$2,017.16
Use 21465 when the open repair is specifically for a mandibular condylar fracture. Code 21461 describes open mandibular fracture treatment without interdental fixation.
On this page
CMS RVU26D · Effective 2026-10-01
21465 Mandibular fracture repair Medicare reimbursement rates in Alaska
Report 21465 for open surgical treatment of a fracture involving the mandibular condyle, the part of the jaw that forms the temporomandibular joint. Compare 21465 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 21465 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
$931.61
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.
Oral and maxillofacial surgery
About 21465: Open mandibular condylar fracture repair
Report 21465 for open surgical treatment of a fracture involving the mandibular condyle, the part of the jaw that forms the temporomandibular joint.
This service involves surgically exposing and realigning a fractured mandibular condyle, with fixation used when needed to stabilize the fragments. It is typically performed in an operating room by an oral and maxillofacial surgeon, or another surgeon qualified to treat facial fractures. The operative record should identify the condylar fracture and describe the open approach and treatment performed. A fracture managed without surgical exposure is not reported with this code.
Select 21465 for the open treatment of a condylar fracture, rather than a general mandibular fracture code or a code for closed management. Documentation should establish the fracture site and the surgical work; note fixation and any additional fracture procedures performed during the session. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeons are paid only with supporting documentation, and team surgery is not permitted.
CMS billing rules for 21465
- 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 procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU12.79 · 59%
- Practice expense (office) RVU7.42 · 34%
- Malpractice RVU1.46 · 7%
27
Medicare services in 2024 · #5725 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.
21465 compared with similar codes
Office rates for Alaska, from the same CMS release.
$2,295.30
21462 describes open mandibular fracture treatment with interdental fixation. For an open condylar fracture, use the condylar-specific 21465.
No office rate
21454 describes open mandibular fracture treatment with external fixation. 21465 identifies open treatment of a condylar fracture.
No office rate
21470 is for complicated mandibular fracture treatment involving multiple approaches. 21465 identifies the condylar fracture service.
Compare 21465 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
$931.61
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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 21465 in Alaska*.
PPRRVU2026_Oct_nonQPP.csv
1,991
- Code
- 21465
- Physician work
- 12.79
- Practice expense
- 7.42
- Malpractice
- 1.46
GPCI2026.csv
5
- Locality
- Alaska*
- Physician work
- 1.500
- Practice expense
- 1.065
- Malpractice
- 0.551
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 12.79 | × 1.500 | 19.1850 |
| Practice expense | 7.42 | × 1.065 | 7.9023 |
| Malpractice | 1.46 | × 0.551 | 0.8045 |
| Total RVUs | 27.8918 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Alaska*$931.61
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 12.79 | 1.5 |
| Practice expense | 7.42 | 1.065 |
| Malpractice | 1.46 | 0.551 |
(12.79 × 1.5 + 7.42 × 1.065 + 1.46 × 0.551) × $33.4009 = $931.61
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.
21465 billing questions
How does 21465 differ from 21461 or 21462?
21465 identifies open treatment of a mandibular condylar fracture. Codes 21461 and 21462 describe open mandibular fracture treatment without the condylar-specific designation; 21462 includes interdental fixation.
Can 21465 be reported for a fracture treated without open surgery?
No. Use a code for the applicable closed or percutaneous treatment when the fracture is managed without open surgical exposure.
How should bilateral condylar fractures be reported?
When the service is bilateral, report modifier 50; CMS pays the bilateral procedure at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be billed?
Assistant-at-surgery payment may be available. Co-surgeons are paid only when supporting documentation is submitted; team surgery is 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.
1,98821454,,Optx mndblr fx xtrnl fixj,A,,7.18,5.49,NA,5.49,,0.82,13.49,13.49,0,090,0.10,0.69,0.21,2,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,98921461,,Optx mndblr fx wo ntrdntl,A,,9.08,43.24,,18.66,,1.31,53.63,29.05,0,090,0.10,0.69,0.21,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,99021462,,Optx mndblr fx w/ntrdntl,A,,10.73,48.58,,20.79,,1.61,60.92,33.13,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,99121465,,Optx mndblr cndylr fx,A,,12.79,7.42,NA,7.42,,1.46,21.67,21.67,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,99221470,,Optx complicated mndblr fx,A,,17.10,11.46,NA,11.46,,2.56,31.12,31.12,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,99321480,,Cltx tmprmand dislc 1st/sbsq,A,,0.59,4.43,,0.19,,0.13,5.15,0.91,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,99421485,,Cltx tmprmand dislc comp,A,,4.65,24.67,,17.77,,0.67,29.99,23.09,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,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