$60.61
20605 describes needle-based aspiration or injection of an intermediate joint. 21010 requires an open surgical incision into the TMJ.
On this page
CMS RVU26D · Effective 2026-10-01
21010 Jaw joint surgery Medicare reimbursement rates in Connecticut
Reports open surgical entry into the temporomandibular joint for direct access to joint pathology, rather than needle-based aspiration or manipulation. Compare 21010 office and facility rates across CMS payment localities in Connecticut.
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 21010 in Connecticut?
Connecticut 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
$710.94
1 of 1 localities have a supported rate.
Payment area: Connecticut
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 21010: Temporomandibular joint arthrotomy
Reports open surgical entry into the temporomandibular joint for direct access to joint pathology, rather than needle-based aspiration or manipulation.
CPT 21010 describes surgically opening the temporomandibular joint (TMJ) to access the joint directly. Oral and maxillofacial surgeons and other surgeons with appropriate training may perform it in an operating room, commonly for a joint problem that requires open evaluation or treatment. The code represents the joint incision, not removal of the mandibular condyle or joint cartilage; those procedures have distinct codes when performed and supported by the operative work.
Report 21010 when the operative note supports an open incision into the TMJ, identifying the side, indication, and work performed. It has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral surgery, modifier 50 is paid at 150%. 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. An assistant at surgery is paid only when medical necessity is documented; co-surgeons and team surgery are not permitted.
CMS billing rules for 21010
- 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 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 RVU10.76 · 53%
- Practice expense (office) RVU7.82 · 39%
- Malpractice RVU1.56 · 8%
18
Medicare services in 2024 · #5960 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.
21010 compared with similar codes
Office rates for Connecticut, from the same CMS release.
No office rate
21060 describes removal of TMJ cartilage. Choose 21010 when the documented service is opening the joint without that removal procedure.
No office rate
21050 describes removal of the mandibular condyle at the TMJ. 21010 describes open joint entry, not condylar removal.
$458.70
21073 is therapeutic manipulation of the TMJ under anesthesia. It does not describe open surgical entry into the joint.
Compare 21010 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
Connecticut →
Office / nonfacility
Unavailable
Facility
$710.94
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 21010 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
1,836
- Code
- 21010
- Physician work
- 10.76
- Practice expense
- 7.82
- Malpractice
- 1.56
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.76 | × 1.020 | 10.9752 |
| Practice expense | 7.82 | × 1.077 | 8.4221 |
| Malpractice | 1.56 | × 1.210 | 1.8876 |
| Total RVUs | 21.2849 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Connecticut$710.94
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 10.76 | 1.02 |
| Practice expense | 7.82 | 1.077 |
| Malpractice | 1.56 | 1.21 |
(10.76 × 1.02 + 7.82 × 1.077 + 1.56 × 1.21) × $33.4009 = $710.94
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.
21010 billing questions
When should 21010 be chosen instead of TMJ arthrocentesis?
Use 21010 for open surgical entry into the joint. Needle-based aspiration or injection is a different service and is not an arthrotomy.
Does 21010 include removal of the joint disc or mandibular condyle?
No. The code describes opening the TMJ; removal of joint cartilage or the condyle is a distinct operative service with its own code when performed.
How should bilateral TMJ arthrotomy be reported?
Report the bilateral procedure with modifier 50. CMS pays it at 150% under the supplied bilateral rule.
What postoperative care is included in 21010?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon be reported with 21010?
An assistant at surgery is paid only when the record documents medical necessity. Co-surgeons and team surgery are not permitted under the CMS facts for this code.
What documentation supports reporting 21010?
Document the TMJ side, the clinical indication, the open incision into the joint, and the operative findings and work performed. The note should distinguish the procedure from needle-based treatment or a separate removal procedure.
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.
1,83320983,,Ablate bone tumor(s) perq,A,,6.71,139.34,,1.52,,0.83,146.88,9.06,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,83420985,,Cptr-asst dir ms px,A,,2.44,0.77,NA,0.77,,0.50,3.71,3.71,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,83520999,,Unlisted px muscskel general,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
1,83621010,,Incision of jaw joint,A,,10.76,7.82,NA,7.82,,1.56,20.14,20.14,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,83721011,,Exc face les sc <2 cm,A,,2.92,8.38,,4.04,,0.53,11.83,7.49,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,83821012,,Exc face les sbq 2 cm/>,A,,4.34,4.45,NA,4.45,,0.91,9.70,9.70,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,83921013,,Exc face tum deep < 2 cm,A,,5.28,10.67,,4.87,,0.98,16.93,11.13,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808