No office rate
Both describe subperiosteal implant reconstruction; 21245 is partial, while 21246 is complete.
On this page
CMS RVU26D · Effective 2026-10-01
21245 Jaw reconstruction Medicare reimbursement rates in Florida
Reports reconstruction of part of the mandible or maxilla with a subperiosteal implant, typically when severe jawbone loss limits conventional implant support. Compare 21245 office and facility rates across CMS payment localities in Florida.
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 21245 in Florida?
Florida has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
$1282.27–$1413.44
3 of 3 localities have a supported rate.
Facility setting
$881.21–$976.72
3 of 3 localities have a supported rate.
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.
Where 21245 pays more and less in Florida
3 payment localities
$1282.27 to $1413.44
Oral and maxillofacial surgery
About 21245: Partial subperiosteal jaw implant reconstruction
Reports reconstruction of part of the mandible or maxilla with a subperiosteal implant, typically when severe jawbone loss limits conventional implant support.
This procedure reconstructs part of the mandible or maxilla using a subperiosteal implant positioned beneath the periosteum and over the jawbone. Oral and maxillofacial surgeons typically perform it for substantial jawbone loss, including severe atrophy that makes conventional implant support difficult. The operative report should identify the jaw treated, the extent reconstructed, and the subperiosteal implant approach.
Select this code for partial reconstruction; a complete reconstruction belongs to the corresponding complete-service code. Documentation should distinguish a subperiosteal implant from an endosteal implant and describe the treated anatomy and extent. The service has a 90-day global period, including 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% reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 21245
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU12.79 · 33%
- Practice expense (office) RVU23.87 · 62%
- Malpractice RVU1.85 · 5%
65
Medicare services in 2024 · #5184 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.
21245 compared with similar codes
Office rates for Florida, from the same CMS release.
$1,024.21–$1,123.40
21245 is for partial reconstruction with a subperiosteal implant. 21248 is for partial reconstruction with an endosteal implant.
No office rate
21244 describes mandibular reconstruction with bone graft using a different approach; 21245 is partial reconstruction with a subperiosteal implant.
Compare 21245 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.
3 of 3 payment localities
Fort Lauderdale →
Office / nonfacility
$1346.56
Facility
$921.59
Miami →
Office / nonfacility
$1413.44
Facility
$976.72
Rest Of Florida →
Office / nonfacility
$1282.27
Facility
$881.21
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.
21245 billing questions
How does this differ from 21246?
21245 is for partial subperiosteal implant reconstruction. The corresponding complete reconstruction is reported with 21246.
How does this differ from 21248?
21245 describes a partial subperiosteal implant reconstruction; 21248 is for partial reconstruction using an endosteal implant.
Should modifier 50 be reported for both sides?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
What documentation supports reporting 21245?
The operative report should identify the mandible or maxilla treated, the partial extent of reconstruction, and the use of a subperiosteal implant.
Can an assistant surgeon be reported?
An assistant at surgery may be paid. Co-surgeons and team surgery are not permitted for this code under the listed CMS rules.
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.
1,92121242,,Reconstruction of jaw joint,A,,14.23,11.35,NA,11.35,,2.06,27.64,27.64,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,92221243,,Reconstruction of jaw joint,A,,23.92,16.40,NA,16.40,,3.28,43.60,43.60,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,92321244,,Reconstruction of lower jaw,A,,13.28,11.65,NA,11.65,,1.94,26.87,26.87,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,92421245,,Reconstruction of jaw,A,,12.79,23.87,,11.31,,1.85,38.51,25.95,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,92521246,,Reconstruction of jaw,A,,12.60,8.56,NA,8.56,,1.83,22.99,22.99,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,92621247,,Reconstruct lower jaw bone,A,,23.76,15.28,NA,15.28,,3.45,42.49,42.49,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,92721248,,Reconstruction of jaw,A,,12.42,16.71,,7.79,,1.51,30.64,21.72,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00