No office rate
21385 describes a transantral-only approach. Choose 21387 when the operative report documents combined access.
On this page
CMS RVU26D · Effective 2026-10-01
21387 in Delaware
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$693.82
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.
Facial fracture surgery
About 21387: Combined-approach orbital floor fracture repair
Reports open repair of an orbital floor blowout fracture when the surgeon uses combined access to reach and treat the fracture.
This service repairs an orbital floor blowout fracture through a combined approach, typically using both periorbital and transantral access. The surgeon exposes the fracture, addresses displaced bone or tissue at the floor, and restores support to the orbit. It may be performed by an oculoplastic, facial plastic, oral and maxillofacial, or other surgeon treating complex facial trauma, usually in an operating room. Such fractures may follow blunt facial injury and can be associated with restricted eye movement, double vision, or a sunken appearance of the eye.
Report this code when the operative record supports open treatment through the combined approach; the documented approach, fracture site, and repair should distinguish it from a single-access repair. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is paid at 150% for bilateral procedures. Assistant-at-surgery payment may be allowed; co-surgeons and team surgery are not permitted.
CMS billing rules for 21387
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.86 · 47%
- Practice expense (office) RVU9.33 · 44%
- Malpractice RVU1.83 · 9%
13
Medicare services in 2024 · #6121 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.
21387 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
21386 describes a periorbital-only approach; 21387 is for combined access to the orbital floor.
No office rate
21390 describes periorbital repair with an implant. This code is distinguished by combined access rather than that periorbital implant description.
No office rate
21395 describes periorbital repair with a bone graft. Use this code when combined access, rather than that graft-specific service, is documented.
The same code, a different location
How does Delaware compare?
21387 across payment areas
Same release and payment basis · bars start at $0
Delaware · This locality
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 Delaware 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
Alabama
Alabama · 21387
Office
Unavailable
Facility
$636.61
No comparable office rate is available.
Arkansas
Arkansas · 21387
Office
Unavailable
Facility
$628.50
No comparable office rate is available.
Arizona
Arizona · 21387
Office
Unavailable
Facility
$683.62
No comparable office rate is available.
Bakersfield
California · 21387
Office
Unavailable
Facility
$714.36
No comparable office rate is available.
Chico
California · 21387
Office
Unavailable
Facility
$709.24
No comparable office rate is available.
El Centro
California · 21387
Office
Unavailable
Facility
$709.55
No comparable office rate is available.
Fresno
California · 21387
Office
Unavailable
Facility
$709.24
No comparable office rate is available.
Hanford-Corcoran
California · 21387
Office
Unavailable
Facility
$709.24
No comparable office rate is available.
Madera
California · 21387
Office
Unavailable
Facility
$709.24
No comparable office rate is available.
Merced
California · 21387
Office
Unavailable
Facility
$709.24
No comparable office rate is available.
Modesto
California · 21387
Office
Unavailable
Facility
$709.24
No comparable office rate is available.
Napa
California · 21387
Office
Unavailable
Facility
$791.86
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 21387
Office
Unavailable
Facility
$744.98
No comparable office rate is available.
Redding
California · 21387
Office
Unavailable
Facility
$709.24
No comparable office rate is available.
Rest Of California
California · 21387
Office
Unavailable
Facility
$709.24
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 21387
Office
Unavailable
Facility
$728.95
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 21387
Office
Unavailable
Facility
$736.38
No comparable office rate is available.
Salinas
California · 21387
Office
Unavailable
Facility
$733.48
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 21387
Office
Unavailable
Facility
$745.05
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 21387
Office
Unavailable
Facility
$828.07
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 21387
Office
Unavailable
Facility
$826.00
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 21387
Office
Unavailable
Facility
$847.69
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 21387
Office
Unavailable
Facility
$839.20
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 21387
Office
Unavailable
Facility
$722.64
No comparable office rate is available.
Santa Cruz-Watsonville
California · 21387
Office
Unavailable
Facility
$747.64
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 21387
Office
Unavailable
Facility
$734.68
No comparable office rate is available.
Santa Rosa-Petaluma
California · 21387
Office
Unavailable
Facility
$754.66
No comparable office rate is available.
Stockton
California · 21387
Office
Unavailable
Facility
$709.24
No comparable office rate is available.
Vallejo
California · 21387
Office
Unavailable
Facility
$788.87
No comparable office rate is available.
Visalia
California · 21387
Office
Unavailable
Facility
$709.24
No comparable office rate is available.
Yuba City
California · 21387
Office
Unavailable
Facility
$709.24
No comparable office rate is available.
Colorado
Colorado · 21387
Office
Unavailable
Facility
$712.60
No comparable office rate is available.
Connecticut
Connecticut · 21387
Office
Unavailable
Facility
$745.51
No comparable office rate is available.
Fort Lauderdale
Florida · 21387
Office
Unavailable
Facility
$755.53
No comparable office rate is available.
Rest Of Florida
Florida · 21387
Office
Unavailable
Facility
$719.12
No comparable office rate is available.
Atlanta
Georgia · 21387
Office
Unavailable
Facility
$720.35
No comparable office rate is available.
Rest Of Georgia
Georgia · 21387
Office
Unavailable
Facility
$680.17
No comparable office rate is available.
Hawaii, Guam
Hawaii · 21387
Office
Unavailable
Facility
$719.05
No comparable office rate is available.
Iowa
Iowa · 21387
Office
Unavailable
Facility
$638.74
No comparable office rate is available.
Idaho
Idaho · 21387
Office
Unavailable
Facility
$644.94
No comparable office rate is available.
East St. Louis
Illinois · 21387
Office
Unavailable
Facility
$739.14
No comparable office rate is available.
Rest Of Illinois
Illinois · 21387
Office
Unavailable
Facility
$709.39
No comparable office rate is available.
Suburban Chicago
Illinois · 21387
Office
Unavailable
Facility
$759.99
No comparable office rate is available.
Indiana
Indiana · 21387
Office
Unavailable
Facility
$647.92
No comparable office rate is available.
Kansas
Kansas · 21387
Office
Unavailable
Facility
$641.85
No comparable office rate is available.
Kentucky
Kentucky · 21387
Office
Unavailable
Facility
$662.30
No comparable office rate is available.
New Orleans
Louisiana · 21387
Office
Unavailable
Facility
$692.01
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 21387
Office
Unavailable
Facility
$663.68
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 21387
Office
Unavailable
Facility
$769.32
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 21387
Office
Unavailable
Facility
$711.46
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 21387
Office
Unavailable
Facility
$744.59
No comparable office rate is available.
Rest Of Maryland
Maryland · 21387
Office
Unavailable
Facility
$704.11
No comparable office rate is available.
Rest Of Maine
Maine · 21387
Office
Unavailable
Facility
$654.05
No comparable office rate is available.
Southern Maine
Maine · 21387
Office
Unavailable
Facility
$676.73
No comparable office rate is available.
Detroit
Michigan · 21387
Office
Unavailable
Facility
$733.11
No comparable office rate is available.
Rest Of Michigan
Michigan · 21387
Office
Unavailable
Facility
$682.86
No comparable office rate is available.
Minnesota
Minnesota · 21387
Office
Unavailable
Facility
$668.09
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 21387
Office
Unavailable
Facility
$681.67
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 21387
Office
Unavailable
Facility
$687.25
No comparable office rate is available.
Rest Of Missouri
Missouri · 21387
Office
Unavailable
Facility
$657.49
No comparable office rate is available.
Mississippi
Mississippi · 21387
Office
Unavailable
Facility
$642.82
No comparable office rate is available.
Montana**
Montana · 21387
Office
Unavailable
Facility
$701.96
No comparable office rate is available.
North Carolina
North Carolina · 21387
Office
Unavailable
Facility
$659.14
No comparable office rate is available.
North Dakota**
North Dakota · 21387
Office
Unavailable
Facility
$665.78
No comparable office rate is available.
Nebraska
Nebraska · 21387
Office
Unavailable
Facility
$640.07
No comparable office rate is available.
New Hampshire
New Hampshire · 21387
Office
Unavailable
Facility
$707.22
No comparable office rate is available.
Northern Nj
New Jersey · 21387
Office
Unavailable
Facility
$776.85
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 21387
Office
Unavailable
Facility
$749.86
No comparable office rate is available.
New Mexico
New Mexico · 21387
Office
Unavailable
Facility
$688.51
No comparable office rate is available.
Nevada**
Nevada · 21387
Office
Unavailable
Facility
$692.19
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 21387
Office
Unavailable
Facility
$834.45
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 21387
Office
Unavailable
Facility
$759.35
No comparable office rate is available.
Queens
New York · 21387
Office
Unavailable
Facility
$806.90
No comparable office rate is available.
Rest Of New York
New York · 21387
Office
Unavailable
Facility
$668.35
No comparable office rate is available.
Ohio
Ohio · 21387
Office
Unavailable
Facility
$675.46
No comparable office rate is available.
Oklahoma
Oklahoma · 21387
Office
Unavailable
Facility
$655.11
No comparable office rate is available.
Portland
Oregon · 21387
Office
Unavailable
Facility
$726.30
No comparable office rate is available.
Rest Of Oregon
Oregon · 21387
Office
Unavailable
Facility
$682.69
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 21387
Office
Unavailable
Facility
$732.59
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 21387
Office
Unavailable
Facility
$673.17
No comparable office rate is available.
Puerto Rico
Puerto Rico · 21387
Office
Unavailable
Facility
$704.60
No comparable office rate is available.
Rhode Island
Rhode Island · 21387
Office
Unavailable
Facility
$712.03
No comparable office rate is available.
South Carolina
South Carolina · 21387
Office
Unavailable
Facility
$669.23
No comparable office rate is available.
South Dakota**
South Dakota · 21387
Office
Unavailable
Facility
$661.50
No comparable office rate is available.
Tennessee
Tennessee · 21387
Office
Unavailable
Facility
$645.43
No comparable office rate is available.
Austin
Texas · 21387
Office
Unavailable
Facility
$713.85
No comparable office rate is available.
Beaumont
Texas · 21387
Office
Unavailable
Facility
$669.70
No comparable office rate is available.
Brazoria
Texas · 21387
Office
Unavailable
Facility
$688.47
No comparable office rate is available.
Dallas
Texas · 21387
Office
Unavailable
Facility
$695.12
No comparable office rate is available.
Fort Worth
Texas · 21387
Office
Unavailable
Facility
$692.80
No comparable office rate is available.
Galveston
Texas · 21387
Office
Unavailable
Facility
$692.03
No comparable office rate is available.
Houston
Texas · 21387
Office
Unavailable
Facility
$725.52
No comparable office rate is available.
Rest Of Texas
Texas · 21387
Office
Unavailable
Facility
$680.26
No comparable office rate is available.
Utah
Utah · 21387
Office
Unavailable
Facility
$677.15
No comparable office rate is available.
Virginia
Virginia · 21387
Office
Unavailable
Facility
$678.82
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 21387
Office
Unavailable
Facility
$704.60
No comparable office rate is available.
Vermont
Vermont · 21387
Office
Unavailable
Facility
$668.78
No comparable office rate is available.
Rest Of Washington
Washington · 21387
Office
Unavailable
Facility
$708.28
No comparable office rate is available.
Seattle (King Cnty)
Washington · 21387
Office
Unavailable
Facility
$778.11
No comparable office rate is available.
Wisconsin
Wisconsin · 21387
Office
Unavailable
Facility
$646.70
No comparable office rate is available.
West Virginia
West Virginia · 21387
Office
Unavailable
Facility
$687.61
No comparable office rate is available.
Wyoming**
Wyoming · 21387
Office
Unavailable
Facility
$686.19
No comparable office rate is available.
See how rates vary across the country
21387 · 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?
Delaware is a Medicare payment area. Our Census mapping connects it to 79 cities and communities in Delaware, 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.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 21387 in Delaware. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$763.20
$693.82 × 110% = $763.20
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 21387 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
1,966
- Code
- 21387
- Physician work
- 9.86
- Practice expense
- 9.33
- Malpractice
- 1.83
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.86 | × 1.005 | 9.9093 |
| Practice expense | 9.33 | × 0.988 | 9.2180 |
| Malpractice | 1.83 | × 0.899 | 1.6452 |
| Total RVUs | 20.7725 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$693.82
Open 21387 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.86 | 1.005 |
| Practice expense | 9.33 | 0.988 |
| Malpractice | 1.83 | 0.899 |
(9.86 × 1.005 + 9.33 × 0.988 + 1.83 × 0.899) × $33.4009 = $693.82
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
21387 · 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 | $693.82 | RVU26D |
| 2026-07-01 | Not available in this setting | $693.82 | RVU26C |
| 2026-04-01 | Not available in this setting | $693.82 | RVU26B |
| 2026-01-01 | Not available in this setting | $693.82 | RVU26A |
| 2025-10-01 | Not available in this setting | $747.71 | RVU25D |
| 2025-07-01 | Not available in this setting | $747.71 | RVU25C |
| 2025-04-01 | Not available in this setting | $747.71 | RVU25B |
| 2025-01-01 | Not available in this setting | $747.71 | RVU25A |
21387 billing questions
When should this code be chosen over a single-approach orbital repair?
Use it when the operative documentation supports combined access to treat the orbital floor fracture. A transantral-only or periorbital-only repair points to a different code in the fracture family.
Does the code include the exposure and fracture repair?
The approach and work to treat the orbital floor fracture are part of the reported service. The combined access is not a separate service from the repair.
What documentation supports the combined approach?
The operative report should identify the orbital floor fracture and describe the access routes used and the treatment performed. A general statement that the orbit was repaired may not establish the combined approach.
How is bilateral treatment reported?
CMS identifies this as a bilateral procedure; modifier 50 is paid at 150%. The record should support treatment of fractures on both sides.
Can an assistant surgeon be paid, and can the case have co-surgeons?
Assistant-at-surgery payment may be allowed. CMS does not permit co-surgeons or team surgery for this code.
How does the multiple-procedure reduction affect payment?
For procedures performed in the same session, the highest-valued procedure is paid in full and other procedures are paid at 50%.
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.
1,96321366,,Opn tx complx malar w/grft,A,,18.14,12.59,NA,12.59,,3.36,34.09,34.09,0,090,0.10,0.69,0.21,2,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,96421385,,Opn tx orbit fx transantral,A,,9.33,9.13,NA,9.13,,1.73,20.19,20.19,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,96521386,,Opn tx orbit fx periorbital,A,,9.33,7.83,NA,7.83,,1.73,18.89,18.89,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,96621387,,Opn tx orbit fx combined,A,,9.86,9.33,NA,9.33,,1.83,21.02,21.02,0,090,0.10,0.69,0.21,2,1,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,96721390,,Opn tx orbit periorbtl implt,A,,10.95,8.79,NA,8.79,,1.47,21.21,21.21,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,96821395,,Opn tx orbit periorbt w/grft,A,,14.33,9.87,NA,9.87,,2.65,26.85,26.85,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,96921400,,Closed tx orbit w/o manipulj,A,,1.46,5.43,,3.48,,0.25,7.14,5.19,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503