No office rate
Both describe open nasal fracture treatment, but 21330 is distinguished by skeletal fixation. Use 21325 when the repair does not include that fixation.
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CMS RVU26D · Effective 2026-10-01
21330 Nasal fracture repair Medicare reimbursement rates in Alaska
Report open operative repair of a nasal bone fracture when the surgeon exposes and reduces the fracture and uses skeletal fixation to hold alignment. Compare 21330 office and facility rates across CMS payment localities in Alaska.
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 21330 in Alaska?
Alaska 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
No supported rate
Facility setting
$590.04
1 of 1 localities have a supported rate.
Payment area: Alaska*
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.
Facial fracture surgery
About 21330: Open nasal fracture treatment with fixation
Report open operative repair of a nasal bone fracture when the surgeon exposes and reduces the fracture and uses skeletal fixation to hold alignment.
An otolaryngologist, facial plastic surgeon, or other surgeon with facial trauma expertise may use this service for a nasal bone fracture that requires operative exposure, reduction, and skeletal fixation. The surgeon restores the fractured bones to alignment and stabilizes them with fixation. These repairs are generally performed in a hospital or ambulatory surgery facility rather than as a routine office procedure.
Choose 21330 when the operative record supports open treatment with skeletal fixation, not simply closed manipulation or open repair without that fixation. Document the fracture and its displacement, the exposure and reduction performed, and the fixation used. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in the same session, the highest-valued procedure is paid in full and additional procedures at 50%. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 21330
- 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 RVU5.65 · 38%
- Practice expense (office) RVU8.20 · 56%
- Malpractice RVU0.83 · 6%
42
Medicare services in 2024 · #5460 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.
21330 compared with similar codes
Office rates for Alaska, from the same CMS release.
$181.30
21315 describes closed treatment without manipulation or stabilization; 21330 involves open operative treatment with skeletal fixation.
$253.70
21320 is closed treatment with manipulation and stabilization. Choose 21330 when the surgeon opens the fracture site and performs skeletal fixation.
No office rate
21335 covers open treatment of both a nasal fracture and a septal fracture, while 21330 identifies open nasal fracture treatment with skeletal fixation.
Compare 21330 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
Alaska* →
Office / nonfacility
Unavailable
Facility
$590.04
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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 21330 in Alaska*.
PPRRVU2026_Oct_nonQPP.csv
1,946
- Code
- 21330
- Physician work
- 5.65
- Practice expense
- 8.20
- Malpractice
- 0.83
GPCI2026.csv
5
- Locality
- Alaska*
- Physician work
- 1.500
- Practice expense
- 1.065
- Malpractice
- 0.551
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.65 | × 1.500 | 8.4750 |
| Practice expense | 8.20 | × 1.065 | 8.7330 |
| Malpractice | 0.83 | × 0.551 | 0.4573 |
| Total RVUs | 17.6653 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Alaska*$590.04
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.65 | 1.5 |
| Practice expense | 8.2 | 1.065 |
| Malpractice | 0.83 | 0.551 |
(5.65 × 1.5 + 8.2 × 1.065 + 0.83 × 0.551) × $33.4009 = $590.04
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.
21330 billing questions
When should 21330 be chosen over 21325?
Use 21330 when the surgeon performs open treatment and skeletal fixation. Code 21325 describes open nasal fracture treatment without the fixation distinction.
Can 21330 and a closed-treatment nasal fracture code be reported for the same fracture?
Do not report a closed-treatment code for the same fracture repair. Select the code that matches the operative approach and fixation documented.
Should modifier 50 be appended for fractures involving both nasal bones?
No. Modifier 50 is inappropriate for 21330; report the service according to the code's treatment definition rather than as a bilateral procedure.
What documentation supports reporting 21330?
The operative note should identify the nasal fracture and describe open exposure, reduction, and the skeletal fixation used to maintain alignment.
When is assistant-at-surgery payment available?
CMS payment for an assistant requires documentation that the assistant's participation was medically necessary.
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.
1,94321315,,Clsd tx nsl fx mnpj wo stblj,A,,0.94,3.69,,0.51,,0.16,4.79,1.61,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,94421320,,Clsd tx nsl fx w/mnpj&stablj,A,,1.55,4.83,,0.67,,0.23,6.61,2.45,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,94521325,,Open tx nose fx uncomplicatd,A,,4.08,7.71,NA,7.71,,0.59,12.38,12.38,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,94621330,,Open tx nose fx w/skele fixj,A,,5.65,8.20,NA,8.20,,0.83,14.68,14.68,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,94721335,,Open tx nose & septal fx,A,,8.79,9.31,NA,9.31,,1.33,19.43,19.43,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,94821336,,Open tx septal fx w/wo stabj,A,,6.60,9.88,NA,9.88,,0.98,17.46,17.46,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,94921337,,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
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
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609