$79.05
This code describes radiographic examination of TMJ arthrography. Code 21116 describes the contrast-injection procedure and includes its radiographic supervision and interpretation.
On this page
CMS RVU26D · Effective 2026-10-01
21116 TMJ arthrography Medicare reimbursement rates in Delaware
Contrast injection into a temporomandibular joint with radiographic assessment is reported to evaluate suspected intra-articular TMJ pathology. Compare 21116 office and facility rates across CMS payment localities in Delaware.
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 21116 in Delaware?
Delaware 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
$219.87
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
Facility setting
$38.37
1 of 1 localities have a supported rate.
Payment area: Delaware
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.
Diagnostic imaging procedure
About 21116: Temporomandibular joint arthrogram injection
Contrast injection into a temporomandibular joint with radiographic assessment is reported to evaluate suspected intra-articular TMJ pathology.
This service places contrast material into a temporomandibular joint so radiographic imaging can outline the joint space and help assess internal derangement, such as suspected disc-related dysfunction. It is generally performed by a radiologist or an oral and maxillofacial surgeon in an imaging suite or equipped office, with the injection and arthrographic imaging interpreted as part of the service. Clinical use may follow persistent joint pain, clicking, or restricted jaw movement when an arthrogram is selected to investigate an intra-articular problem.
Report 21116 for the joint arthrography procedure, documenting the indication, side, contrast injection, and resulting images or findings. Same-day preoperative and postoperative care is included under its 0-day global period. When this and other procedures are performed in one session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple-procedure reduction. For bilateral work, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
CMS billing rules for 21116
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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
- 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 RVU0.79 · 12%
- Practice expense (office) RVU5.75 · 86%
- Malpractice RVU0.12 · 2%
28
Medicare services in 2024 · #5698 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.
21116 compared with similar codes
Office rates for Delaware, from the same CMS release.
$52.87
Use 70330 for bilateral TMJ radiographs without an arthrographic contrast injection; use 21116 when the joint is injected for arthrography.
$256.63
70336 describes MRI of the temporomandibular joint or joints. It is a different imaging method from the contrast-injection arthrography represented by 21116.
Compare 21116 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
Delaware →
Office / nonfacility
$219.87
Facility
$38.37
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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 21116 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
1,876
- Code
- 21116
- Physician work
- 0.79
- Practice expense
- 5.75
- Malpractice
- 0.12
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.79 | × 1.005 | 0.7939 |
| Practice expense | 5.75 | × 0.988 | 5.6810 |
| Malpractice | 0.12 | × 0.899 | 0.1079 |
| Total RVUs | 6.5828 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Delaware$219.87
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.79 | 1.005 |
| Practice expense | 5.75 | 0.988 |
| Malpractice | 0.12 | 0.899 |
(0.79 × 1.005 + 5.75 × 0.988 + 0.12 × 0.899) × $33.4009 = $219.87
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.79 | 1.005 |
| Practice expense | 0.25 | 0.988 |
| Malpractice | 0.12 | 0.899 |
(0.79 × 1.005 + 0.25 × 0.988 + 0.12 × 0.899) × $33.4009 = $38.37
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.
21116 billing questions
When should 21116 be chosen instead of plain TMJ radiographs?
Use 21116 when contrast is injected into the joint for arthrographic evaluation. Plain TMJ radiographs, such as 70328 or 70330, do not describe that contrast-injection procedure.
Does 21116 include the arthrographic imaging?
The service includes radiographic supervision and interpretation associated with the TMJ arthrography. Document the injection and the resulting images or findings; do not assume the same arthrogram imaging is separately reportable.
How is bilateral TMJ work reported?
For bilateral work, report modifier 50; CMS pays the bilateral procedure at 150%.
What happens when 21116 is performed with other procedures in the same session?
The highest-valued procedure is paid in full, and the other procedures are subject to the standard 50% multiple-procedure reduction.
Can an assistant or co-surgeon be reported for 21116?
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.
1,87321089,,Unlisted maxlfcl prosth px,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,0,0,1,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
1,87421100,,Maxillofacial fixation,A,,4.61,13.77,,4.83,,0.51,18.89,9.95,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,87521110,,Interdental fixation,A,,5.84,19.58,,13.65,,0.71,26.13,20.20,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,87621116,,Injection jaw joint x-ray,A,,0.79,5.75,,0.25,,0.12,6.66,1.16,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,87721120,,Genioplasty augmentation,A,,4.97,15.53,,8.74,,0.92,21.42,14.63,0,090,0.10,0.69,0.21,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,87821121,,Geniop sldg osteot 1,A,,7.61,10.98,,6.10,,0.87,19.46,14.58,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,87921122,,Geniop sldg osteot 2/>,A,,8.49,10.90,NA,10.90,,1.57,20.96,20.96,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503