than Chico for the office setting.

  • Ohio

    Ohio · 21121

    Office

    $618.31

    Facility

    $469.49

    $57.72 lower than Chico for the office setting.

  • Oklahoma

    Oklahoma · 21121

    Office

    $604.26

    Facility

    $458.70

    $71.77 lower than Chico for the office setting.

  • Portland

    Oregon · 21121

    Office

    $687.32

    Facility

    $506.23

    $11.29 higher than Chico for the office setting.

  • Rest Of Oregon

    Oregon · 21121

    Office

    $639.88

    Facility

    $477.54

    $36.15 lower than Chico for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 21121

    Office

    $675.20

    Facility

    $505.52

    $0.83 lower than Chico for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 21121

    Office

    $618.31

    Facility

    $468.68

    $57.72 lower than Chico for the office setting.

  • Puerto Rico

    Puerto Rico · 21121

    Office

    $653.58

    Facility

    $488.79

    $22.45 lower than Chico for the office setting.

  • Rhode Island

    Rhode Island · 21121

    Office

    $663.78

    Facility

    $495.40

    $12.25 lower than Chico for the office setting.

  • South Carolina

    South Carolina · 21121

    Office

    $617.75

    Facility

    $467.14

    $58.28 lower than Chico for the office setting.

  • South Dakota**

    South Dakota · 21121

    Office

    $630.69

    Facility

    $467.69

    $45.34 lower than Chico for the office setting.

  • Tennessee

    Tennessee · 21121

    Office

    $603.15

    Facility

    $454.99

    $72.88 lower than Chico for the office setting.

  • Austin

    Texas · 21121

    Office

    $668.45

    Facility

    $496.00

    $7.58 lower than Chico for the office setting.

  • Beaumont

    Texas · 21121

    Office

    $614.91

    Facility

    $466.58

    $61.12 lower than Chico for the office setting.

  • Brazoria

    Texas · 21121

    Office

    $642.32

    Facility

    $480.79

    $33.71 lower than Chico for the office setting.

  • Dallas

    Texas · 21121

    Office

    $646.68

    Facility

    $484.33

    $29.35 lower than Chico for the office setting.

  • Fort Worth

    Texas · 21121

    Office

    $643.39

    Facility

    $482.67

    $32.64 lower than Chico for the office setting.

  • Galveston

    Texas · 21121

    Office

    $644.45

    Facility

    $482.59

    $31.58 lower than Chico for the office setting.

  • Houston

    Texas · 21121

    Office

    $660.37

    Facility

    $498.52

    $15.66 lower than Chico for the office setting.

  • Rest Of Texas

    Texas · 21121

    Office

    $628.46

    Facility

    $473.78

    $47.57 lower than Chico for the office setting.

  • Utah

    Utah · 21121

    Office

    $625.01

    Facility

    $471.80

    $51.02 lower than Chico for the office setting.

  • Virginia

    Virginia · 21121

    Office

    $635.20

    Facility

    $474.98

    $40.83 lower than Chico for the office setting.

  • Virgin Islands

    United States Virgin Islands · 21121

    Office

    $653.58

    Facility

    $488.79

    $22.45 lower than Chico for the office setting.

  • Vermont

    Vermont · 21121

    Office

    $631.96

    Facility

    $470.59

    $44.07 lower than Chico for the office setting.

  • Rest Of Washington

    Washington · 21121

    Office

    $665.78

    Facility

    $494.14

    $10.25 lower than Chico for the office setting.

  • Seattle (King Cnty)

    Washington · 21121

    Office

    $740.62

    Facility

    $540.63

    $64.59 higher than Chico for the office setting.

  • Wisconsin

    Wisconsin · 21121

    Office

    $614.47

    Facility

    $458.32

    $61.56 lower than Chico for the office setting.

  • West Virginia

    West Virginia · 21121

    Office

    $614.46

    Facility

    $472.82

    $61.57 lower than Chico for the office setting.

  • Wyoming**

    Wyoming · 21121

    Office

    $642.43

    Facility

    $479.43

    $33.60 lower than Chico for the office setting.

See how rates vary across the country

21121 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$584.18

$787.86

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$787.861
AL$591.531
AR$584.181
AZ$634.431
CA$676.03–$826.5629
CO$670.141
CT$689.411
DC$732.271
DE$643.921
FL$648.46–$709.453
GA$615.95–$662.452
GU$687.991
HI$687.991
IA$601.291
ID$605.331
IL$634.44–$691.234
IN$608.271
KS$600.361
KY$606.801
LA$606.59–$632.302
MA$667.59–$728.352
MD$654.54–$732.273
ME$609.66–$635.962
MI$621.82–$657.082
MN$640.161
MO$598.62–$632.443
MS$591.421
MT$649.921
NC$614.921
ND$632.721
NE$603.671
NH$661.391
NJ$696.71–$726.652
NM$625.381
NV$645.501
NY$623.01–$760.475
OH$618.311
OK$604.261
OR$639.88–$687.322
PA$618.31–$675.202
PR$653.581
RI$663.781
SC$617.751
SD$630.691
TN$603.151
TX$614.91–$668.458
UT$625.011
VA$635.20–$732.272
VI$653.581
VT$631.961
WA$665.78–$740.622
WI$614.471
WV$614.461
WY$642.431

Explore 21121 on the national rate map →

Where does this rate apply?

Chico is a Medicare payment area. Our Census mapping connects it to 30 cities and communities in California, 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.

Browse all communities in California →

Why are the office and facility amounts different?

For 21121 in Chico, the physician’s office rate is $676.03 and the facility-setting rate is $497.38: a difference of $178.65.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 21121 in Chico. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$743.63

$676.03 × 110% = $743.63

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.

Compare your contract offer →

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 21121 in Chico.

PPRRVU2026_Oct_nonQPP.csv

1,878

Code
21121
Physician work
7.61
Practice expense
10.98
Malpractice
0.87

GPCI2026.csv

9

Locality
Chico
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 21121 in Chico
ComponentRVULocality factorAdjusted
Physician work7.61× 1.0177.7394
Practice expense10.98× 1.09612.0341
Malpractice0.87× 0.5360.4663
Total RVUs20.2398
Conversion factor× 33.4009

Office / nonfacility rate, Chico$676.03

Open 21121 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work7.611.017
Practice expense10.981.096
Malpractice0.870.536

(7.61 × 1.017 + 10.98 × 1.096 + 0.87 × 0.536) × $33.4009 = $676.03

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work7.611.017
Practice expense6.11.096
Malpractice0.870.536

(7.61 × 1.017 + 6.1 × 1.096 + 0.87 × 0.536) × $33.4009 = $497.38

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

21121 · Office / nonfacility

$676.03

Effective 2026-10-01

The base rate is $28.52 higher than on 2025-10-01, moving from $647.51 to $676.03 (4.4%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $647.51changed to$676.03

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 7.81 changed to 7.61
    • Practice expense RVU 10.69 changed to 10.98
    • Malpractice RVU 0.74 changed to 0.87
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $647.51

    Held through RVU25B, RVU25C, RVU25D.

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 fromOffice / nonfacilityFacilityCMS release
2026-10-01$676.03$497.38RVU26D
2026-07-01$676.03$497.38RVU26C
2026-04-01$676.03$497.38RVU26B
2026-01-01$676.03$497.38RVU26A
2025-10-01$647.51$538.97RVU25D
2025-07-01$647.51$538.97RVU25C
2025-04-01$647.51$538.97RVU25B
2025-01-01$647.51$538.97RVU25A

21121 billing questions

How does 21121 differ from 21122?

21121 describes a sliding genioplasty using one bone segment. Use 21122 when the osteotomy divides the chin into two or more segments.

When is 21123 used instead?

Use 21123 when augmentation is performed with the sliding osteotomy. The operative report should identify the augmentation material or graft work.

Can modifier 50 be reported?

No. The chin is a midline site for this procedure, and CMS identifies modifier 50 as inappropriate.

Can an assistant surgeon be paid?

CMS permits assistant-at-surgery payment for 21121. Co-surgeon and team-surgery payment are not permitted for this code.

What postoperative care is included?

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

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.

RVUs for 21121PPRRVU2026_Oct_nonQPP.csv, line 1,878 (RVU26D)
Geographic factors for ChicoGPCI2026.csv, line 9 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet