$184.71
21480 is for closed treatment of a TMJ dislocation. Use 21490 when the surgeon treats the dislocation through an open operative approach.
On this page
CMS RVU26D · Effective 2026-10-01
21490 TMJ dislocation Medicare reimbursement rates in Connecticut
Reports operative open management of a dislocated temporomandibular joint when the surgeon treats the displacement through an open surgical approach. Compare 21490 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 21490 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
$750.73
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 21490: Open treatment of TMJ dislocation
Reports operative open management of a dislocated temporomandibular joint when the surgeon treats the displacement through an open surgical approach.
CPT 21490 represents open operative treatment of a temporomandibular joint dislocation. The surgeon accesses the joint surgically to manage the displaced mandibular condyle. Oral and maxillofacial surgeons and other surgeons with relevant facial-joint expertise may perform this procedure, generally in an operating-room setting. The defining distinction is the open approach, rather than reduction by closed manipulation.
Choose this code when the operative record supports open treatment of the TMJ dislocation; document the affected joint, the dislocation, and the open surgical work performed. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For procedures in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 21490
- 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 RVU12.63 · 59%
- Practice expense (office) RVU7.29 · 34%
- Malpractice RVU1.44 · 7%
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.
21490 compared with similar codes
Office rates for Connecticut, from the same CMS release.
$1,072.95
21485 describes closed treatment of a complicated TMJ dislocation; 21490 describes open treatment. The operative approach distinguishes these codes.
21499
No office rateUnlisted muscskel px head
21499 is an unlisted head musculoskeletal procedure code. Use a specific code such as 21490 when it accurately describes the open TMJ dislocation treatment.
Compare 21490 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
$750.73
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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 21490 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
1,995
- Code
- 21490
- Physician work
- 12.63
- Practice expense
- 7.29
- Malpractice
- 1.44
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 12.63 | × 1.020 | 12.8826 |
| Practice expense | 7.29 | × 1.077 | 7.8513 |
| Malpractice | 1.44 | × 1.210 | 1.7424 |
| Total RVUs | 22.4763 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Connecticut$750.73
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 12.63 | 1.02 |
| Practice expense | 7.29 | 1.077 |
| Malpractice | 1.44 | 1.21 |
(12.63 × 1.02 + 7.29 × 1.077 + 1.44 × 1.21) × $33.4009 = $750.73
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.
21490 billing questions
How does 21490 differ from 21480?
21490 is for open operative treatment of the TMJ dislocation. 21480 describes closed treatment, so use it when the dislocation is managed without an open approach.
When should 21485 be considered instead?
21485 describes closed treatment of a complicated TMJ dislocation. It is not the open-treatment code; choose based on the approach and the documented procedure.
What documentation supports 21490?
The operative report should identify the TMJ dislocation, the joint treated, the open approach, and the operative work performed to manage the displacement.
How does Medicare handle bilateral reporting?
The CMS payment rule lists bilateral reporting with modifier 50 at 150%. Document treatment of both joints and report the modifier according to applicable claim instructions.
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 paid?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; 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.
1,99221470,,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
1,99521490,,Optx tmprmand dislocation,A,,12.63,7.29,NA,7.29,,1.44,21.36,21.36,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,99621497,,Interdental wirg oth/thn fx,A,,4.52,16.45,,11.80,,0.50,21.47,16.82,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,99721499,,Unlisted muscskel px head,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
1,99821501,,I&d dp absc/hmtma sft ts nck,A,,3.88,10.79,,5.10,,0.83,15.50,9.81,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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