No office rate
Choose 21421 for closed reduction with interdental wire fixation. Choose 21422 when the fracture is treated open.
On this page
CMS RVU26D · Effective 2026-10-01
21421 Fracture fixation Medicare reimbursement rates in Alaska
Reports closed management of a palatal or maxillary fracture stabilized with interdental wiring, without surgically exposing the fracture site. Compare 21421 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 21421 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
$776.86
1 of 1 localities have a supported rate.
Payment area: Alaska*
One mapped payment locality.
Facility setting
$621.05
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.
Maxillofacial surgery
About 21421: Closed palatal or maxillary fracture fixation
Reports closed management of a palatal or maxillary fracture stabilized with interdental wiring, without surgically exposing the fracture site.
This service manages a palatal or maxillary fracture by restoring alignment and stabilizing the injury with wires secured to the teeth. The fracture is treated without surgically exposing it. Oral and maxillofacial surgeons commonly perform this work, often in a hospital or other surgical setting, when the fracture pattern can be managed closed and dental fixation can maintain the intended position and occlusion.
Choose this code when the record supports closed reduction and interdental wire fixation of a palatal or maxillary fracture. Document the fracture site and pattern, the reduction and fixation performed, and the reason the approach was closed. 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 not appropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 21421
- 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 RVU5.87 · 30%
- Practice expense (office) RVU13.23 · 67%
- Malpractice RVU0.66 · 3%
13
Medicare services in 2024 · #6122 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.
21421 compared with similar codes
Office rates for Alaska, from the same CMS release.
No office rate
Code 21423 describes open treatment of a complicated palatal or maxillary fracture with multiple approaches; 21421 describes closed wire fixation.
$886.33
Code 21440 is for a fracture limited to the alveolar ridge. Use 21421 when the treated injury is a palatal or maxillary fracture managed with interdental wiring.
Compare 21421 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
$776.86
Facility
$621.05
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 21421 in Alaska*.
PPRRVU2026_Oct_nonQPP.csv
1,974
- Code
- 21421
- Physician work
- 5.87
- Practice expense
- 13.23
- Malpractice
- 0.66
GPCI2026.csv
5
- Locality
- Alaska*
- Physician work
- 1.500
- Practice expense
- 1.065
- Malpractice
- 0.551
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.87 | × 1.500 | 8.8050 |
| Practice expense | 13.23 | × 1.065 | 14.0899 |
| Malpractice | 0.66 | × 0.551 | 0.3637 |
| Total RVUs | 23.2586 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Alaska*$776.86
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.87 | 1.5 |
| Practice expense | 13.23 | 1.065 |
| Malpractice | 0.66 | 0.551 |
(5.87 × 1.5 + 13.23 × 1.065 + 0.66 × 0.551) × $33.4009 = $776.86
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.87 | 1.5 |
| Practice expense | 8.85 | 1.065 |
| Malpractice | 0.66 | 0.551 |
(5.87 × 1.5 + 8.85 × 1.065 + 0.66 × 0.551) × $33.4009 = $621.05
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.
21421 billing questions
How is this code different from 21422?
This code describes closed fracture management with interdental wire fixation. Code 21422 is for open treatment of the palatal or maxillary fracture.
When would 21423 be more appropriate?
Use 21423 for open treatment of a complicated palatal or maxillary fracture involving multiple approaches. This code is for closed treatment with interdental wiring.
Can modifier 50 be reported?
No. Modifier 50 is not appropriate for this code; report the fracture treatment based on the documented service and anatomy.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
What documentation supports this code?
Document the palatal or maxillary fracture, closed reduction, and interdental wire fixation. The record should make clear that the fracture was not surgically exposed for treatment.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.
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.
1,97121406,,Opn tx orbit fx w/o implant,A,,7.23,7.68,NA,7.68,,1.33,16.24,16.24,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,97221407,,Opn tx orbit fx w/implant,A,,8.79,7.29,NA,7.29,,1.21,17.29,17.29,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,97321408,,Opn tx orbit fx w/bone grft,A,,12.46,9.60,NA,9.60,,2.32,24.38,24.38,0,090,0.10,0.69,0.21,2,1,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,97421421,,Cltx palatal/max fx wire fix,A,,5.87,13.23,,8.85,,0.66,19.76,15.38,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,97521422,,Optx palatal/max fracture,A,,8.51,7.92,NA,7.92,,1.24,17.67,17.67,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,97621423,,Optx palatal/max fx comp,A,,10.58,9.07,NA,9.07,,1.96,21.61,21.61,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,97721431,,Cltx craniofacial separation,A,,7.70,10.79,NA,10.79,,0.88,19.37,19.37,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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