$1,107.91
Use 21453 for closed treatment of a mandibular fracture with interdental fixation. Use 21497 for interdental wiring when the indication is not a fracture.
On this page
CMS RVU26D · Effective 2026-10-01
21497 Interdental wiring Medicare reimbursement rates in Delaware
Interdental wiring stabilizes the jaws through dental fixation for a documented nonfracture indication, rather than as part of coded fracture treatment. Compare 21497 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 21497 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
$709.59
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
Facility setting
$556.14
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 21497: Interdental wiring for nonfracture stabilization
Interdental wiring stabilizes the jaws through dental fixation for a documented nonfracture indication, rather than as part of coded fracture treatment.
This service involves placing wire between teeth to hold the jaws in a stable position for a nonfracture indication. It is generally performed by an oral and maxillofacial surgeon, often in a facility setting. The clinical record should identify why interdental stabilization is needed and describe the wiring performed; the indication should not be a fracture treated under a fracture-specific code.
Report the service when the documented work is interdental wiring for a nonfracture condition, not merely because wires are present as part of another procedure. The 90-day global period includes the day-before preoperative visit and related postoperative care during that period. 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% reduction. Modifier 50 is not appropriate for this code. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 21497
- 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU4.52 · 21%
- Practice expense (office) RVU16.45 · 77%
- Malpractice RVU0.50 · 2%
27
Medicare services in 2024 · #5726 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.
21497 compared with similar codes
Office rates for Delaware, from the same CMS release.
$2,011.67
Use 21462 for open treatment of a mandibular fracture with interdental fixation. This code describes nonfracture interdental wiring instead.
21499
No office rateUnlisted muscskel px head
Use 21499 only when no listed code describes the service. Code 21497 specifically describes interdental wiring for a nonfracture indication.
Compare 21497 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
$709.59
Facility
$556.14
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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 21497 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
1,996
- Code
- 21497
- Physician work
- 4.52
- Practice expense
- 16.45
- Malpractice
- 0.50
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.52 | × 1.005 | 4.5426 |
| Practice expense | 16.45 | × 0.988 | 16.2526 |
| Malpractice | 0.50 | × 0.899 | 0.4495 |
| Total RVUs | 21.2447 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Delaware$709.59
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.52 | 1.005 |
| Practice expense | 16.45 | 0.988 |
| Malpractice | 0.5 | 0.899 |
(4.52 × 1.005 + 16.45 × 0.988 + 0.5 × 0.899) × $33.4009 = $709.59
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.52 | 1.005 |
| Practice expense | 11.8 | 0.988 |
| Malpractice | 0.5 | 0.899 |
(4.52 × 1.005 + 11.8 × 0.988 + 0.5 × 0.899) × $33.4009 = $556.14
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.
21497 billing questions
How is this distinguished from mandibular fracture treatment?
This code is for interdental wiring with a nonfracture indication. When the wiring is part of treatment for a mandibular fracture, select the fracture-specific code that matches the treatment approach.
What documentation supports reporting this code?
Document the nonfracture indication, the need for interdental stabilization, and the wiring work performed. The record should make clear that the service is not being reported as fracture treatment.
Can the wiring be separately reported with another operation?
The code represents the interdental wiring service itself. Report another procedure only when its distinct work is documented and separate reporting is supported by the applicable coding rules.
Can modifier 50 be used when both sides are treated?
No. CMS identifies bilateral adjustment as inappropriate for this code; report the service without modifier 50.
When is an assistant-at-surgery payment allowed?
CMS permits assistant-at-surgery payment only when medical necessity is documented. Co-surgeon and team-surgery payment are not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
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.
1,99321480,,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
1,99921502,,I&d dp abs/hmtm nck rib ostc,A,,7.36,6.11,NA,6.11,,1.85,15.32,15.32,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,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