No office rate
Both address nasoethmoid complex fractures, but 21338 is for open treatment without internal fixation; 21340 is for percutaneous treatment.
On this page
CMS RVU26D · Effective 2026-10-01
21340 in Wyoming**
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$645.85
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Facial fracture treatment
About 21340: Percutaneous nasoethmoid fracture treatment
Reports percutaneous treatment of a nasoethmoid complex fracture when the surgeon manipulates the fracture through a percutaneous approach rather than open exposure.
This code represents treatment of a fracture involving the nasoethmoid complex through a percutaneous approach, with fracture manipulation and stabilization as part of the treatment. It is distinct from open repair, which requires surgical exposure of the fracture. Otolaryngologists, facial plastic surgeons, plastic surgeons, and oral and maxillofacial surgeons may perform this work, often in an operating room after facial trauma such as a motor vehicle collision.
Choose the code based on the documented fracture site and treatment approach, not simply the presence of a nasal fracture. The operative report should identify the nasoethmoid injury and describe the percutaneous manipulation and stabilization performed. CMS assigns 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 multiple procedure reduction. Modifier 50 is inappropriate. An assistant is payable only when medical necessity is documented; co-surgeons and team surgery are not permitted.
CMS billing rules for 21340
- 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU11.20 · 57%
- Practice expense (office) RVU6.93 · 35%
- Malpractice RVU1.63 · 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.
21340 compared with similar codes
Office rates for Wyoming**, from the same CMS release.
No office rate
21339 describes open treatment with internal fixation. Choose 21340 when the documented treatment is percutaneous rather than open.
$158.60
21315 concerns closed treatment of a nasal fracture. Use 21340 when the treated injury is a nasoethmoid complex fracture managed percutaneously.
$218.78
21320 is for closed nasal fracture treatment with manipulation and stabilization; 21340 identifies percutaneous treatment of a nasoethmoid complex fracture.
The same code, a different location
How does Wyoming** compare?
21340 across payment areas
Same release and payment basis · bars start at $0
Wyoming** · This locality
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Wyoming appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Alabama
Alabama · 21340
Office
Unavailable
Facility
$607.44
No comparable office rate is available.
Arkansas
Arkansas · 21340
Office
Unavailable
Facility
$600.96
No comparable office rate is available.
Arizona
Arizona · 21340
Office
Unavailable
Facility
$644.99
No comparable office rate is available.
Bakersfield
California · 21340
Office
Unavailable
Facility
$668.04
No comparable office rate is available.
Chico
California · 21340
Office
Unavailable
Facility
$663.32
No comparable office rate is available.
El Centro
California · 21340
Office
Unavailable
Facility
$663.59
No comparable office rate is available.
Fresno
California · 21340
Office
Unavailable
Facility
$663.32
No comparable office rate is available.
Hanford-Corcoran
California · 21340
Office
Unavailable
Facility
$663.32
No comparable office rate is available.
Madera
California · 21340
Office
Unavailable
Facility
$663.32
No comparable office rate is available.
Merced
California · 21340
Office
Unavailable
Facility
$663.32
No comparable office rate is available.
Modesto
California · 21340
Office
Unavailable
Facility
$663.32
No comparable office rate is available.
Napa
California · 21340
Office
Unavailable
Facility
$730.39
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 21340
Office
Unavailable
Facility
$692.08
No comparable office rate is available.
Redding
California · 21340
Office
Unavailable
Facility
$663.32
No comparable office rate is available.
Rest Of California
California · 21340
Office
Unavailable
Facility
$663.32
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 21340
Office
Unavailable
Facility
$680.95
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 21340
Office
Unavailable
Facility
$685.94
No comparable office rate is available.
Salinas
California · 21340
Office
Unavailable
Facility
$683.14
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 21340
Office
Unavailable
Facility
$691.66
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 21340
Office
Unavailable
Facility
$760.99
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 21340
Office
Unavailable
Facility
$759.14
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 21340
Office
Unavailable
Facility
$778.20
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 21340
Office
Unavailable
Facility
$770.63
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 21340
Office
Unavailable
Facility
$673.27
No comparable office rate is available.
Santa Cruz-Watsonville
California · 21340
Office
Unavailable
Facility
$692.36
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 21340
Office
Unavailable
Facility
$683.64
No comparable office rate is available.
Santa Rosa-Petaluma
California · 21340
Office
Unavailable
Facility
$698.74
No comparable office rate is available.
Stockton
California · 21340
Office
Unavailable
Facility
$663.32
No comparable office rate is available.
Vallejo
California · 21340
Office
Unavailable
Facility
$727.72
No comparable office rate is available.
Visalia
California · 21340
Office
Unavailable
Facility
$663.32
No comparable office rate is available.
Yuba City
California · 21340
Office
Unavailable
Facility
$663.32
No comparable office rate is available.
Colorado
Colorado · 21340
Office
Unavailable
Facility
$667.38
No comparable office rate is available.
Connecticut
Connecticut · 21340
Office
Unavailable
Facility
$696.74
No comparable office rate is available.
Delaware
Delaware · 21340
Office
Unavailable
Facility
$653.60
No comparable office rate is available.
Fort Lauderdale
Florida · 21340
Office
Unavailable
Facility
$707.00
No comparable office rate is available.
Rest Of Florida
Florida · 21340
Office
Unavailable
Facility
$677.20
No comparable office rate is available.
Atlanta
Georgia · 21340
Office
Unavailable
Facility
$675.77
No comparable office rate is available.
Rest Of Georgia
Georgia · 21340
Office
Unavailable
Facility
$645.46
No comparable office rate is available.
Hawaii, Guam
Hawaii · 21340
Office
Unavailable
Facility
$668.79
No comparable office rate is available.
Iowa
Iowa · 21340
Office
Unavailable
Facility
$607.50
No comparable office rate is available.
Idaho
Idaho · 21340
Office
Unavailable
Facility
$612.79
No comparable office rate is available.
East St. Louis
Illinois · 21340
Office
Unavailable
Facility
$696.69
No comparable office rate is available.
Rest Of Illinois
Illinois · 21340
Office
Unavailable
Facility
$670.52
No comparable office rate is available.
Suburban Chicago
Illinois · 21340
Office
Unavailable
Facility
$710.90
No comparable office rate is available.
Indiana
Indiana · 21340
Office
Unavailable
Facility
$615.12
No comparable office rate is available.
Kansas
Kansas · 21340
Office
Unavailable
Facility
$610.78
No comparable office rate is available.
Kentucky
Kentucky · 21340
Office
Unavailable
Facility
$629.68
No comparable office rate is available.
New Orleans
Louisiana · 21340
Office
Unavailable
Facility
$653.75
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 21340
Office
Unavailable
Facility
$631.10
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 21340
Office
Unavailable
Facility
$714.26
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 21340
Office
Unavailable
Facility
$667.20
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 21340
Office
Unavailable
Facility
$695.79
No comparable office rate is available.
Rest Of Maryland
Maryland · 21340
Office
Unavailable
Facility
$662.06
No comparable office rate is available.
Rest Of Maine
Maine · 21340
Office
Unavailable
Facility
$620.90
No comparable office rate is available.
Southern Maine
Maine · 21340
Office
Unavailable
Facility
$637.83
No comparable office rate is available.
Detroit
Michigan · 21340
Office
Unavailable
Facility
$689.25
No comparable office rate is available.
Rest Of Michigan
Michigan · 21340
Office
Unavailable
Facility
$646.89
No comparable office rate is available.
Minnesota
Minnesota · 21340
Office
Unavailable
Facility
$628.39
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 21340
Office
Unavailable
Facility
$644.63
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 21340
Office
Unavailable
Facility
$649.00
No comparable office rate is available.
Rest Of Missouri
Missouri · 21340
Office
Unavailable
Facility
$626.64
No comparable office rate is available.
Mississippi
Mississippi · 21340
Office
Unavailable
Facility
$613.62
No comparable office rate is available.
Montana**
Montana · 21340
Office
Unavailable
Facility
$659.89
No comparable office rate is available.
North Carolina
North Carolina · 21340
Office
Unavailable
Facility
$624.84
No comparable office rate is available.
North Dakota**
North Dakota · 21340
Office
Unavailable
Facility
$627.66
No comparable office rate is available.
Nebraska
Nebraska · 21340
Office
Unavailable
Facility
$608.31
No comparable office rate is available.
New Hampshire
New Hampshire · 21340
Office
Unavailable
Facility
$662.69
No comparable office rate is available.
Northern Nj
New Jersey · 21340
Office
Unavailable
Facility
$724.31
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 21340
Office
Unavailable
Facility
$701.54
No comparable office rate is available.
New Mexico
New Mexico · 21340
Office
Unavailable
Facility
$651.73
No comparable office rate is available.
Nevada**
Nevada · 21340
Office
Unavailable
Facility
$651.14
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 21340
Office
Unavailable
Facility
$774.35
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 21340
Office
Unavailable
Facility
$710.26
No comparable office rate is available.
Queens
New York · 21340
Office
Unavailable
Facility
$750.13
No comparable office rate is available.
Rest Of New York
New York · 21340
Office
Unavailable
Facility
$632.26
No comparable office rate is available.
Ohio
Ohio · 21340
Office
Unavailable
Facility
$640.30
No comparable office rate is available.
Oklahoma
Oklahoma · 21340
Office
Unavailable
Facility
$623.09
No comparable office rate is available.
Portland
Oregon · 21340
Office
Unavailable
Facility
$677.74
No comparable office rate is available.
Rest Of Oregon
Oregon · 21340
Office
Unavailable
Facility
$642.91
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 21340
Office
Unavailable
Facility
$686.73
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 21340
Office
Unavailable
Facility
$638.03
No comparable office rate is available.
Puerto Rico
Puerto Rico · 21340
Office
Unavailable
Facility
$661.73
No comparable office rate is available.
Rhode Island
Rhode Island · 21340
Office
Unavailable
Facility
$668.87
No comparable office rate is available.
South Carolina
South Carolina · 21340
Office
Unavailable
Facility
$634.24
No comparable office rate is available.
South Dakota**
South Dakota · 21340
Office
Unavailable
Facility
$623.85
No comparable office rate is available.
Tennessee
Tennessee · 21340
Office
Unavailable
Facility
$613.73
No comparable office rate is available.
Austin
Texas · 21340
Office
Unavailable
Facility
$667.97
No comparable office rate is available.
Beaumont
Texas · 21340
Office
Unavailable
Facility
$635.30
No comparable office rate is available.
Brazoria
Texas · 21340
Office
Unavailable
Facility
$648.93
No comparable office rate is available.
Dallas
Texas · 21340
Office
Unavailable
Facility
$654.71
No comparable office rate is available.
Fort Worth
Texas · 21340
Office
Unavailable
Facility
$653.10
No comparable office rate is available.
Galveston
Texas · 21340
Office
Unavailable
Facility
$652.01
No comparable office rate is available.
Houston
Texas · 21340
Office
Unavailable
Facility
$681.84
No comparable office rate is available.
Rest Of Texas
Texas · 21340
Office
Unavailable
Facility
$642.92
No comparable office rate is available.
Utah
Utah · 21340
Office
Unavailable
Facility
$640.56
No comparable office rate is available.
Virginia
Virginia · 21340
Office
Unavailable
Facility
$640.06
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 21340
Office
Unavailable
Facility
$661.73
No comparable office rate is available.
Vermont
Vermont · 21340
Office
Unavailable
Facility
$630.79
No comparable office rate is available.
Rest Of Washington
Washington · 21340
Office
Unavailable
Facility
$664.12
No comparable office rate is available.
Seattle (King Cnty)
Washington · 21340
Office
Unavailable
Facility
$721.29
No comparable office rate is available.
Wisconsin
Wisconsin · 21340
Office
Unavailable
Facility
$612.61
No comparable office rate is available.
West Virginia
West Virginia · 21340
Office
Unavailable
Facility
$653.14
No comparable office rate is available.
See how rates vary across the country
21340 · 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?
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.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 21340 in Wyoming**. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$710.44
$645.85 × 110% = $710.44
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 21340 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
1,952
- Code
- 21340
- Physician work
- 11.20
- Practice expense
- 6.93
- Malpractice
- 1.63
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 11.20 | × 1.000 | 11.2000 |
| Practice expense | 6.93 | × 1.000 | 6.9300 |
| Malpractice | 1.63 | × 0.740 | 1.2062 |
| Total RVUs | 19.3362 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$645.85
Open 21340 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 11.2 | 1 |
| Practice expense | 6.93 | 1 |
| Malpractice | 1.63 | 0.74 |
(11.2 × 1 + 6.93 × 1 + 1.63 × 0.74) × $33.4009 = $645.85
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
21340 · 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 | $645.85 | RVU26D |
| 2026-07-01 | Not available in this setting | $645.85 | RVU26C |
| 2026-04-01 | Not available in this setting | $645.85 | RVU26B |
| 2026-01-01 | Not available in this setting | $645.85 | RVU26A |
| 2025-10-01 | Not available in this setting | $724.70 | RVU25D |
| 2025-07-01 | Not available in this setting | $724.70 | RVU25C |
| 2025-04-01 | Not available in this setting | $724.70 | RVU25B |
| 2025-01-01 | Not available in this setting | $724.70 | RVU25A |
21340 billing questions
How does this differ from codes 21338 and 21339?
21340 describes percutaneous treatment of a nasoethmoid complex fracture. Codes 21338 and 21339 describe open treatment, with 21339 involving internal fixation.
Can this be reported for an isolated nasal bone fracture?
Use this code for a nasoethmoid complex fracture treated percutaneously, not merely because the nose is fractured. Codes 21315 and 21320 concern closed treatment of nasal fractures.
Is modifier 50 appropriate when both sides are involved?
No. CMS does not apply a bilateral adjustment to this code, and modifier 50 is inappropriate.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
When can an assistant be reported?
CMS pays an assistant at surgery only when the record documents medical necessity. Co-surgeons and team surgery are not permitted.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures in the session are subject to the standard multiple procedure reduction.
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.
1,94921337,,Closed tx septal&nose fx,A,,3.31,8.96,,4.63,,0.50,12.77,8.44,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,95021338,,Open nasoethmoid fx w/o fixj,A,,6.70,11.08,NA,11.08,,0.99,18.77,18.77,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,95121339,,Open nasoethmoid fx w/ fixj,A,,8.29,11.46,NA,11.46,,1.21,20.96,20.96,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,95221340,,Perq tx nasoethmoid fx,A,,11.20,6.93,NA,6.93,,1.63,19.76,19.76,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,95321343,,Open tx dprsd front sinus fx,A,,13.96,13.17,NA,13.17,,2.05,29.18,29.18,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,95421344,,Open tx compl front sinus fx,A,,21.03,12.31,NA,12.31,,3.05,36.39,36.39,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,95521345,,Closed tx nose/jaw fx,A,,8.83,13.81,,6.89,,1.29,23.93,17.01,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,