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CMS RVU26D · Effective 2026-10-01

21116 in Merced

Office / nonfacility

$239.48

Base rate per service

Facility setting

$38.14

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.

Diagnostic imaging procedure

About 21116: Temporomandibular joint arthrogram injection

Contrast injection into a temporomandibular joint with radiographic assessment is reported to evaluate suspected intra-articular TMJ pathology.

This service places contrast material into a temporomandibular joint so radiographic imaging can outline the joint space and help assess internal derangement, such as suspected disc-related dysfunction. It is generally performed by a radiologist or an oral and maxillofacial surgeon in an imaging suite or equipped office, with the injection and arthrographic imaging interpreted as part of the service. Clinical use may follow persistent joint pain, clicking, or restricted jaw movement when an arthrogram is selected to investigate an intra-articular problem.

Report 21116 for the joint arthrography procedure, documenting the indication, side, contrast injection, and resulting images or findings. Same-day preoperative and postoperative care is included under its 0-day global period. When this and other procedures are performed in one session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple-procedure reduction. For bilateral work, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.

CMS billing rules for 21116

Global period
Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU0.79 · 12%
  • Practice expense (office) RVU5.75 · 86%
  • Malpractice RVU0.12 · 2%

28

Medicare services in 2024 · #5698 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.

21116 compared with similar codes

Office rates for Merced, from the same CMS release.

70332

TMJ imaging

Arthrographic study

$85.34

This code describes radiographic examination of TMJ arthrography. Code 21116 describes the contrast-injection procedure and includes its radiographic supervision and interpretation.

70330

TMJ X-ray

Both joints, open and closed mouth

$57.59

Use 70330 for bilateral TMJ radiographs without an arthrographic contrast injection; use 21116 when the joint is injected for arthrography.

70336

Jaw joint MRI

Magnetic resonance imaging

$278.59

70336 describes MRI of the temporomandibular joint or joints. It is a different imaging method from the contrast-injection arthrography represented by 21116.

The same code, a different location

How does Merced compare?

In Bakersfield, the office rate for 21116 is $239.82—$0.34 higher than the $239.48 rate in Merced. Both use the same code, release and participation basis.

21116 across payment areas

Same release and payment basis · bars start at $0

  1. Merced · This locality

    $239.48

  2. Bakersfield

    $239.82

    $0.34 higher than Merced

  3. Chico

    $239.48

    The same base rate than Merced

  4. El Centro

    $239.50

    $0.02 higher than Merced

  5. Fresno

    $239.48

    The same base rate than Merced

  6. Hanford-Corcoran

    $239.48

    The same base rate than Merced

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

    $257.33

    $17.85 higher than Merced

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, 21116 ranges from $193.43 in Arkansas to $308.38 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

  • Madera

    California · 21116

    Office

    $239.48

    Facility

    $38.14

    The same base rate than Merced for the office setting.

  • Modesto

    California · 21116

    Office

    $239.48

    Facility

    $38.14

    The same base rate than Merced for the office setting.

  • Napa

    California · 21116

    Office

    $283.21

    Facility

    $41.09

    $43.73 higher than Merced for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 21116

    Office

    $256.63

    Facility

    $39.49

    $17.15 higher than Merced for the office setting.

  • Redding

    California · 21116

    Office

    $239.48

    Facility

    $38.14

    The same base rate than Merced for the office setting.

  • Rest Of California

    California · 21116

    Office

    $239.48

    Facility

    $38.14

    The same base rate than Merced for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 21116

    Office

    $240.77

    Facility

    $39.43

    $1.29 higher than Merced for the office setting.

  • Sacramento-Roseville-Folsom

    California · 21116

    Office

    $252.85

    Facility

    $39.20

    $13.37 higher than Merced for the office setting.

  • Salinas

    California · 21116

    Office

    $251.94

    Facility

    $39.03

    $12.46 higher than Merced for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 21116

    Office

    $259.05

    Facility

    $39.34

    $19.57 higher than Merced for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 21116

    Office

    $301.53

    Facility

    $42.51

    $62.05 higher than Merced for the office setting.

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

    California · 21116

    Office

    $301.39

    Facility

    $42.37

    $61.91 higher than Merced for the office setting.

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

    California · 21116

    Office

    $308.38

    Facility

    $43.48

    $68.90 higher than Merced for the office setting.

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

    California · 21116

    Office

    $307.82

    Facility

    $42.92

    $68.34 higher than Merced for the office setting.

  • San Luis Obispo-Paso Robles

    California · 21116

    Office

    $247.73

    Facility

    $38.49

    $8.25 higher than Merced for the office setting.

  • Santa Cruz-Watsonville

    California · 21116

    Office

    $262.44

    Facility

    $39.23

    $22.96 higher than Merced for the office setting.

  • Santa Maria-Santa Barbara

    California · 21116

    Office

    $253.21

    Facility

    $39.01

    $13.73 higher than Merced for the office setting.

  • Santa Rosa-Petaluma

    California · 21116

    Office

    $265.17

    Facility

    $39.58

    $25.69 higher than Merced for the office setting.

  • Stockton

    California · 21116

    Office

    $239.48

    Facility

    $38.14

    The same base rate than Merced for the office setting.

  • Vallejo

    California · 21116

    Office

    $283.02

    Facility

    $40.89

    $43.54 higher than Merced for the office setting.

  • Visalia

    California · 21116

    Office

    $239.48

    Facility

    $38.14

    The same base rate than Merced for the office setting.

  • Yuba City

    California · 21116

    Office

    $239.48

    Facility

    $38.14

    The same base rate than Merced for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 21116

    Office

    $258.51

    Facility

    $42.11

    $19.03 higher than Merced for the office setting.

  • Miami

    Florida · 21116

    Office

    $236.45

    Facility

    $45.22

    $3.03 lower than Merced for the office setting.

  • Chicago

    Illinois · 21116

    Office

    $228.79

    Facility

    $44.16

    $10.69 lower than Merced for the office setting.

  • Manhattan

    New York · 21116

    Office

    $257.60

    Facility

    $44.14

    $18.12 higher than Merced for the office setting.

  • Alaska*

    Alaska · 21116

    Office

    $246.33

    Facility

    $50.68

    $6.85 higher than Merced for the office setting.

  • Alabama

    Alabama · 21116

    Office

    $196.70

    Facility

    $35.96

    $42.78 lower than Merced for the office setting.

  • Arkansas

    Arkansas · 21116

    Office

    $193.43

    Facility

    $35.62

    $46.05 lower than Merced for the office setting.

  • Arizona

    Arizona · 21116

    Office

    $215.92

    Facility

    $37.91

    $23.56 lower than Merced for the office setting.

  • Colorado

    Colorado · 21116

    Office

    $234.18

    Facility

    $38.72

    $5.30 lower than Merced for the office setting.

  • Connecticut

    Connecticut · 21116

    Office

    $238.61

    Facility

    $40.76

    $0.87 lower than Merced for the office setting.

  • Delaware

    Delaware · 21116

    Office

    $219.87

    Facility

    $38.37

    $19.61 lower than Merced for the office setting.

  • Fort Lauderdale

    Florida · 21116

    Office

    $228.19

    Facility

    $42.09

    $11.29 lower than Merced for the office setting.

  • Rest Of Florida

    Florida · 21116

    Office

    $216.02

    Facility

    $40.39

    $23.46 lower than Merced for the office setting.

  • Atlanta

    Georgia · 21116

    Office

    $226.41

    Facility

    $39.76

    $13.07 lower than Merced for the office setting.

  • Rest Of Georgia

    Georgia · 21116

    Office

    $202.48

    Facility

    $38.61

    $37.00 lower than Merced for the office setting.

  • Hawaii, Guam

    Hawaii · 21116

    Office

    $247.07

    Facility

    $38.20

    $7.59 higher than Merced for the office setting.

  • Iowa

    Iowa · 21116

    Office

    $203.71

    Facility

    $35.62

    $35.77 lower than Merced for the office setting.

  • Idaho

    Idaho · 21116

    Office

    $204.97

    Facility

    $35.96

    $34.51 lower than Merced for the office setting.

  • East St. Louis

    Illinois · 21116

    Office

    $211.15

    Facility

    $42.14

    $28.33 lower than Merced for the office setting.

  • Rest Of Illinois

    Illinois · 21116

    Office

    $208.00

    Facility

    $40.28

    $31.48 lower than Merced for the office setting.

  • Suburban Chicago

    Illinois · 21116

    Office

    $230.91

    Facility

    $42.25

    $8.57 lower than Merced for the office setting.

  • Indiana

    Indiana · 21116

    Office

    $206.37

    Facility

    $36.08

    $33.11 lower than Merced for the office setting.

  • Kansas

    Kansas · 21116

    Office

    $202.02

    Facility

    $35.96

    $37.46 lower than Merced for the office setting.

  • Kentucky

    Kentucky · 21116

    Office

    $200.79

    Facility

    $37.48

    $38.69 lower than Merced for the office setting.

  • New Orleans

    Louisiana · 21116

    Office

    $211.66

    Facility

    $38.80

    $27.82 lower than Merced for the office setting.

  • Rest Of Louisiana

    Louisiana · 21116

    Office

    $200.20

    Facility

    $37.62

    $39.28 lower than Merced for the office setting.

  • Metropolitan Boston

    Massachusetts · 21116

    Office

    $260.35

    Facility

    $41.01

    $20.87 higher than Merced for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 21116

    Office

    $232.24

    Facility

    $38.80

    $7.24 lower than Merced for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 21116

    Office

    $237.84

    Facility

    $40.73

    $1.64 lower than Merced for the office setting.

  • Rest Of Maryland

    Maryland · 21116

    Office

    $224.69

    Facility

    $38.78

    $14.79 lower than Merced for the office setting.

  • Rest Of Maine

    Maine · 21116

    Office

    $205.57

    Facility

    $36.56

    $33.91 lower than Merced for the office setting.

  • Southern Maine

    Maine · 21116

    Office

    $219.24

    Facility

    $37.19

    $20.24 lower than Merced for the office setting.

  • Detroit

    Michigan · 21116

    Office

    $218.48

    Facility

    $41.20

    $21.00 lower than Merced for the office setting.

  • Rest Of Michigan

    Michigan · 21116

    Office

    $206.26

    Facility

    $38.54

    $33.22 lower than Merced for the office setting.

  • Minnesota

    Minnesota · 21116

    Office

    $225.20

    Facility

    $36.17

    $14.28 lower than Merced for the office setting.

  • Metropolitan Kansas City

    Missouri · 21116

    Office

    $210.64

    Facility

    $38.14

    $28.84 lower than Merced for the office setting.

  • Metropolitan St. Louis

    Missouri · 21116

    Office

    $213.24

    Facility

    $38.35

    $26.24 lower than Merced for the office setting.

  • Rest Of Missouri

    Missouri · 21116

    Office

    $195.84

    Facility

    $37.49

    $43.64 lower than Merced for the office setting.

  • Mississippi

    Mississippi · 21116

    Office

    $194.71

    Facility

    $36.54

    $44.77 lower than Merced for the office setting.

  • Montana**

    Montana · 21116

    Office

    $222.44

    Facility

    $38.74

    $17.04 lower than Merced for the office setting.

  • North Carolina

    North Carolina · 21116

    Office

    $208.14

    Facility

    $36.74

    $31.34 lower than Merced for the office setting.

  • North Dakota**

    North Dakota · 21116

    Office

    $220.07

    Facility

    $36.36

    $19.41 lower than Merced for the office setting.

  • Nebraska

    Nebraska · 21116

    Office

    $205.17

    Facility

    $35.61

    $34.31 lower than Merced for the office setting.

  • New Hampshire

    New Hampshire · 21116

    Office

    $229.82

    Facility

    $38.59

    $9.66 lower than Merced for the office setting.

  • Northern Nj

    New Jersey · 21116

    Office

    $255.11

    Facility

    $42.02

    $15.63 higher than Merced for the office setting.

  • Rest Of New Jersey

    New Jersey · 21116

    Office

    $241.56

    Facility

    $40.96

    $2.08 higher than Merced for the office setting.

  • New Mexico

    New Mexico · 21116

    Office

    $207.32

    Facility

    $38.86

    $32.16 lower than Merced for the office setting.

  • Nevada**

    Nevada · 21116

    Office

    $221.97

    Facility

    $38.08

    $17.51 lower than Merced for the office setting.

  • Nyc Suburbs/Long Island

    New York · 21116

    Office

    $263.87

    Facility

    $45.45

    $24.39 higher than Merced for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 21116

    Office

    $242.72

    Facility

    $41.57

    $3.24 higher than Merced for the office setting.

  • Queens

    New York · 21116

    Office

    $260.86

    Facility

    $43.73

    $21.38 higher than Merced for the office setting.

  • Rest Of New York

    New York · 21116

    Office

    $211.66

    Facility

    $37.14

    $27.82 lower than Merced for the office setting.

  • Ohio

    Ohio · 21116

    Office

    $205.77

    Facility

    $38.05

    $33.71 lower than Merced for the office setting.

  • Oklahoma

    Oklahoma · 21116

    Office

    $201.01

    Facility

    $36.96

    $38.47 lower than Merced for the office setting.

  • Portland

    Oregon · 21116

    Office

    $243.16

    Facility

    $39.07

    $3.68 higher than Merced for the office setting.

  • Rest Of Oregon

    Oregon · 21116

    Office

    $220.49

    Facility

    $37.52

    $18.99 lower than Merced for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 21116

    Office

    $231.57

    Facility

    $40.34

    $7.91 lower than Merced for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 21116

    Office

    $206.48

    Facility

    $37.84

    $33.00 lower than Merced for the office setting.

  • Puerto Rico

    Puerto Rico · 21116

    Office

    $224.50

    Facility

    $38.78

    $14.98 lower than Merced for the office setting.

  • Rhode Island

    Rhode Island · 21116

    Office

    $228.86

    Facility

    $39.09

    $10.62 lower than Merced for the office setting.

  • South Carolina

    South Carolina · 21116

    Office

    $207.25

    Facility

    $37.51

    $32.23 lower than Merced for the office setting.

  • South Dakota**

    South Dakota · 21116

    Office

    $219.79

    Facility

    $36.08

    $19.69 lower than Merced for the office setting.

  • Tennessee

    Tennessee · 21116

    Office

    $203.12

    Facility

    $36.13

    $36.36 lower than Merced for the office setting.

  • Austin

    Texas · 21116

    Office

    $233.19

    Facility

    $38.83

    $6.29 lower than Merced for the office setting.

  • Beaumont

    Texas · 21116

    Office

    $204.88

    Facility

    $37.71

    $34.60 lower than Merced for the office setting.

  • Brazoria

    Texas · 21116

    Office

    $220.05

    Facility

    $38.00

    $19.43 lower than Merced for the office setting.

  • Dallas

    Texas · 21116

    Office

    $221.35

    Facility

    $38.38

    $18.13 lower than Merced for the office setting.

  • Fort Worth

    Texas · 21116

    Office

    $219.48

    Facility

    $38.35

    $20.00 lower than Merced for the office setting.

  • Galveston

    Texas · 21116

    Office

    $220.63

    Facility

    $38.21

    $18.85 lower than Merced for the office setting.

  • Houston

    Texas · 21116

    Office

    $222.82

    Facility

    $40.40

    $16.66 lower than Merced for the office setting.

  • Rest Of Texas

    Texas · 21116

    Office

    $212.27

    Facility

    $37.93

    $27.21 lower than Merced for the office setting.

  • Utah

    Utah · 21116

    Office

    $210.52

    Facility

    $37.84

    $28.96 lower than Merced for the office setting.

  • Virginia

    Virginia · 21116

    Office

    $218.01

    Facility

    $37.42

    $21.47 lower than Merced for the office setting.

  • Virgin Islands

    United States Virgin Islands · 21116

    Office

    $224.50

    Facility

    $38.78

    $14.98 lower than Merced for the office setting.

  • Vermont

    Vermont · 21116

    Office

    $218.55

    Facility

    $36.68

    $20.93 lower than Merced for the office setting.

  • Rest Of Washington

    Washington · 21116

    Office

    $232.01

    Facility

    $38.57

    $7.47 lower than Merced for the office setting.

  • Seattle (King Cnty)

    Washington · 21116

    Office

    $266.63

    Facility

    $41.23

    $27.15 higher than Merced for the office setting.

  • Wisconsin

    Wisconsin · 21116

    Office

    $211.61

    Facility

    $35.62

    $27.87 lower than Merced for the office setting.

  • West Virginia

    West Virginia · 21116

    Office

    $199.02

    Facility

    $39.38

    $40.46 lower than Merced for the office setting.

  • Wyoming**

    Wyoming · 21116

    Office

    $221.41

    Facility

    $37.70

    $18.07 lower than Merced for the office setting.

See how rates vary across the country

21116 · 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.

$193.43

$273.93

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$246.331
AL$196.701
AR$193.431
AZ$215.921
CA$239.48–$308.3829
CO$234.181
CT$238.611
DC$258.511
DE$219.871
FL$216.02–$236.453
GA$202.48–$226.412
GU$247.071
HI$247.071
IA$203.711
ID$204.971
IL$208.00–$230.914
IN$206.371
KS$202.021
KY$200.791
LA$200.20–$211.662
MA$232.24–$260.352
MD$224.69–$258.513
ME$205.57–$219.242
MI$206.26–$218.482
MN$225.201
MO$195.84–$213.243
MS$194.711
MT$222.441
NC$208.141
ND$220.071
NE$205.171
NH$229.821
NJ$241.56–$255.112
NM$207.321
NV$221.971
NY$211.66–$263.875
OH$205.771
OK$201.011
OR$220.49–$243.162
PA$206.48–$231.572
PR$224.501
RI$228.861
SC$207.251
SD$219.791
TN$203.121
TX$204.88–$233.198
UT$210.521
VA$218.01–$258.512
VI$224.501
VT$218.551
WA$232.01–$266.632
WI$211.611
WV$199.021
WY$221.411

Explore 21116 on the national rate map →

Where does this rate apply?

Merced is a Medicare payment area. Our Census mapping connects it to 24 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 21116 in Merced, the physician’s office rate is $239.48 and the facility-setting rate is $38.14: a difference of $201.34.

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 21116 in Merced. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$263.43

$239.48 × 110% = $263.43

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.

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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 21116 in Merced.

PPRRVU2026_Oct_nonQPP.csv

1,876

Code
21116
Physician work
0.79
Practice expense
5.75
Malpractice
0.12

GPCI2026.csv

15

Locality
Merced
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 21116 in Merced
ComponentRVULocality factorAdjusted
Physician work0.79× 1.0170.8034
Practice expense5.75× 1.0966.3020
Malpractice0.12× 0.5360.0643
Total RVUs7.1698
Conversion factor× 33.4009

Office / nonfacility rate, Merced$239.48

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 21116 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work0.791.017
Practice expense5.751.096
Malpractice0.120.536

(0.79 × 1.017 + 5.75 × 1.096 + 0.12 × 0.536) × $33.4009 = $239.48

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work0.791.017
Practice expense0.251.096
Malpractice0.120.536

(0.79 × 1.017 + 0.25 × 1.096 + 0.12 × 0.536) × $33.4009 = $38.14

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

21116 · Office / nonfacility

$239.48

Effective 2026-10-01

The base rate is $23.91 higher than on 2025-10-01, moving from $215.57 to $239.48 (11.1%).

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

    $215.57changed to$239.48

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.81 changed to 0.79
    • Practice expense RVU 5.31 changed to 5.75
    • Malpractice RVU 0.07 changed to 0.12
    • 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: $215.57

    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$239.48$38.14RVU26D
2026-07-01$239.48$38.14RVU26C
2026-04-01$239.48$38.14RVU26B
2026-01-01$239.48$38.14RVU26A
2025-10-01$215.57$43.39RVU25D
2025-07-01$215.57$43.39RVU25C
2025-04-01$215.57$43.39RVU25B
2025-01-01$215.57$43.39RVU25A

21116 billing questions

When should 21116 be chosen instead of plain TMJ radiographs?

Use 21116 when contrast is injected into the joint for arthrographic evaluation. Plain TMJ radiographs, such as 70328 or 70330, do not describe that contrast-injection procedure.

Does 21116 include the arthrographic imaging?

The service includes radiographic supervision and interpretation associated with the TMJ arthrography. Document the injection and the resulting images or findings; do not assume the same arthrogram imaging is separately reportable.

How is bilateral TMJ work reported?

For bilateral work, report modifier 50; CMS pays the bilateral procedure at 150%.

What happens when 21116 is performed with other procedures in the same session?

The highest-valued procedure is paid in full, and the other procedures are subject to the standard 50% multiple-procedure reduction.

Can an assistant or co-surgeon be reported for 21116?

Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are 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.

RVUs for 21116PPRRVU2026_Oct_nonQPP.csv, line 1,876 (RVU26D)
Geographic factors for MercedGPCI2026.csv, line 15 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet