$1,771.06
Both involve open mandibular fracture treatment. 21462 includes interdental fixation; 21461 is the option without it.
On this page
CMS RVU26D · Effective 2026-10-01
21462 Mandibular fracture repair Medicare reimbursement rates in Delaware
Reports operative reduction of a mandibular fracture stabilized with interdental fixation, typically performed by an oral and maxillofacial surgeon. Compare 21462 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 21462 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
$2011.67
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
Facility setting
$1094.60
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.
Oral and maxillofacial surgery
About 21462: Open mandibular fracture repair with interdental fixation
Reports operative reduction of a mandibular fracture stabilized with interdental fixation, typically performed by an oral and maxillofacial surgeon.
This operation treats a broken mandible by surgically exposing and repositioning the fracture, then stabilizing the jaw with fixation that engages the teeth. Interdental fixation may use arch bars or wiring to hold the dental arches in the intended relationship. Oral and maxillofacial surgeons commonly perform the repair in an operating room; other surgeons with appropriate expertise may also provide it.
Report 21462 when the operative treatment includes both open reduction and interdental fixation. The operative report should identify the mandibular fracture and document the reduction and fixation method; fracture complexity and the presence of interdental fixation help distinguish nearby codes. The day-before preoperative visit and 90 days of related postoperative care are included in the global period. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 21462
- 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 RVU10.73 · 18%
- Practice expense (office) RVU48.58 · 80%
- Malpractice RVU1.61 · 3%
220
Medicare services in 2024 · #4234 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.
21462 compared with similar codes
Office rates for Delaware, from the same CMS release.
$1,107.91
21453 is closed treatment with interdental fixation. Use 21462 when the fracture is treated with open reduction and interdental fixation.
No office rate
21454 describes open treatment with external fixation. 21462 is distinguished by interdental fixation.
No office rate
21470 is for open treatment of a complicated mandibular fracture. 21462 describes open treatment with interdental fixation when the complicated-fracture code is not indicated.
Compare 21462 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
$2011.67
Facility
$1094.60
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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 21462 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
1,990
- Code
- 21462
- Physician work
- 10.73
- Practice expense
- 48.58
- Malpractice
- 1.61
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.73 | × 1.005 | 10.7836 |
| Practice expense | 48.58 | × 0.988 | 47.9970 |
| Malpractice | 1.61 | × 0.899 | 1.4474 |
| Total RVUs | 60.2281 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Delaware$2011.67
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 10.73 | 1.005 |
| Practice expense | 48.58 | 0.988 |
| Malpractice | 1.61 | 0.899 |
(10.73 × 1.005 + 48.58 × 0.988 + 1.61 × 0.899) × $33.4009 = $2011.67
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 10.73 | 1.005 |
| Practice expense | 20.79 | 0.988 |
| Malpractice | 1.61 | 0.899 |
(10.73 × 1.005 + 20.79 × 0.988 + 1.61 × 0.899) × $33.4009 = $1094.60
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.
21462 billing questions
How does 21462 differ from 21461?
Both describe open treatment of a mandibular fracture, but 21462 includes interdental fixation. Use 21461 for open treatment without that fixation.
When is 21453 a better fit?
21453 describes closed treatment of a mandibular fracture with interdental fixation. Choose 21462 when the fracture is treated by open reduction.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What documentation supports reporting 21462?
Document the mandibular fracture, the open reduction, and the interdental fixation used to stabilize the jaw. The operative note should make the fixation method clear.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
May an assistant or co-surgeon be reported?
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.
1,98721453,,Cltx mndblr fx ntrdntl fixj,A,,6.47,26.10,,19.25,,0.98,33.55,26.70,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,98821454,,Optx mndblr fx xtrnl fixj,A,,7.18,5.49,NA,5.49,,0.82,13.49,13.49,0,090,0.10,0.69,0.21,2,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,98921461,,Optx mndblr fx wo ntrdntl,A,,9.08,43.24,,18.66,,1.31,53.63,29.05,0,090,0.10,0.69,0.21,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,99021462,,Optx mndblr fx w/ntrdntl,A,,10.73,48.58,,20.79,,1.61,60.92,33.13,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,99121465,,Optx mndblr cndylr fx,A,,12.79,7.42,NA,7.42,,1.46,21.67,21.67,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,99221470,,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
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