No office rate
Choose 20912 when cartilage is taken from the nasal septum. This code is for cartilage harvested from the ear.
On this page
CMS RVU26D · Effective 2026-10-01
21235 Cartilage graft Medicare reimbursement rates in Connecticut
Reports harvesting and placing a patient's ear cartilage to support nasal or auricular reconstruction, with the donor-site work included. Compare 21235 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 21235 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
$784.53
1 of 1 localities have a supported rate.
Payment area: Connecticut
One mapped payment locality.
Facility setting
$535.60
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.
Reconstructive surgery
About 21235: Autologous ear cartilage graft
Reports harvesting and placing a patient's ear cartilage to support nasal or auricular reconstruction, with the donor-site work included.
The surgeon removes cartilage from the patient's ear, shapes it, and places it to support reconstruction of the nose or ear. Common situations include adding structural support during nasal reconstruction after trauma or prior surgery, or rebuilding an auricular contour. Otolaryngologists and plastic or facial plastic surgeons typically perform the graft as part of a reconstructive operation.
Report this code when ear cartilage is harvested and used at the documented recipient site; obtaining the graft is included, so do not separately report the ear harvest. The operative note should identify the donor ear, recipient site, graft purpose, and placement. Medicare includes the day-before preoperative visit and 90 days of related postoperative care in the 90-day global period. For multiple procedures 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 inappropriate. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
CMS billing rules for 21235
- 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 RVU7.31 · 33%
- Practice expense (office) RVU13.74 · 62%
- Malpractice RVU1.02 · 5%
7K
Medicare services in 2024 · #1666 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.
21235 compared with similar codes
Office rates for Connecticut, from the same CMS release.
No office rate
Choose 21230 when the graft is harvested from a rib. This code applies when the donor cartilage comes from the ear.
30400
No office rateReconstruction of nose
30400 reports primary rhinoplasty; this code reports the ear-cartilage graft and includes obtaining that graft.
Compare 21235 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
$784.53
Facility
$535.60
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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 21235 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
1,919
- Code
- 21235
- Physician work
- 7.31
- Practice expense
- 13.74
- Malpractice
- 1.02
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.31 | × 1.020 | 7.4562 |
| Practice expense | 13.74 | × 1.077 | 14.7980 |
| Malpractice | 1.02 | × 1.210 | 1.2342 |
| Total RVUs | 23.4884 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Connecticut$784.53
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.31 | 1.02 |
| Practice expense | 13.74 | 1.077 |
| Malpractice | 1.02 | 1.21 |
(7.31 × 1.02 + 13.74 × 1.077 + 1.02 × 1.21) × $33.4009 = $784.53
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.31 | 1.02 |
| Practice expense | 6.82 | 1.077 |
| Malpractice | 1.02 | 1.21 |
(7.31 × 1.02 + 6.82 × 1.077 + 1.02 × 1.21) × $33.4009 = $535.60
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.
21235 billing questions
When should I use this code instead of a septal cartilage graft code?
Use this code when the graft is harvested from the ear. A nasal septum cartilage graft is reported with 20912 when that is the donor source.
Can the ear cartilage harvest be billed separately?
No. The graft service includes obtaining the ear cartilage.
Can modifier 50 be used when cartilage is taken from both ears?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
What documentation supports reporting this graft?
Document the ear used as the donor site, the nasal or auricular recipient site, why structural cartilage was needed, and how the graft was placed.
How does the 90-day global period affect postoperative care?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or co-surgeon be reported for this procedure?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are 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.
1,91621210,,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
1,92021240,,Reconstruction of jaw joint,A,,15.67,10.48,NA,10.48,,2.10,28.25,28.25,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,92121242,,Reconstruction of jaw joint,A,,14.23,11.35,NA,11.35,,2.06,27.64,27.64,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,92221243,,Reconstruction of jaw joint,A,,23.92,16.40,NA,16.40,,3.28,43.60,43.60,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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