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CMS RVU26D · Effective 2026-10-01

21245 in Redding

Office / nonfacility

$1341.40

Base rate per service

Facility setting

$881.61

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 21245: Partial subperiosteal jaw implant reconstruction

Reports reconstruction of part of the mandible or maxilla with a subperiosteal implant, typically when severe jawbone loss limits conventional implant support.

This procedure reconstructs part of the mandible or maxilla using a subperiosteal implant positioned beneath the periosteum and over the jawbone. Oral and maxillofacial surgeons typically perform it for substantial jawbone loss, including severe atrophy that makes conventional implant support difficult. The operative report should identify the jaw treated, the extent reconstructed, and the subperiosteal implant approach.

Select this code for partial reconstruction; a complete reconstruction belongs to the corresponding complete-service code. Documentation should distinguish a subperiosteal implant from an endosteal implant and describe the treated anatomy and extent. The service 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. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.

CMS billing rules for 21245

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 RVU12.79 · 33%
  • Practice expense (office) RVU23.87 · 62%
  • Malpractice RVU1.85 · 5%

65

Medicare services in 2024 · #5184 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.

21245 compared with similar codes

Office rates for Redding, from the same CMS release.

21246

Jaw reconstruction

Endosteal implant

No office rate

Both describe subperiosteal implant reconstruction; 21245 is partial, while 21246 is complete.

21248

Jaw reconstruction

Partial endosteal implant

$1,060.63

21245 is for partial reconstruction with a subperiosteal implant. 21248 is for partial reconstruction with an endosteal implant.

21244

Jaw reconstruction

Extraoral, with bone plate

No office rate

21244 describes mandibular reconstruction with bone graft using a different approach; 21245 is partial reconstruction with a subperiosteal implant.

The same code, a different location

How does Redding compare?

In Bakersfield, the office rate for 21245 is $1346.76—$5.36 higher than the $1341.40 rate in Redding. Both use the same code, release and participation basis.

21245 across payment areas

Same release and payment basis · bars start at $0

  1. Redding · This locality

    $1341.40

  2. Bakersfield

    $1346.76

    $5.36 higher than Redding

  3. Chico

    $1341.40

    The same base rate than Redding

  4. El Centro

    $1341.71

    $0.31 higher than Redding

  5. Fresno

    $1341.40

    The same base rate than Redding

  6. Hanford-Corcoran

    $1341.40

    The same base rate than Redding

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

    $1428.92

    $87.52 higher than Redding

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, 21245 ranges from $1143.88 in Arkansas to $1656.99 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 · 21245

    Office

    $1341.40

    Facility

    $881.61

    The same base rate than Redding for the office setting.

  • Merced

    California · 21245

    Office

    $1341.40

    Facility

    $881.61

    The same base rate than Redding for the office setting.

  • Modesto

    California · 21245

    Office

    $1341.40

    Facility

    $881.61

    The same base rate than Redding for the office setting.

  • Napa

    California · 21245

    Office

    $1536.32

    Facility

    $983.39

    $194.92 higher than Redding for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 21245

    Office

    $1420.04

    Facility

    $924.17

    $78.64 higher than Redding for the office setting.

  • Rest Of California

    California · 21245

    Office

    $1341.40

    Facility

    $881.61

    The same base rate than Redding for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 21245

    Office

    $1361.41

    Facility

    $901.62

    $20.01 higher than Redding for the office setting.

  • Sacramento-Roseville-Folsom

    California · 21245

    Office

    $1402.93

    Facility

    $915.04

    $61.53 higher than Redding for the office setting.

  • Salinas

    California · 21245

    Office

    $1397.61

    Facility

    $911.39

    $56.21 higher than Redding for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 21245

    Office

    $1427.05

    Facility

    $925.31

    $85.65 higher than Redding for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 21245

    Office

    $1620.31

    Facility

    $1028.79

    $278.91 higher than Redding for the office setting.

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

    California · 21245

    Office

    $1618.21

    Facility

    $1026.69

    $276.81 higher than Redding for the office setting.

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

    California · 21245

    Office

    $1656.99

    Facility

    $1052.05

    $315.59 higher than Redding for the office setting.

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

    California · 21245

    Office

    $1648.40

    Facility

    $1043.46

    $307.00 higher than Redding for the office setting.

  • San Luis Obispo-Paso Robles

    California · 21245

    Office

    $1375.68

    Facility

    $897.85

    $34.28 higher than Redding for the office setting.

  • Santa Cruz-Watsonville

    California · 21245

    Office

    $1437.98

    Facility

    $928.27

    $96.58 higher than Redding for the office setting.

  • Santa Maria-Santa Barbara

    California · 21245

    Office

    $1401.91

    Facility

    $912.75

    $60.51 higher than Redding for the office setting.

  • Santa Rosa-Petaluma

    California · 21245

    Office

    $1452.19

    Facility

    $937.03

    $110.79 higher than Redding for the office setting.

  • Stockton

    California · 21245

    Office

    $1341.40

    Facility

    $881.61

    The same base rate than Redding for the office setting.

  • Vallejo

    California · 21245

    Office

    $1533.29

    Facility

    $980.37

    $191.89 higher than Redding for the office setting.

  • Visalia

    California · 21245

    Office

    $1341.40

    Facility

    $881.61

    The same base rate than Redding for the office setting.

  • Yuba City

    California · 21245

    Office

    $1341.40

    Facility

    $881.61

    The same base rate than Redding for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 21245

    Office

    $1458.24

    Facility

    $964.05

    $116.84 higher than Redding for the office setting.

  • Miami

    Florida · 21245

    Office

    $1413.44

    Facility

    $976.72

    $72.04 higher than Redding for the office setting.

  • Chicago

    Illinois · 21245

    Office

    $1373.27

    Facility

    $951.65

    $31.87 higher than Redding for the office setting.

  • Manhattan

    New York · 21245

    Office

    $1478.98

    Facility

    $991.50

    $137.58 higher than Redding for the office setting.

  • Alaska*

    Alaska · 21245

    Office

    $1523.95

    Facility

    $1077.16

    $182.55 higher than Redding for the office setting.

  • Alabama

    Alabama · 21245

    Office

    $1159.79

    Facility

    $792.72

    $181.61 lower than Redding for the office setting.

  • Arkansas

    Arkansas · 21245

    Office

    $1143.88

    Facility

    $783.52

    $197.52 lower than Redding for the office setting.

  • Arizona

    Arizona · 21245

    Office

    $1252.65

    Facility

    $846.14

    $88.75 lower than Redding for the office setting.

  • Colorado

    Colorado · 21245

    Office

    $1328.89

    Facility

    $882.52

    $12.51 lower than Redding for the office setting.

  • Connecticut

    Connecticut · 21245

    Office

    $1369.18

    Facility

    $917.36

    $27.78 higher than Redding for the office setting.

  • Delaware

    Delaware · 21245

    Office

    $1272.60

    Facility

    $858.12

    $68.80 lower than Redding for the office setting.

  • Fort Lauderdale

    Florida · 21245

    Office

    $1346.56

    Facility

    $921.59

    $5.16 higher than Redding for the office setting.

  • Rest Of Florida

    Florida · 21245

    Office

    $1282.27

    Facility

    $881.21

    $59.13 lower than Redding for the office setting.

  • Atlanta

    Georgia · 21245

    Office

    $1312.73

    Facility

    $886.50

    $28.67 lower than Redding for the office setting.

  • Rest Of Georgia

    Georgia · 21245

    Office

    $1212.03

    Facility

    $837.82

    $129.37 lower than Redding for the office setting.

  • Hawaii, Guam

    Hawaii · 21245

    Office

    $1369.48

    Facility

    $892.49

    $28.08 higher than Redding for the office setting.

  • Iowa

    Iowa · 21245

    Office

    $1181.24

    Facility

    $797.38

    $160.16 lower than Redding for the office setting.

  • Idaho

    Idaho · 21245

    Office

    $1189.92

    Facility

    $803.97

    $151.48 lower than Redding for the office setting.

  • East St. Louis

    Illinois · 21245

    Office

    $1285.14

    Facility

    $899.19

    $56.26 lower than Redding for the office setting.

  • Rest Of Illinois

    Illinois · 21245

    Office

    $1251.69

    Facility

    $868.68

    $89.71 lower than Redding for the office setting.

  • Suburban Chicago

    Illinois · 21245

    Office

    $1358.49

    Facility

    $927.65

    $17.09 higher than Redding for the office setting.

  • Indiana

    Indiana · 21245

    Office

    $1196.31

    Facility

    $807.42

    $145.09 lower than Redding for the office setting.

  • Kansas

    Kansas · 21245

    Office

    $1179.08

    Facility

    $799.84

    $162.32 lower than Redding for the office setting.

  • Kentucky

    Kentucky · 21245

    Office

    $1192.52

    Facility

    $819.57

    $148.88 lower than Redding for the office setting.

  • New Orleans

    Louisiana · 21245

    Office

    $1247.63

    Facility

    $852.87

    $93.77 lower than Redding for the office setting.

  • Rest Of Louisiana

    Louisiana · 21245

    Office

    $1191.99

    Facility

    $820.72

    $149.41 lower than Redding for the office setting.

  • Metropolitan Boston

    Massachusetts · 21245

    Office

    $1451.66

    Facility

    $950.76

    $110.26 higher than Redding for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 21245

    Office

    $1322.82

    Facility

    $881.07

    $18.58 lower than Redding for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 21245

    Office

    $1365.95

    Facility

    $915.81

    $24.55 higher than Redding for the office setting.

  • Rest Of Maryland

    Maryland · 21245

    Office

    $1295.04

    Facility

    $870.49

    $46.36 lower than Redding for the office setting.

  • Rest Of Maine

    Maine · 21245

    Office

    $1199.13

    Facility

    $813.17

    $142.27 lower than Redding for the office setting.

  • Southern Maine

    Maine · 21245

    Office

    $1256.29

    Facility

    $840.55

    $85.11 lower than Redding for the office setting.

  • Detroit

    Michigan · 21245

    Office

    $1300.75

    Facility

    $895.92

    $40.65 lower than Redding for the office setting.

  • Rest Of Michigan

    Michigan · 21245

    Office

    $1224.88

    Facility

    $841.86

    $116.52 lower than Redding for the office setting.

  • Minnesota

    Minnesota · 21245

    Office

    $1265.89

    Facility

    $834.21

    $75.51 lower than Redding for the office setting.

  • Metropolitan Kansas City

    Missouri · 21245

    Office

    $1236.21

    Facility

    $842.29

    $105.19 lower than Redding for the office setting.

  • Metropolitan St. Louis

    Missouri · 21245

    Office

    $1248.12

    Facility

    $848.74

    $93.28 lower than Redding for the office setting.

  • Rest Of Missouri

    Missouri · 21245

    Office

    $1174.64

    Facility

    $813.02

    $166.76 lower than Redding for the office setting.

  • Mississippi

    Mississippi · 21245

    Office

    $1159.32

    Facility

    $798.12

    $182.08 lower than Redding for the office setting.

  • Montana**

    Montana · 21245

    Office

    $1286.15

    Facility

    $866.63

    $55.25 lower than Redding for the office setting.

  • North Carolina

    North Carolina · 21245

    Office

    $1210.54

    Facility

    $819.14

    $130.86 lower than Redding for the office setting.

  • North Dakota**

    North Dakota · 21245

    Office

    $1249.56

    Facility

    $830.05

    $91.84 lower than Redding for the office setting.

  • Nebraska

    Nebraska · 21245

    Office

    $1186.44

    Facility

    $799.23

    $154.96 lower than Redding for the office setting.

  • New Hampshire

    New Hampshire · 21245

    Office

    $1311.23

    Facility

    $874.52

    $30.17 lower than Redding for the office setting.

  • Northern Nj

    New Jersey · 21245

    Office

    $1444.95

    Facility

    $958.31

    $103.55 higher than Redding for the office setting.

  • Rest Of New Jersey

    New Jersey · 21245

    Office

    $1382.70

    Facility

    $924.59

    $41.30 higher than Redding for the office setting.

  • New Mexico

    New Mexico · 21245

    Office

    $1232.51

    Facility

    $847.82

    $108.89 lower than Redding for the office setting.

  • Nevada**

    Nevada · 21245

    Office

    $1276.75

    Facility

    $856.81

    $64.65 lower than Redding for the office setting.

  • Nyc Suburbs/Long Island

    New York · 21245

    Office

    $1517.25

    Facility

    $1018.45

    $175.85 higher than Redding for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 21245

    Office

    $1394.21

    Facility

    $934.84

    $52.81 higher than Redding for the office setting.

  • Queens

    New York · 21245

    Office

    $1486.03

    Facility

    $990.16

    $144.63 higher than Redding for the office setting.

  • Rest Of New York

    New York · 21245

    Office

    $1228.05

    Facility

    $829.51

    $113.35 lower than Redding for the office setting.

  • Ohio

    Ohio · 21245

    Office

    $1217.40

    Facility

    $834.38

    $124.00 lower than Redding for the office setting.

  • Oklahoma

    Oklahoma · 21245

    Office

    $1187.18

    Facility

    $812.55

    $154.22 lower than Redding for the office setting.

  • Portland

    Oregon · 21245

    Office

    $1365.78

    Facility

    $899.70

    $24.38 higher than Redding for the office setting.

  • Rest Of Oregon

    Oregon · 21245

    Office

    $1264.73

    Facility

    $846.89

    $76.67 lower than Redding for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 21245

    Office

    $1338.57

    Facility

    $901.86

    $2.83 lower than Redding for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 21245

    Office

    $1217.49

    Facility

    $832.38

    $123.91 lower than Redding for the office setting.

  • Puerto Rico

    Puerto Rico · 21245

    Office

    $1294.11

    Facility

    $869.98

    $47.29 lower than Redding for the office setting.

  • Rhode Island

    Rhode Island · 21245

    Office

    $1314.02

    Facility

    $880.66

    $27.38 lower than Redding for the office setting.

  • South Carolina

    South Carolina · 21245

    Office

    $1216.41

    Facility

    $828.77

    $124.99 lower than Redding for the office setting.

  • South Dakota**

    South Dakota · 21245

    Office

    $1245.24

    Facility

    $825.72

    $96.16 lower than Redding for the office setting.

  • Tennessee

    Tennessee · 21245

    Office

    $1185.11

    Facility

    $803.77

    $156.29 lower than Redding for the office setting.

  • Austin

    Texas · 21245

    Office

    $1326.32

    Facility

    $882.47

    $15.08 lower than Redding for the office setting.

  • Beaumont

    Texas · 21245

    Office

    $1210.13

    Facility

    $828.37

    $131.27 lower than Redding for the office setting.

  • Brazoria

    Texas · 21245

    Office

    $1268.92

    Facility

    $853.18

    $72.48 lower than Redding for the office setting.

  • Dallas

    Texas · 21245

    Office

    $1278.15

    Facility

    $860.31

    $63.25 lower than Redding for the office setting.

  • Fort Worth

    Texas · 21245

    Office

    $1270.98

    Facility

    $857.34

    $70.42 lower than Redding for the office setting.

  • Galveston

    Texas · 21245

    Office

    $1273.48

    Facility

    $856.90

    $67.92 lower than Redding for the office setting.

  • Houston

    Texas · 21245

    Office

    $1307.34

    Facility

    $890.76

    $34.06 lower than Redding for the office setting.

  • Rest Of Texas

    Texas · 21245

    Office

    $1239.61

    Facility

    $841.49

    $101.79 lower than Redding for the office setting.

  • Utah

    Utah · 21245

    Office

    $1232.13

    Facility

    $837.78

    $109.27 lower than Redding for the office setting.

  • Virginia

    Virginia · 21245

    Office

    $1254.55

    Facility

    $842.16

    $86.85 lower than Redding for the office setting.

  • Virgin Islands

    United States Virgin Islands · 21245

    Office

    $1294.11

    Facility

    $869.98

    $47.29 lower than Redding for the office setting.

  • Vermont

    Vermont · 21245

    Office

    $1247.77

    Facility

    $832.45

    $93.63 lower than Redding for the office setting.

  • Rest Of Washington

    Washington · 21245

    Office

    $1319.31

    Facility

    $877.56

    $22.09 lower than Redding for the office setting.

  • Seattle (King Cnty)

    Washington · 21245

    Office

    $1477.30

    Facility

    $962.56

    $135.90 higher than Redding for the office setting.

  • Wisconsin

    Wisconsin · 21245

    Office

    $1210.02

    Facility

    $808.13

    $131.38 lower than Redding for the office setting.

  • West Virginia

    West Virginia · 21245

    Office

    $1208.46

    Facility

    $843.90

    $132.94 lower than Redding for the office setting.

  • Wyoming**

    Wyoming · 21245

    Office

    $1270.20

    Facility

    $850.69

    $71.20 lower than Redding for the office setting.

See how rates vary across the country

21245 · 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.

$1,143.88

$1,523.95

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$1,523.951
AL$1,159.791
AR$1,143.881
AZ$1,252.651
CA$1,341.40–$1,656.9929
CO$1,328.891
CT$1,369.181
DC$1,458.241
DE$1,272.601
FL$1,282.27–$1,413.443
GA$1,212.03–$1,312.732
GU$1,369.481
HI$1,369.481
IA$1,181.241
ID$1,189.921
IL$1,251.69–$1,373.274
IN$1,196.311
KS$1,179.081
KY$1,192.521
LA$1,191.99–$1,247.632
MA$1,322.82–$1,451.662
MD$1,295.04–$1,458.243
ME$1,199.13–$1,256.292
MI$1,224.88–$1,300.752
MN$1,265.891
MO$1,174.64–$1,248.123
MS$1,159.321
MT$1,286.151
NC$1,210.541
ND$1,249.561
NE$1,186.441
NH$1,311.231
NJ$1,382.70–$1,444.952
NM$1,232.511
NV$1,276.751
NY$1,228.05–$1,517.255
OH$1,217.401
OK$1,187.181
OR$1,264.73–$1,365.782
PA$1,217.49–$1,338.572
PR$1,294.111
RI$1,314.021
SC$1,216.411
SD$1,245.241
TN$1,185.111
TX$1,210.13–$1,326.328
UT$1,232.131
VA$1,254.55–$1,458.242
VI$1,294.111
VT$1,247.771
WA$1,319.31–$1,477.302
WI$1,210.021
WV$1,208.461
WY$1,270.201

Explore 21245 on the national rate map →

Where does this rate apply?

Redding is a Medicare payment area. Our Census mapping connects it to 32 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 21245 in Redding, the physician’s office rate is $1341.40 and the facility-setting rate is $881.61: a difference of $459.79.

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 21245 in Redding. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$1475.54

$1341.40 × 110% = $1475.54

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 21245 in Redding.

PPRRVU2026_Oct_nonQPP.csv

1,924

Code
21245
Physician work
12.79
Practice expense
23.87
Malpractice
1.85

GPCI2026.csv

19

Locality
Redding
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 21245 in Redding
ComponentRVULocality factorAdjusted
Physician work12.79× 1.01713.0074
Practice expense23.87× 1.09626.1615
Malpractice1.85× 0.5360.9916
Total RVUs40.1606
Conversion factor× 33.4009

Office / nonfacility rate, Redding$1341.40

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

Open 21245 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work12.791.017
Practice expense23.871.096
Malpractice1.850.536

(12.79 × 1.017 + 23.87 × 1.096 + 1.85 × 0.536) × $33.4009 = $1341.40

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work12.791.017
Practice expense11.311.096
Malpractice1.850.536

(12.79 × 1.017 + 11.31 × 1.096 + 1.85 × 0.536) × $33.4009 = $881.61

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

21245 · Office / nonfacility

$1341.40

Effective 2026-10-01

The base rate is $108.11 higher than on 2025-10-01, moving from $1233.29 to $1341.40 (8.8%).

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

    $1233.29changed to$1341.40

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 13.12 changed to 12.79
    • Practice expense RVU 22.02 changed to 23.87
    • Malpractice RVU 1.35 changed to 1.85
    • 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: $1233.29

    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$1341.40$881.61RVU26D
2026-07-01$1341.40$881.61RVU26C
2026-04-01$1341.40$881.61RVU26B
2026-01-01$1341.40$881.61RVU26A
2025-10-01$1233.29$949.39RVU25D
2025-07-01$1233.29$949.39RVU25C
2025-04-01$1233.29$949.39RVU25B
2025-01-01$1233.29$949.39RVU25A

21245 billing questions

How does this differ from 21246?

21245 is for partial subperiosteal implant reconstruction. The corresponding complete reconstruction is reported with 21246.

How does this differ from 21248?

21245 describes a partial subperiosteal implant reconstruction; 21248 is for partial reconstruction using an endosteal implant.

Should modifier 50 be reported for both sides?

No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.

What documentation supports reporting 21245?

The operative report should identify the mandible or maxilla treated, the partial extent of reconstruction, and the use of a subperiosteal implant.

Can an assistant surgeon be reported?

An assistant at surgery may be paid. Co-surgeons and team surgery are not permitted for this code under the listed CMS rules.

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 21245PPRRVU2026_Oct_nonQPP.csv, line 1,924 (RVU26D)
Geographic factors for ReddingGPCI2026.csv, line 19 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet