No office rate
Use 21194 when the lower-jaw reconstruction includes a bone graft; 21193 is the no-graft variant.
On this page
CMS RVU26D · Effective 2026-10-01
21193 in Modesto
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$1116.24
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 21193: Lower jaw reconstruction without bone graft
Reports operative reconstruction of the lower jaw when the documented procedure is performed without a bone graft.
CPT 21193 covers operative reconstruction of the lower jaw without a bone graft. Oral and maxillofacial, plastic, or craniofacial surgeons may perform this work to restore mandibular form or function after a defect or deformity. The operative report should identify the mandibular reconstruction performed and establish that a bone graft was not used as part of that reconstruction.
Choose this code based on the documented procedure and graft use, not simply the diagnosis or the fact that the mandible is involved. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. The code is priced as bilateral, so modifier 50 does not increase payment. Assistant-at-surgery services may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 21193
- 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
- The code is already priced as bilateral; modifier 50 does not increase payment.
- 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 RVU18.43 · 56%
- Practice expense (office) RVU12.08 · 36%
- Malpractice RVU2.68 · 8%
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.
21193 compared with similar codes
Office rates for Modesto, from the same CMS release.
No office rate
This lower-jaw reconstruction variant is specified as without fixation. Select based on the operative technique documented rather than treating it as interchangeable with 21193.
No office rate
This lower-jaw reconstruction variant is specified as with fixation. The operative report's description of the procedure determines whether it fits instead of 21193.
No office rate
21199 identifies lower-jaw reconstruction involving advancement; 21193 is distinguished by reconstruction without a bone graft.
The same code, a different location
How does Modesto compare?
21193 across payment areas
Same release and payment basis · bars start at $0
Modesto · 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.
No comparable rate is available in this setting.
Other payment areas listed in California 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
Madera
California · 21193
Office
Unavailable
Facility
$1116.24
No comparable office rate is available.
Merced
California · 21193
Office
Unavailable
Facility
$1116.24
No comparable office rate is available.
Napa
California · 21193
Office
Unavailable
Facility
$1231.62
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 21193
Office
Unavailable
Facility
$1165.50
No comparable office rate is available.
Redding
California · 21193
Office
Unavailable
Facility
$1116.24
No comparable office rate is available.
Rest Of California
California · 21193
Office
Unavailable
Facility
$1116.24
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 21193
Office
Unavailable
Facility
$1145.23
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 21193
Office
Unavailable
Facility
$1154.97
No comparable office rate is available.
Salinas
California · 21193
Office
Unavailable
Facility
$1150.28
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 21193
Office
Unavailable
Facility
$1165.13
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 21193
Office
Unavailable
Facility
$1284.06
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 21193
Office
Unavailable
Facility
$1281.01
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 21193
Office
Unavailable
Facility
$1313.09
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 21193
Office
Unavailable
Facility
$1300.65
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 21193
Office
Unavailable
Facility
$1133.59
No comparable office rate is available.
Santa Cruz-Watsonville
California · 21193
Office
Unavailable
Facility
$1166.72
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 21193
Office
Unavailable
Facility
$1151.26
No comparable office rate is available.
Santa Rosa-Petaluma
California · 21193
Office
Unavailable
Facility
$1177.50
No comparable office rate is available.
Stockton
California · 21193
Office
Unavailable
Facility
$1116.24
No comparable office rate is available.
Vallejo
California · 21193
Office
Unavailable
Facility
$1227.24
No comparable office rate is available.
Visalia
California · 21193
Office
Unavailable
Facility
$1116.24
No comparable office rate is available.
Yuba City
California · 21193
Office
Unavailable
Facility
$1116.24
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 21193
Office
Unavailable
Facility
$1223.75
No comparable office rate is available.
Miami
Florida · 21193
Office
Unavailable
Facility
$1261.99
No comparable office rate is available.
Chicago
Illinois · 21193
Office
Unavailable
Facility
$1230.82
No comparable office rate is available.
Manhattan
New York · 21193
Office
Unavailable
Facility
$1265.79
No comparable office rate is available.
Alaska*
Alaska · 21193
Office
Unavailable
Facility
$1402.40
No comparable office rate is available.
Alabama
Alabama · 21193
Office
Unavailable
Facility
$1019.29
No comparable office rate is available.
Arkansas
Arkansas · 21193
Office
Unavailable
Facility
$1008.27
No comparable office rate is available.
Arizona
Arizona · 21193
Office
Unavailable
Facility
$1083.18
No comparable office rate is available.
Colorado
Colorado · 21193
Office
Unavailable
Facility
$1122.18
No comparable office rate is available.
Connecticut
Connecticut · 21193
Office
Unavailable
Facility
$1170.75
No comparable office rate is available.
Delaware
Delaware · 21193
Office
Unavailable
Facility
$1097.77
No comparable office rate is available.
Fort Lauderdale
Florida · 21193
Office
Unavailable
Facility
$1186.15
No comparable office rate is available.
Rest Of Florida
Florida · 21193
Office
Unavailable
Facility
$1135.85
No comparable office rate is available.
Atlanta
Georgia · 21193
Office
Unavailable
Facility
$1134.87
No comparable office rate is available.
Rest Of Georgia
Georgia · 21193
Office
Unavailable
Facility
$1082.19
No comparable office rate is available.
Hawaii, Guam
Hawaii · 21193
Office
Unavailable
Facility
$1126.17
No comparable office rate is available.
Iowa
Iowa · 21193
Office
Unavailable
Facility
$1020.30
No comparable office rate is available.
Idaho
Idaho · 21193
Office
Unavailable
Facility
$1029.12
No comparable office rate is available.
East St. Louis
Illinois · 21193
Office
Unavailable
Facility
$1167.06
No comparable office rate is available.
Rest Of Illinois
Illinois · 21193
Office
Unavailable
Facility
$1123.87
No comparable office rate is available.
Suburban Chicago
Illinois · 21193
Office
Unavailable
Facility
$1192.88
No comparable office rate is available.
Indiana
Indiana · 21193
Office
Unavailable
Facility
$1033.11
No comparable office rate is available.
Kansas
Kansas · 21193
Office
Unavailable
Facility
$1025.44
No comparable office rate is available.
Kentucky
Kentucky · 21193
Office
Unavailable
Facility
$1056.18
No comparable office rate is available.
New Orleans
Louisiana · 21193
Office
Unavailable
Facility
$1096.94
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 21193
Office
Unavailable
Facility
$1058.42
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 21193
Office
Unavailable
Facility
$1202.24
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 21193
Office
Unavailable
Facility
$1121.64
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 21193
Office
Unavailable
Facility
$1169.09
No comparable office rate is available.
Rest Of Maryland
Maryland · 21193
Office
Unavailable
Facility
$1112.23
No comparable office rate is available.
Rest Of Maine
Maine · 21193
Office
Unavailable
Facility
$1042.46
No comparable office rate is available.
Southern Maine
Maine · 21193
Office
Unavailable
Facility
$1071.91
No comparable office rate is available.
Detroit
Michigan · 21193
Office
Unavailable
Facility
$1155.86
No comparable office rate is available.
Rest Of Michigan
Michigan · 21193
Office
Unavailable
Facility
$1085.02
No comparable office rate is available.
Minnesota
Minnesota · 21193
Office
Unavailable
Facility
$1057.26
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 21193
Office
Unavailable
Facility
$1081.90
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 21193
Office
Unavailable
Facility
$1089.39
No comparable office rate is available.
Rest Of Missouri
Missouri · 21193
Office
Unavailable
Facility
$1050.57
No comparable office rate is available.
Mississippi
Mississippi · 21193
Office
Unavailable
Facility
$1029.13
No comparable office rate is available.
Montana**
Montana · 21193
Office
Unavailable
Facility
$1108.40
No comparable office rate is available.
North Carolina
North Carolina · 21193
Office
Unavailable
Facility
$1049.23
No comparable office rate is available.
North Dakota**
North Dakota · 21193
Office
Unavailable
Facility
$1055.40
No comparable office rate is available.
Nebraska
Nebraska · 21193
Office
Unavailable
Facility
$1021.83
No comparable office rate is available.
New Hampshire
New Hampshire · 21193
Office
Unavailable
Facility
$1113.93
No comparable office rate is available.
Northern Nj
New Jersey · 21193
Office
Unavailable
Facility
$1218.00
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 21193
Office
Unavailable
Facility
$1179.00
No comparable office rate is available.
New Mexico
New Mexico · 21193
Office
Unavailable
Facility
$1093.08
No comparable office rate is available.
Nevada**
Nevada · 21193
Office
Unavailable
Facility
$1094.03
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 21193
Office
Unavailable
Facility
$1300.95
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 21193
Office
Unavailable
Facility
$1193.41
No comparable office rate is available.
Queens
New York · 21193
Office
Unavailable
Facility
$1260.97
No comparable office rate is available.
Rest Of New York
New York · 21193
Office
Unavailable
Facility
$1061.82
No comparable office rate is available.
Ohio
Ohio · 21193
Office
Unavailable
Facility
$1074.19
No comparable office rate is available.
Oklahoma
Oklahoma · 21193
Office
Unavailable
Facility
$1045.44
No comparable office rate is available.
Portland
Oregon · 21193
Office
Unavailable
Facility
$1140.30
No comparable office rate is available.
Rest Of Oregon
Oregon · 21193
Office
Unavailable
Facility
$1080.38
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 21193
Office
Unavailable
Facility
$1153.48
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 21193
Office
Unavailable
Facility
$1070.57
No comparable office rate is available.
Puerto Rico
Puerto Rico · 21193
Office
Unavailable
Facility
$1111.67
No comparable office rate is available.
Rhode Island
Rhode Island · 21193
Office
Unavailable
Facility
$1123.92
No comparable office rate is available.
South Carolina
South Carolina · 21193
Office
Unavailable
Facility
$1064.48
No comparable office rate is available.
South Dakota**
South Dakota · 21193
Office
Unavailable
Facility
$1049.14
No comparable office rate is available.
Tennessee
Tennessee · 21193
Office
Unavailable
Facility
$1030.41
No comparable office rate is available.
Austin
Texas · 21193
Office
Unavailable
Facility
$1123.00
No comparable office rate is available.
Beaumont
Texas · 21193
Office
Unavailable
Facility
$1065.91
No comparable office rate is available.
Brazoria
Texas · 21193
Office
Unavailable
Facility
$1090.18
No comparable office rate is available.
Dallas
Texas · 21193
Office
Unavailable
Facility
$1099.79
No comparable office rate is available.
Fort Worth
Texas · 21193
Office
Unavailable
Facility
$1096.92
No comparable office rate is available.
Galveston
Texas · 21193
Office
Unavailable
Facility
$1095.28
No comparable office rate is available.
Houston
Texas · 21193
Office
Unavailable
Facility
$1144.33
No comparable office rate is available.
Rest Of Texas
Texas · 21193
Office
Unavailable
Facility
$1079.32
No comparable office rate is available.
Utah
Utah · 21193
Office
Unavailable
Facility
$1075.24
No comparable office rate is available.
Virginia
Virginia · 21193
Office
Unavailable
Facility
$1075.40
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 21193
Office
Unavailable
Facility
$1111.67
No comparable office rate is available.
Vermont
Vermont · 21193
Office
Unavailable
Facility
$1060.32
No comparable office rate is available.
Rest Of Washington
Washington · 21193
Office
Unavailable
Facility
$1116.57
No comparable office rate is available.
Seattle (King Cnty)
Washington · 21193
Office
Unavailable
Facility
$1214.56
No comparable office rate is available.
Wisconsin
Wisconsin · 21193
Office
Unavailable
Facility
$1029.69
No comparable office rate is available.
West Virginia
West Virginia · 21193
Office
Unavailable
Facility
$1094.30
No comparable office rate is available.
Wyoming**
Wyoming · 21193
Office
Unavailable
Facility
$1085.30
No comparable office rate is available.
See how rates vary across the country
21193 · 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?
Modesto is a Medicare payment area. Our Census mapping connects it to 33 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.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 21193 in Modesto. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$1227.86
$1116.24 × 110% = $1227.86
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 21193 in Modesto.
PPRRVU2026_Oct_nonQPP.csv
1,907
- Code
- 21193
- Physician work
- 18.43
- Practice expense
- 12.08
- Malpractice
- 2.68
GPCI2026.csv
16
- Locality
- Modesto
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 18.43 | × 1.017 | 18.7433 |
| Practice expense | 12.08 | × 1.096 | 13.2397 |
| Malpractice | 2.68 | × 0.536 | 1.4365 |
| Total RVUs | 33.4195 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Modesto$1116.24
Open 21193 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 18.43 | 1.017 |
| Practice expense | 12.08 | 1.096 |
| Malpractice | 2.68 | 0.536 |
(18.43 × 1.017 + 12.08 × 1.096 + 2.68 × 0.536) × $33.4009 = $1116.24
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
21193 · 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 | $1116.24 | RVU26D |
| 2026-07-01 | Not available in this setting | $1116.24 | RVU26C |
| 2026-04-01 | Not available in this setting | $1116.24 | RVU26B |
| 2026-01-01 | Not available in this setting | $1116.24 | RVU26A |
| 2025-10-01 | Not available in this setting | $1227.43 | RVU25D |
| 2025-07-01 | Not available in this setting | $1227.43 | RVU25C |
| 2025-04-01 | Not available in this setting | $1227.43 | RVU25B |
| 2025-01-01 | Not available in this setting | $1227.43 | RVU25A |
21193 billing questions
How do I distinguish 21193 from 21194?
The key distinction is whether a bone graft is used in the lower-jaw reconstruction. Use 21193 for reconstruction without a graft and 21194 when the reconstruction includes a graft.
Does modifier 50 increase payment for 21193?
No. CMS prices 21193 as bilateral, so modifier 50 does not increase payment.
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 reported?
Assistant-at-surgery services may be paid. Co-surgeons are paid only when supporting documentation is provided.
How does payment work when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction.
What documentation supports selecting 21193?
The operative report should describe the lower-jaw reconstruction and make clear that no bone graft was used as part of it.
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.
1,90421183,,Reconstruct cranial bone,A,,34.81,18.81,NA,18.81,,6.46,60.08,60.08,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,90521184,,Reconstruct cranial bone,A,,37.65,19.84,NA,19.84,,7.01,64.50,64.50,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,90621188,,Reconstruction of midface,A,,22.57,16.94,NA,16.94,,3.27,42.78,42.78,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,90721193,,Reconst lwr jaw w/o graft,A,,18.43,12.08,NA,12.08,,2.68,33.19,33.19,0,090,0.10,0.69,0.21,2,2,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,90821194,,Reconst lwr jaw w/graft,A,,21.27,13.97,NA,13.97,,3.07,38.31,38.31,0,090,0.10,0.69,0.21,2,2,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,90921195,,Reconst lwr jaw w/o fixation,A,,18.68,15.06,NA,15.06,,2.71,36.45,36.45,0,090,0.10,0.69,0.21,2,2,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,91021196,,Reconst lwr jaw w/fixation,A,,20.31,15.56,NA,15.56,,2.95,38.82,38.82,0,090,0.10,0.69,0.21,2,2,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664
1401112,CA,58,MADERA,1.017,1.096,0.536
1501112,CA,59,MERCED,1.017,1.096,0.536
1601112,CA,60,MODESTO,1.017,1.096,0.536
1701112,CA,51,NAPA,1.063,1.318,0.508
1801182,CA,17,OXNARD-THOUSAND OAKS-VENTURA,1.028,1.182,0.623
1901112,CA,61,REDDING,1.017,1.096,0.536