No office rate
Both are open repairs of nasoethmoid fractures. 21339 includes fixation; 21338 is for open treatment without fixation.
On this page
CMS RVU26D · Effective 2026-10-01
21339 Nasoethmoid repair Medicare reimbursement rates in Delaware
Reports open surgical repair of a nasoethmoid complex fracture with fixation to restore alignment and stabilize the injured facial bones. Compare 21339 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 21339 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
No supported rate
Facility setting
$692.79
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.
Facial fracture surgery
About 21339: Open nasoethmoid fracture repair with fixation
Reports open surgical repair of a nasoethmoid complex fracture with fixation to restore alignment and stabilize the injured facial bones.
This service involves surgically exposing and repairing a fracture of the nasoethmoid complex, the central facial area around the bridge of the nose and inner eye sockets, and stabilizing the repair with fixation. It is typically performed by an otolaryngologist, plastic surgeon, or oral and maxillofacial surgeon treating facial trauma, often in an operating room. The fracture pattern and operative approach distinguish this repair from treatment limited to the nasal bones or a closed or percutaneous reduction.
Report 21339 when the operative note supports open repair of the nasoethmoid fracture and fixation; documentation should identify the fracture pattern, surgical exposure, reduction, and fixation performed. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. 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. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 21339
- 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
- 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 RVU8.29 · 40%
- Practice expense (office) RVU11.46 · 55%
- Malpractice RVU1.21 · 6%
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.
21339 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
21340 is for percutaneous treatment. 21339 requires open surgical exposure with fixation.
No office rate
21346 applies to an open nasomaxillary fracture treated with fixation; 21339 is for a nasoethmoid fracture pattern.
No office rate
21330 addresses an open nasal fracture treated with skeletal fixation, rather than an open nasoethmoid complex fracture.
Compare 21339 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
Unavailable
Facility
$692.79
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 21339 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
1,951
- Code
- 21339
- Physician work
- 8.29
- Practice expense
- 11.46
- Malpractice
- 1.21
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.29 | × 1.005 | 8.3314 |
| Practice expense | 11.46 | × 0.988 | 11.3225 |
| Malpractice | 1.21 | × 0.899 | 1.0878 |
| Total RVUs | 20.7417 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$692.79
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.29 | 1.005 |
| Practice expense | 11.46 | 0.988 |
| Malpractice | 1.21 | 0.899 |
(8.29 × 1.005 + 11.46 × 0.988 + 1.21 × 0.899) × $33.4009 = $692.79
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.
21339 billing questions
How does 21339 differ from 21338?
Both address open treatment of a nasoethmoid fracture. Choose 21339 when fixation is performed; 21338 represents open treatment without fixation.
When is 21340 a better choice?
21340 describes percutaneous treatment of a nasoethmoid fracture. Use 21339 when the surgeon treats the fracture through open surgical exposure and performs fixation.
Should modifier 50 be added for a bilateral injury?
No. CMS identifies bilateral adjustment as inappropriate for 21339 based on its descriptor or anatomy.
What documentation supports reporting fixation?
The operative report should establish the nasoethmoid fracture, open surgical exposure, reduction, and fixation used to stabilize the repair.
How does the 90-day global period affect postoperative visits?
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?
Assistant-at-surgery payment may be made. 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.
1,94821336,,Open tx septal fx w/wo stabj,A,,6.60,9.88,NA,9.88,,0.98,17.46,17.46,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,94921337,,Closed tx septal&nose fx,A,,3.31,8.96,,4.63,,0.50,12.77,8.44,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,95021338,,Open nasoethmoid fx w/o fixj,A,,6.70,11.08,NA,11.08,,0.99,18.77,18.77,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,95121339,,Open nasoethmoid fx w/ fixj,A,,8.29,11.46,NA,11.46,,1.21,20.96,20.96,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,95221340,,Perq tx nasoethmoid fx,A,,11.20,6.93,NA,6.93,,1.63,19.76,19.76,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,95321343,,Open tx dprsd front sinus fx,A,,13.96,13.17,NA,13.17,,2.05,29.18,29.18,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,95421344,,Open tx compl front sinus fx,A,,21.03,12.31,NA,12.31,,3.05,36.39,36.39,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,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