$4,349.65
Use 21210 for grafting the nasal, maxillary, or malar area; use 21215 when the graft is placed in the lower jaw.
On this page
CMS RVU26D · Effective 2026-10-01
21210 Facial bone graft Medicare reimbursement rates in Colorado
Reports bone grafting to a nasal, upper-jaw, or cheekbone area to fill or rebuild a facial skeletal defect during reconstructive surgery. Compare 21210 office and facility rates across CMS payment localities in Colorado.
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 21210 in Colorado?
Colorado 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
$1875.95
1 of 1 localities have a supported rate.
Payment area: Colorado
One mapped payment locality.
Facility setting
$704.96
1 of 1 localities have a supported rate.
Payment area: Colorado
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 reconstruction
About 21210: Facial bone graft to nasal or cheek region
Reports bone grafting to a nasal, upper-jaw, or cheekbone area to fill or rebuild a facial skeletal defect during reconstructive surgery.
This service places bone graft material in a defect of the nasal, maxillary, or malar skeleton. Oral and maxillofacial surgeons, plastic surgeons, and otolaryngologists may perform it when rebuilding facial bone after trauma, congenital deficiency, or prior surgery. The graft is used to restore skeletal contour or provide support in the specified facial region; the code includes obtaining the graft. Procedures are commonly performed in an operating room, though Medicare records services in both office and facility settings.
Choose the code based on the grafted facial site and the operative work, not merely the diagnosis. The record should identify the defect, treated bone, graft placement, and reconstructive purpose. CMS assigns a 90-day global period, including the day before surgery and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Report the service for the treated anatomy rather than appending modifier 50. CMS does not pay an assistant at surgery and does not permit co-surgeon or team-surgery payment for this code.
CMS billing rules for 21210
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU11.40 · 21%
- Practice expense (office) RVU40.96 · 76%
- Malpractice RVU1.34 · 2%
2.2K
Medicare services in 2024 · #2408 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.
21210 compared with similar codes
Office rates for Colorado, from the same CMS release.
$1,731.35
Code 21208 describes facial-bone augmentation. Select 21210 when the documented work is a bone graft to the nasal, maxillary, or malar region.
No office rate
Code 21206 is for reconstruction of the upper jaw. This code describes graft placement at the specified nasal, maxillary, or malar facial sites.
Compare 21210 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
Colorado →
Office / nonfacility
$1875.95
Facility
$704.96
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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 21210 in Colorado.
PPRRVU2026_Oct_nonQPP.csv
1,916
- Code
- 21210
- Physician work
- 11.40
- Practice expense
- 40.96
- Malpractice
- 1.34
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 11.40 | × 1.012 | 11.5368 |
| Practice expense | 40.96 | × 1.064 | 43.5814 |
| Malpractice | 1.34 | × 0.781 | 1.0465 |
| Total RVUs | 56.1648 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Colorado$1875.95
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 11.4 | 1.012 |
| Practice expense | 40.96 | 1.064 |
| Malpractice | 1.34 | 0.781 |
(11.4 × 1.012 + 40.96 × 1.064 + 1.34 × 0.781) × $33.4009 = $1875.95
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 11.4 | 1.012 |
| Practice expense | 8.01 | 1.064 |
| Malpractice | 1.34 | 0.781 |
(11.4 × 1.012 + 8.01 × 1.064 + 1.34 × 0.781) × $33.4009 = $704.96
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.
21210 billing questions
How is this code distinguished from 21215?
This code is for grafting the nasal, maxillary, or malar area. Code 21215 is the corresponding bone-graft service for the lower jaw.
Is graft harvest separately reported?
Obtaining the graft is included in this service. Document the graft placement and the facial site treated rather than separately reporting routine graft acquisition.
Should modifier 50 be used when grafting both sides?
No. Report the grafting service for the treated anatomy without modifier 50; CMS identifies bilateral adjustment as inappropriate for this code.
What documentation supports reporting this service?
The operative report should identify the nasal, maxillary, or malar defect, explain why reconstruction was performed, and describe graft placement and the resulting repair.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
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.
1,91321206,,Reconstruct upper jaw bone,A,,15.20,9.19,NA,9.19,,1.76,26.15,26.15,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,91421208,,Augmentation of facial bones,A,,11.13,37.17,,7.64,,1.31,49.61,20.08,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,91521209,,Reduction of facial bones,A,,7.62,15.46,,8.02,,0.93,24.01,16.57,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,91621210,,Face bone graft,A,,11.40,40.96,,8.01,,1.34,53.70,20.75,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,91721215,,Lower jaw bone graft,A,,11.92,110.02,,8.24,,1.41,123.35,21.57,0,090,0.10,0.69,0.21,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,91821230,,Rib cartilage graft,A,,10.89,7.11,NA,7.11,,1.75,19.75,19.75,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,91921235,,Ear cartilage graft,A,,7.31,13.74,,6.82,,1.02,22.07,15.15,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3401112,CA,69,VISALIA,1.017,1.096,0.536
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899