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CMS RVU26D · Effective 2026-10-01

21235 in Wyoming**

Office / nonfacility

$728.30

Base rate per service

Facility setting

$497.17

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.

Reconstructive surgery

About 21235: Autologous ear cartilage graft

Reports harvesting and placing a patient's ear cartilage to support nasal or auricular reconstruction, with the donor-site work included.

The surgeon removes cartilage from the patient's ear, shapes it, and places it to support reconstruction of the nose or ear. Common situations include adding structural support during nasal reconstruction after trauma or prior surgery, or rebuilding an auricular contour. Otolaryngologists and plastic or facial plastic surgeons typically perform the graft as part of a reconstructive operation.

Report this code when ear cartilage is harvested and used at the documented recipient site; obtaining the graft is included, so do not separately report the ear harvest. The operative note should identify the donor ear, recipient site, graft purpose, and placement. Medicare includes the day-before preoperative visit and 90 days of related postoperative care in the 90-day global period. For multiple procedures 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. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.

CMS billing rules for 21235

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
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 RVU7.31 · 33%
  • Practice expense (office) RVU13.74 · 62%
  • Malpractice RVU1.02 · 5%

7K

Medicare services in 2024 · #1666 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.

21235 compared with similar codes

Office rates for Wyoming**, from the same CMS release.

20912

Cartilage graft

Nasal septum

No office rate

Choose 20912 when cartilage is taken from the nasal septum. This code is for cartilage harvested from the ear.

21230

Rib cartilage graft

Autogenous cartilage

No office rate

Choose 21230 when the graft is harvested from a rib. This code applies when the donor cartilage comes from the ear.

30400

Reconstruction of nose

No office rate

30400 reports primary rhinoplasty; this code reports the ear-cartilage graft and includes obtaining that graft.

The same code, a different location

How does Wyoming** compare?

21235 across payment areas

Same release and payment basis · bars start at $0

  1. Wyoming** · This locality

    $728.30

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

    $819.71

    $91.41 higher than Wyoming**

  3. Dc + Md/Va Suburbs

    $835.88

    $107.58 higher than Wyoming**

  4. Miami

    $808.07

    $79.77 higher than Wyoming**

  5. Chicago

    $785.28

    $56.98 higher than Wyoming**

  6. Manhattan

    $847.09

    $118.79 higher than Wyoming**

  7. Alaska*

    $873.77

    $145.47 higher than Wyoming**

Other payment areas listed in Wyoming 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, 21235 ranges from $655.93 in Arkansas to $951.05 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

  • Alabama

    Alabama · 21235

    Office

    $665.01

    Facility

    $462.76

    $63.29 lower than Wyoming** for the office setting.

  • Arkansas

    Arkansas · 21235

    Office

    $655.93

    Facility

    $457.38

    $72.37 lower than Wyoming** for the office setting.

  • Arizona

    Arizona · 21235

    Office

    $718.03

    Facility

    $494.06

    $10.27 lower than Wyoming** for the office setting.

  • Bakersfield

    California · 21235

    Office

    $772.53

    Facility

    $519.21

    $44.23 higher than Wyoming** for the office setting.

  • Chico

    California · 21235

    Office

    $769.56

    Facility

    $516.23

    $41.26 higher than Wyoming** for the office setting.

  • El Centro

    California · 21235

    Office

    $769.73

    Facility

    $516.40

    $41.43 higher than Wyoming** for the office setting.

  • Fresno

    California · 21235

    Office

    $769.56

    Facility

    $516.23

    $41.26 higher than Wyoming** for the office setting.

  • Hanford-Corcoran

    California · 21235

    Office

    $769.56

    Facility

    $516.23

    $41.26 higher than Wyoming** for the office setting.

  • Madera

    California · 21235

    Office

    $769.56

    Facility

    $516.23

    $41.26 higher than Wyoming** for the office setting.

  • Merced

    California · 21235

    Office

    $769.56

    Facility

    $516.23

    $41.26 higher than Wyoming** for the office setting.

  • Modesto

    California · 21235

    Office

    $769.56

    Facility

    $516.23

    $41.26 higher than Wyoming** for the office setting.

  • Napa

    California · 21235

    Office

    $881.72

    Facility

    $577.08

    $153.42 higher than Wyoming** for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 21235

    Office

    $814.68

    Facility

    $541.47

    $86.38 higher than Wyoming** for the office setting.

  • Redding

    California · 21235

    Office

    $769.56

    Facility

    $516.23

    $41.26 higher than Wyoming** for the office setting.

  • Rest Of California

    California · 21235

    Office

    $769.56

    Facility

    $516.23

    $41.26 higher than Wyoming** for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 21235

    Office

    $780.60

    Facility

    $527.28

    $52.30 higher than Wyoming** for the office setting.

  • Sacramento-Roseville-Folsom

    California · 21235

    Office

    $804.94

    Facility

    $536.14

    $76.64 higher than Wyoming** for the office setting.

  • Salinas

    California · 21235

    Office

    $801.89

    Facility

    $534.00

    $73.59 higher than Wyoming** for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 21235

    Office

    $818.83

    Facility

    $542.39

    $90.53 higher than Wyoming** for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 21235

    Office

    $930.08

    Facility

    $604.18

    $201.78 higher than Wyoming** for the office setting.

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

    California · 21235

    Office

    $928.92

    Facility

    $603.02

    $200.62 higher than Wyoming** for the office setting.

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

    California · 21235

    Office

    $951.05

    Facility

    $617.76

    $222.75 higher than Wyoming** for the office setting.

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

    California · 21235

    Office

    $946.32

    Facility

    $613.02

    $218.02 higher than Wyoming** for the office setting.

  • San Luis Obispo-Paso Robles

    California · 21235

    Office

    $789.29

    Facility

    $526.03

    $60.99 higher than Wyoming** for the office setting.

  • Santa Cruz-Watsonville

    California · 21235

    Office

    $825.15

    Facility

    $544.32

    $96.85 higher than Wyoming** for the office setting.

  • Santa Maria-Santa Barbara

    California · 21235

    Office

    $804.37

    Facility

    $534.87

    $76.07 higher than Wyoming** for the office setting.

  • Santa Rosa-Petaluma

    California · 21235

    Office

    $833.31

    Facility

    $549.48

    $105.01 higher than Wyoming** for the office setting.

  • Stockton

    California · 21235

    Office

    $769.56

    Facility

    $516.23

    $41.26 higher than Wyoming** for the office setting.

  • Vallejo

    California · 21235

    Office

    $880.05

    Facility

    $575.41

    $151.75 higher than Wyoming** for the office setting.

  • Visalia

    California · 21235

    Office

    $769.56

    Facility

    $516.23

    $41.26 higher than Wyoming** for the office setting.

  • Yuba City

    California · 21235

    Office

    $769.56

    Facility

    $516.23

    $41.26 higher than Wyoming** for the office setting.

  • Colorado

    Colorado · 21235

    Office

    $762.00

    Facility

    $516.07

    $33.70 higher than Wyoming** for the office setting.

  • Connecticut

    Connecticut · 21235

    Office

    $784.53

    Facility

    $535.60

    $56.23 higher than Wyoming** for the office setting.

  • Delaware

    Delaware · 21235

    Office

    $729.43

    Facility

    $501.07

    $1.13 higher than Wyoming** for the office setting.

  • Fort Lauderdale

    Florida · 21235

    Office

    $770.65

    Facility

    $536.51

    $42.35 higher than Wyoming** for the office setting.

  • Rest Of Florida

    Florida · 21235

    Office

    $734.10

    Facility

    $513.14

    $5.80 higher than Wyoming** for the office setting.

  • Atlanta

    Georgia · 21235

    Office

    $752.08

    Facility

    $517.25

    $23.78 higher than Wyoming** for the office setting.

  • Rest Of Georgia

    Georgia · 21235

    Office

    $694.13

    Facility

    $487.96

    $34.17 lower than Wyoming** for the office setting.

  • Hawaii, Guam

    Hawaii · 21235

    Office

    $785.69

    Facility

    $522.89

    $57.39 higher than Wyoming** for the office setting.

  • Iowa

    Iowa · 21235

    Office

    $677.61

    Facility

    $466.12

    $50.69 lower than Wyoming** for the office setting.

  • Idaho

    Idaho · 21235

    Office

    $682.49

    Facility

    $469.85

    $45.81 lower than Wyoming** for the office setting.

  • East St. Louis

    Illinois · 21235

    Office

    $734.99

    Facility

    $522.35

    $6.69 higher than Wyoming** for the office setting.

  • Rest Of Illinois

    Illinois · 21235

    Office

    $716.41

    Facility

    $505.39

    $11.89 lower than Wyoming** for the office setting.

  • Suburban Chicago

    Illinois · 21235

    Office

    $777.56

    Facility

    $540.18

    $49.26 higher than Wyoming** for the office setting.

  • Indiana

    Indiana · 21235

    Office

    $686.14

    Facility

    $471.88

    $42.16 lower than Wyoming** for the office setting.

  • Kansas

    Kansas · 21235

    Office

    $676.20

    Facility

    $467.26

    $52.10 lower than Wyoming** for the office setting.

  • Kentucky

    Kentucky · 21235

    Office

    $683.32

    Facility

    $477.84

    $44.98 lower than Wyoming** for the office setting.

  • New Orleans

    Louisiana · 21235

    Office

    $714.71

    Facility

    $497.22

    $13.59 lower than Wyoming** for the office setting.

  • Rest Of Louisiana

    Louisiana · 21235

    Office

    $682.95

    Facility

    $478.40

    $45.35 lower than Wyoming** for the office setting.

  • Metropolitan Boston

    Massachusetts · 21235

    Office

    $832.45

    Facility

    $556.48

    $104.15 higher than Wyoming** for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 21235

    Office

    $758.47

    Facility

    $515.09

    $30.17 higher than Wyoming** for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 21235

    Office

    $782.64

    Facility

    $534.63

    $54.34 higher than Wyoming** for the office setting.

  • Rest Of Maryland

    Maryland · 21235

    Office

    $742.31

    Facility

    $508.41

    $14.01 higher than Wyoming** for the office setting.

  • Rest Of Maine

    Maine · 21235

    Office

    $687.57

    Facility

    $474.92

    $40.73 lower than Wyoming** for the office setting.

  • Southern Maine

    Maine · 21235

    Office

    $720.46

    Facility

    $491.40

    $7.84 lower than Wyoming** for the office setting.

  • Detroit

    Michigan · 21235

    Office

    $744.47

    Facility

    $521.42

    $16.17 higher than Wyoming** for the office setting.

  • Rest Of Michigan

    Michigan · 21235

    Office

    $701.63

    Facility

    $490.60

    $26.67 lower than Wyoming** for the office setting.

  • Minnesota

    Minnesota · 21235

    Office

    $726.48

    Facility

    $488.65

    $1.82 lower than Wyoming** for the office setting.

  • Metropolitan Kansas City

    Missouri · 21235

    Office

    $708.38

    Facility

    $491.34

    $19.92 lower than Wyoming** for the office setting.

  • Metropolitan St. Louis

    Missouri · 21235

    Office

    $715.20

    Facility

    $495.16

    $13.10 lower than Wyoming** for the office setting.

  • Rest Of Missouri

    Missouri · 21235

    Office

    $672.94

    Facility

    $473.70

    $55.36 lower than Wyoming** for the office setting.

  • Mississippi

    Mississippi · 21235

    Office

    $664.47

    Facility

    $465.47

    $63.83 lower than Wyoming** for the office setting.

  • Montana**

    Montana · 21235

    Office

    $737.09

    Facility

    $505.96

    $8.79 higher than Wyoming** for the office setting.

  • North Carolina

    North Carolina · 21235

    Office

    $694.11

    Facility

    $478.46

    $34.19 lower than Wyoming** for the office setting.

  • North Dakota**

    North Dakota · 21235

    Office

    $716.92

    Facility

    $485.79

    $11.38 lower than Wyoming** for the office setting.

  • Nebraska

    Nebraska · 21235

    Office

    $680.63

    Facility

    $467.29

    $47.67 lower than Wyoming** for the office setting.

  • New Hampshire

    New Hampshire · 21235

    Office

    $751.72

    Facility

    $511.10

    $23.42 higher than Wyoming** for the office setting.

  • Northern Nj

    New Jersey · 21235

    Office

    $828.29

    Facility

    $560.17

    $99.99 higher than Wyoming** for the office setting.

  • Rest Of New Jersey

    New Jersey · 21235

    Office

    $792.45

    Facility

    $540.05

    $64.15 higher than Wyoming** for the office setting.

  • New Mexico

    New Mexico · 21235

    Office

    $705.91

    Facility

    $493.96

    $22.39 lower than Wyoming** for the office setting.

  • Nevada**

    Nevada · 21235

    Office

    $731.93

    Facility

    $500.56

    $3.63 higher than Wyoming** for the office setting.

  • Nyc Suburbs/Long Island

    New York · 21235

    Office

    $868.72

    Facility

    $593.90

    $140.42 higher than Wyoming** for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 21235

    Office

    $798.90

    Facility

    $545.81

    $70.60 higher than Wyoming** for the office setting.

  • Queens

    New York · 21235

    Office

    $851.37

    Facility

    $578.17

    $123.07 higher than Wyoming** for the office setting.

  • Rest Of New York

    New York · 21235

    Office

    $704.09

    Facility

    $484.52

    $24.21 lower than Wyoming** for the office setting.

  • Ohio

    Ohio · 21235

    Office

    $697.50

    Facility

    $486.48

    $30.80 lower than Wyoming** for the office setting.

  • Oklahoma

    Oklahoma · 21235

    Office

    $680.46

    Facility

    $474.05

    $47.84 lower than Wyoming** for the office setting.

  • Portland

    Oregon · 21235

    Office

    $783.28

    Facility

    $526.49

    $54.98 higher than Wyoming** for the office setting.

  • Rest Of Oregon

    Oregon · 21235

    Office

    $725.20

    Facility

    $494.99

    $3.10 lower than Wyoming** for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 21235

    Office

    $766.94

    Facility

    $526.33

    $38.64 higher than Wyoming** for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 21235

    Office

    $697.65

    Facility

    $485.47

    $30.65 lower than Wyoming** for the office setting.

  • Puerto Rico

    Puerto Rico · 21235

    Office

    $741.70

    Facility

    $508.02

    $13.40 higher than Wyoming** for the office setting.

  • Rhode Island

    Rhode Island · 21235

    Office

    $753.26

    Facility

    $514.50

    $24.96 higher than Wyoming** for the office setting.

  • South Carolina

    South Carolina · 21235

    Office

    $697.17

    Facility

    $483.60

    $31.13 lower than Wyoming** for the office setting.

  • South Dakota**

    South Dakota · 21235

    Office

    $714.54

    Facility

    $483.40

    $13.76 lower than Wyoming** for the office setting.

  • Tennessee

    Tennessee · 21235

    Office

    $679.62

    Facility

    $469.52

    $48.68 lower than Wyoming** for the office setting.

  • Austin

    Texas · 21235

    Office

    $760.38

    Facility

    $515.84

    $32.08 higher than Wyoming** for the office setting.

  • Beaumont

    Texas · 21235

    Office

    $693.44

    Facility

    $483.10

    $34.86 lower than Wyoming** for the office setting.

  • Brazoria

    Texas · 21235

    Office

    $727.49

    Facility

    $498.43

    $0.81 lower than Wyoming** for the office setting.

  • Dallas

    Texas · 21235

    Office

    $732.68

    Facility

    $502.47

    $4.38 higher than Wyoming** for the office setting.

  • Fort Worth

    Texas · 21235

    Office

    $728.54

    Facility

    $500.64

    $0.24 higher than Wyoming** for the office setting.

  • Galveston

    Texas · 21235

    Office

    $730.04

    Facility

    $500.52

    $1.74 higher than Wyoming** for the office setting.

  • Houston

    Texas · 21235

    Office

    $748.71

    Facility

    $519.19

    $20.41 higher than Wyoming** for the office setting.

  • Rest Of Texas

    Texas · 21235

    Office

    $710.45

    Facility

    $491.10

    $17.85 lower than Wyoming** for the office setting.

  • Utah

    Utah · 21235

    Office

    $706.15

    Facility

    $488.88

    $22.15 lower than Wyoming** for the office setting.

  • Virginia

    Virginia · 21235

    Office

    $719.34

    Facility

    $492.13

    $8.96 lower than Wyoming** for the office setting.

  • Virgin Islands

    United States Virgin Islands · 21235

    Office

    $741.70

    Facility

    $508.02

    $13.40 higher than Wyoming** for the office setting.

  • Vermont

    Vermont · 21235

    Office

    $715.74

    Facility

    $486.92

    $12.56 lower than Wyoming** for the office setting.

  • Rest Of Washington

    Washington · 21235

    Office

    $756.51

    Facility

    $513.13

    $28.21 higher than Wyoming** for the office setting.

  • Seattle (King Cnty)

    Washington · 21235

    Office

    $847.31

    Facility

    $563.71

    $119.01 higher than Wyoming** for the office setting.

  • Wisconsin

    Wisconsin · 21235

    Office

    $694.31

    Facility

    $472.88

    $33.99 lower than Wyoming** for the office setting.

  • West Virginia

    West Virginia · 21235

    Office

    $691.72

    Facility

    $490.87

    $36.58 lower than Wyoming** for the office setting.

See how rates vary across the country

21235 · 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.

$655.93

$873.77

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$873.771
AL$665.011
AR$655.931
AZ$718.031
CA$769.56–$951.0529
CO$762.001
CT$784.531
DC$835.881
DE$729.431
FL$734.10–$808.073
GA$694.13–$752.082
GU$785.691
HI$785.691
IA$677.611
ID$682.491
IL$716.41–$785.284
IN$686.141
KS$676.201
KY$683.321
LA$682.95–$714.712
MA$758.47–$832.452
MD$742.31–$835.883
ME$687.57–$720.462
MI$701.63–$744.472
MN$726.481
MO$672.94–$715.203
MS$664.471
MT$737.091
NC$694.111
ND$716.921
NE$680.631
NH$751.721
NJ$792.45–$828.292
NM$705.911
NV$731.931
NY$704.09–$868.725
OH$697.501
OK$680.461
OR$725.20–$783.282
PA$697.65–$766.942
PR$741.701
RI$753.261
SC$697.171
SD$714.541
TN$679.621
TX$693.44–$760.388
UT$706.151
VA$719.34–$835.882
VI$741.701
VT$715.741
WA$756.51–$847.312
WI$694.311
WV$691.721
WY$728.301

Explore 21235 on the national rate map →

Where does this rate apply?

Wyoming** is a Medicare payment area. Our Census mapping connects it to 205 cities and communities in Wyoming, 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 Wyoming →

Why are the office and facility amounts different?

For 21235 in Wyoming**, the physician’s office rate is $728.30 and the facility-setting rate is $497.17: a difference of $231.13.

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 21235 in Wyoming**. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$801.13

$728.30 × 110% = $801.13

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 21235 in Wyoming**.

PPRRVU2026_Oct_nonQPP.csv

1,919

Code
21235
Physician work
7.31
Practice expense
13.74
Malpractice
1.02

GPCI2026.csv

112

Locality
Wyoming**
Physician work
1.000
Practice expense
1.000
Malpractice
0.740
Office / nonfacility calculation for 21235 in Wyoming**
ComponentRVULocality factorAdjusted
Physician work7.31× 1.0007.3100
Practice expense13.74× 1.00013.7400
Malpractice1.02× 0.7400.7548
Total RVUs21.8048
Conversion factor× 33.4009

Office / nonfacility rate, Wyoming**$728.30

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

Open 21235 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work7.311
Practice expense13.741
Malpractice1.020.74

(7.31 × 1 + 13.74 × 1 + 1.02 × 0.74) × $33.4009 = $728.30

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work7.311
Practice expense6.821
Malpractice1.020.74

(7.31 × 1 + 6.82 × 1 + 1.02 × 0.74) × $33.4009 = $497.17

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

21235 · Office / nonfacility

$728.30

Effective 2026-10-01

The base rate is $18.58 higher than on 2025-10-01, moving from $709.72 to $728.30 (2.6%).

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

    $709.72changed to$728.30

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 7.50 changed to 7.31
    • Practice expense RVU 13.68 changed to 13.74
    • Malpractice RVU 1.03 changed to 1.02
    • Malpractice GPCI 0.739 changed to 0.740

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $709.72

    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$728.30$497.17RVU26D
2026-07-01$728.30$497.17RVU26C
2026-04-01$728.30$497.17RVU26B
2026-01-01$728.30$497.17RVU26A
2025-10-01$709.72$551.55RVU25D
2025-07-01$709.72$551.55RVU25C
2025-04-01$709.72$551.55RVU25B
2025-01-01$709.72$551.55RVU25A

21235 billing questions

When should I use this code instead of a septal cartilage graft code?

Use this code when the graft is harvested from the ear. A nasal septum cartilage graft is reported with 20912 when that is the donor source.

Can the ear cartilage harvest be billed separately?

No. The graft service includes obtaining the ear cartilage.

Can modifier 50 be used when cartilage is taken from both ears?

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

What documentation supports reporting this graft?

Document the ear used as the donor site, the nasal or auricular recipient site, why structural cartilage was needed, and how the graft was placed.

How does the 90-day global period affect postoperative care?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period.

Can an assistant or co-surgeon be reported for this procedure?

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 21235PPRRVU2026_Oct_nonQPP.csv, line 1,919 (RVU26D)
Geographic factors for Wyoming**GPCI2026.csv, line 112 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet