Billing code 21210: Facial bone graftMedicare rate & RVUs in Florida

Reports bone grafting to a nasal, upper-jaw, or cheekbone area to fill or rebuild a facial skeletal defect during reconstructive surgery.

CMS RVU26DEffective Oct 1, 20263 payment localities2.2K Medicare services in 2024

Medicare pays $1,755.94–$1,918.15 for 21210 in the office in Florida, from Rest Of Florida to Miami. Which amount applies depends on the service address.

$1,755.94–$1,918.15Office (non-facility)
$703.81–$772.47Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 21210 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Florida
  2. What 21210 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 21210 covers

This service places bone graft material in a defect of the nasal, maxillary, or malar skeleton. Oral and maxillofacial surgeons, plastic surgeons, and otolaryngologists may perform it when rebuilding facial bone after trauma, congenital deficiency, or prior surgery. The graft is used to restore skeletal contour or provide support in the specified facial region; the code includes obtaining the graft. Procedures are commonly performed in an operating room, though Medicare records services in both office and facility settings.

Choose the code based on the grafted facial site and the operative work, not merely the diagnosis. The record should identify the defect, treated bone, graft placement, and reconstructive purpose. CMS assigns a 90-day global period, including the day before surgery and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Report the service for the treated anatomy rather than appending modifier 50. CMS does not pay an assistant at surgery and does not permit co-surgeon or team-surgery payment for this code.

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.

Where 21210 pays more and less in Florida

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

3 payment localities

$1755.94 to $1918.15

$1755.94$1837.05$1918.15
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.
21210 office and facility rates by payment locality
Payment localityOfficeFacility
Fort Lauderdale$1,847.58$732.71
Miami$1,918.15$772.47
Rest Of Florida$1,755.94$703.81

How the 21210 rate is calculated

Each of 21210’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 · 21210

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 11.40Practice expense 40.96Malpractice 1.34

53.7000 adjusted RVUs×$33.4009 conversion factor=$1,793.63

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 21210

21210 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21210

Facial bone graft

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 21210

Facial bone graft

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

21210 without 51 · national office

$1,793.63

Facial bone graft

21210-51 · Second procedure: 50%

$896.82

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%).

When to use modifier 51

21210 compared with similar codes

Compare codes

21210 vs 21215 vs 21208 vs 21206: national Medicare rates

Swap in your local Medicare rate.

  • 21210
    Facial bone graft · 11.4 wRVU
    $1,793.63
  • 21215
    Bone graft · 11.92 wRVU
    $4,120.00+$2,326.37
  • 21208
    Bone augmentation · 11.13 wRVU
    $1,657.02−$136.61
  • 21206
    Maxillary osteotomy · 15.2 wRVU
    —

How to choose

21215Bone graft
Use 21210 for grafting the nasal, maxillary, or malar area; use 21215 when the graft is placed in the lower jaw.
21208Bone augmentation
Code 21208 describes facial-bone augmentation. Select 21210 when the documented work is a bone graft to the nasal, maxillary, or malar region.
21206Maxillary osteotomy
Code 21206 is for reconstruction of the upper jaw. This code describes graft placement at the specified nasal, maxillary, or malar facial sites.

21210 billing questions

How is this code distinguished from 21215?

This code is for grafting the nasal, maxillary, or malar area. Code 21215 is the corresponding bone-graft service for the lower jaw.

Is graft harvest separately reported?

Obtaining the graft is included in this service. Document the graft placement and the facial site treated rather than separately reporting routine graft acquisition.

Should modifier 50 be used when grafting both sides?

No. Report the grafting service for the treated anatomy without modifier 50; CMS identifies bilateral adjustment as inappropriate for this code.

What documentation supports reporting this service?

The operative report should identify the nasal, maxillary, or malar defect, explain why reconstruction was performed, and describe graft placement and the resulting repair.

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.

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
RVUs for 21210PPRRVU2026_Oct_nonQPP.csv, line 1,916 (RVU26D)

Open CMS sourceHow we calculate rates

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