Billing code 21315: Nasal fracture treatmentMedicare rate & RVUs in Delaware
Reports closed treatment of a nasal bone fracture when the physician manages the fracture without repositioning the bone.
Medicare pays $158.13 for 21315 in the office in Delaware (Delaware). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 21315 covers
Code 21315 describes closed care for a nasal bone fracture when the physician does not manipulate the fracture to reposition it. An otolaryngologist, plastic surgeon, or facial trauma surgeon may provide this treatment after blunt nasal trauma, in an office or facility setting. The documented clinical findings should support treatment without manipulation rather than reduction or open repair.
Choose this code when the nasal bone fracture is treated without repositioning; use a different code when treatment includes manipulation, fixation, or open repair. Same-day preoperative and postoperative care is included in the 0-day global period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Do not append modifier 50 for bilateral nasal fractures. Medicare does not pay for an assistant at surgery for this service, and co-surgeon or team-surgery billing is not permitted.
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.
21315 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | $158.13 | $53.19 |
How the 21315 rate is calculated
Each of 21315’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 21315
RVUs × geographic indexes × conversion factor
Work0.94
0.94 RVUs× 1.000 GPCI
Practice expense3.69
3.69 RVUs× 1.000 GPCI
Malpractice0.16
0.16 RVUs× 1.000 GPCI
Adjusted RVUs
4.7900
Conversion factor
$33.4009
Medicare rate
$159.99
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 21315
The CMS indicators that decide how 21315 is paid alongside other services.
CMS payment indicators · 21315
Nasal fracture treatment
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
21315 without 51 · national office
$159.99
Nasal fracture treatment
21315-51 · Second procedure: 50%
$80.00
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
21315 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 21320Nasal fracture treatment
- 21315 is for closed treatment without manipulation. Choose 21320 when the physician manipulates the nasal fracture and stabilizes it.
- 21325Nasal fracture repair
- 21325 describes open treatment of a nasal bone fracture. Use 21315 for closed treatment without manipulation.
- 21330Nasal fracture repair
- 21330 involves open treatment with skeletal fixation. It is distinct from closed treatment without repositioning under 21315.
- 21337Septal fracture
- 21337 is for closed treatment involving both nasal and septal fractures. Code 21315 addresses the nasal bone fracture without manipulation.
21315 billing questions
How does 21315 differ from 21320?
Use 21315 when the fracture is treated without repositioning. Code 21320 describes closed treatment that includes manipulation and stabilization.
Can 21315 be reported for fractures of both nasal bones?
Do not append modifier 50 for bilateral nasal fractures under this code.
Is routine same-day care separately reportable?
Same-day preoperative and postoperative care is included in the 0-day global period. A separately identifiable E/M service requires distinct documentation and must meet applicable E/M reporting requirements.
How does Medicare handle 21315 with another procedure in the same session?
The highest-valued procedure is paid in full, and other procedures in that session are paid at 50% under the standard multiple procedure reduction.
Can an assistant or co-surgeon be billed for 21315?
Medicare does not pay for an assistant at surgery for this service. Co-surgeon and team-surgery billing 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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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