$677.39
Both address mandibular or maxillary alveolar ridge fractures; 21440 is closed treatment, while 21445 is open treatment.
On this page
CMS RVU26D · Effective 2026-10-01
21440 Fracture treatment Medicare reimbursement rates in Alabama
Reports closed management of a fracture in the tooth-bearing alveolar ridge of the mandible or maxilla, rather than open fracture repair. Compare 21440 office and facility rates across CMS payment localities in Alabama.
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.
What does Medicare pay for 21440 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$704.02
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
Facility setting
$535.39
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Oral and maxillofacial surgery
About 21440: Closed alveolar ridge fracture treatment
Reports closed management of a fracture in the tooth-bearing alveolar ridge of the mandible or maxilla, rather than open fracture repair.
This service treats a fracture of the tooth-bearing alveolar process of the upper or lower jaw without open surgical exposure. The clinician assesses the fracture and manages the involved ridge segment using a closed approach, which may include alignment or stabilization. Oral and maxillofacial surgeons and dentists commonly provide this care in office or facility settings. The operative or treatment note should identify the affected jaw and alveolar ridge, describe the fracture and the closed method used, and distinguish the injury from a broader mandibular or maxillary fracture.
Report 21440 for closed treatment; open exposure and repair belong to the open-treatment code. The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery. 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% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 21440
- 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 RVU3.35 · 14%
- Practice expense (office) RVU19.95 · 84%
- Malpractice RVU0.48 · 2%
58
Medicare services in 2024 · #5264 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.
21440 compared with similar codes
Office rates for Alabama, from the same CMS release.
$534.02
21450 is closed treatment of a mandibular fracture without manipulation. Choose 21440 when the treated fracture is specifically in the tooth-bearing alveolar ridge.
$699.03
21451 is closed treatment of a mandibular fracture with manipulation. It is not the alveolar-ridge-specific service reported with 21440.
$595.20
21421 addresses a palatal or maxillary fracture treated with interdental wire fixation; 21440 is for a fracture of the alveolar ridge.
Compare 21440 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
$704.02
Facility
$535.39
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 21440 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
1,982
- Code
- 21440
- Physician work
- 3.35
- Practice expense
- 19.95
- Malpractice
- 0.48
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.35 | × 1.000 | 3.3500 |
| Practice expense | 19.95 | × 0.875 | 17.4563 |
| Malpractice | 0.48 | × 0.566 | 0.2717 |
| Total RVUs | 21.0779 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Alabama$704.02
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.35 | 1 |
| Practice expense | 19.95 | 0.875 |
| Malpractice | 0.48 | 0.566 |
(3.35 × 1 + 19.95 × 0.875 + 0.48 × 0.566) × $33.4009 = $704.02
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.35 | 1 |
| Practice expense | 14.18 | 0.875 |
| Malpractice | 0.48 | 0.566 |
(3.35 × 1 + 14.18 × 0.875 + 0.48 × 0.566) × $33.4009 = $535.39
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.
21440 billing questions
How is 21440 different from 21445?
21440 is for closed management of the alveolar ridge fracture. Use 21445 when the fracture is treated through an open surgical approach.
When is 21440 more appropriate than 21450 or 21451?
Use 21440 when the fracture involves the tooth-bearing alveolar ridge. Codes 21450 and 21451 describe closed treatment of a mandibular fracture outside that specific alveolar-ridge service.
Can modifier 50 be reported for fractures on both sides?
No. CMS identifies bilateral adjustment as inappropriate for 21440; modifier 50 should not be used.
What documentation supports reporting 21440?
Document the affected jaw and alveolar ridge, the fracture treated, and how it was managed without open surgical exposure. The note should make clear that the service is not treatment of a broader mandibular or maxillary fracture.
How does the 90-day global period affect follow-up care?
The global period includes the day-before preoperative visit and related postoperative care for 90 days. Unrelated services are not included solely because they occur during that period.
When may an assistant-at-surgery be paid?
Assistant-at-surgery payment is allowed only when the record documents medical necessity. Co-surgeons and team surgery are not permitted for this code.
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.
1,97921433,,Optx cranfcl sep comp mlt,A,,25.63,15.31,NA,15.31,,4.76,45.70,45.70,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,98021435,,Optx crnfc sep comp int&/xtr,A,,19.75,14.36,NA,14.36,,3.66,37.77,37.77,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,98121436,,Optx crnfcl sep comp mlt int,A,,29.54,19.00,NA,19.00,,5.49,54.03,54.03,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,98221440,,Cltx mndblr/max alv ridge fx,A,,3.35,19.95,,14.18,,0.48,23.78,18.01,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,98321445,,Optx mndblr/max alv ridge fx,A,,6.10,15.76,,10.18,,0.69,22.55,16.97,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,98421450,,Cltx mndblr fx w/o mnpj,A,,3.62,13.87,,9.74,,0.41,17.90,13.77,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,98521451,,Cltx mndblr fx w/mnpj,A,,5.51,17.22,,12.08,,0.62,23.35,18.21,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515