Billing code 21440: Fracture treatmentMedicare rate & RVUs in Florida
Reports closed management of a fracture in the tooth-bearing alveolar ridge of the mandible or maxilla, rather than open fracture repair.
Medicare pays $773.02–$846.11 for 21440 in the office in Florida, from Rest Of Florida to Miami. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 21440 covers
This service treats a fracture of the tooth-bearing alveolar process of the upper or lower jaw without open surgical exposure. The clinician assesses the fracture and manages the involved ridge segment using a closed approach, which may include alignment or stabilization. Oral and maxillofacial surgeons and dentists commonly provide this care in office or facility settings. The operative or treatment note should identify the affected jaw and alveolar ridge, describe the fracture and the closed method used, and distinguish the injury from a broader mandibular or maxillary fracture.
Report 21440 for closed treatment; open exposure and repair belong to the open-treatment code. The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery. 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 requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
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 21440 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
$773.02 to $846.11
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $815.89 | $620.66 |
| Miami | $846.11 | $645.48 |
| Rest Of Florida | $773.02 | $588.78 |
How the 21440 rate is calculated
Each of 21440’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 · 21440
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 3.35Practice expense 19.95Malpractice 0.48
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 21440
21440 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21440
Fracture treatment
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 21440
Fracture treatment
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
21440 without 51 · national office
$794.27
Fracture treatment
21440-51 · Second procedure: 50%
$397.14
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%).
21440 compared with similar codes
Compare codes
21440 vs 21445 vs 21450 vs 21451 vs 21421: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 21445Alveolar fracture
- Both address mandibular or maxillary alveolar ridge fractures; 21440 is closed treatment, while 21445 is open treatment.
- 21450Mandibular fracture care
- 21450 is closed treatment of a mandibular fracture without manipulation. Choose 21440 when the treated fracture is specifically in the tooth-bearing alveolar ridge.
- 21451Mandibular fracture
- 21451 is closed treatment of a mandibular fracture with manipulation. It is not the alveolar-ridge-specific service reported with 21440.
- 21421Fracture fixation
- 21421 addresses a palatal or maxillary fracture treated with interdental wire fixation; 21440 is for a fracture of the alveolar ridge.
21440 billing questions
How is 21440 different from 21445?
21440 is for closed management of the alveolar ridge fracture. Use 21445 when the fracture is treated through an open surgical approach.
When is 21440 more appropriate than 21450 or 21451?
Use 21440 when the fracture involves the tooth-bearing alveolar ridge. Codes 21450 and 21451 describe closed treatment of a mandibular fracture outside that specific alveolar-ridge service.
Can modifier 50 be reported for fractures on both sides?
No. CMS identifies bilateral adjustment as inappropriate for 21440; modifier 50 should not be used.
What documentation supports reporting 21440?
Document the affected jaw and alveolar ridge, the fracture treated, and how it was managed without open surgical exposure. The note should make clear that the service is not treatment of a broader mandibular or maxillary fracture.
How does the 90-day global period affect follow-up care?
The global period includes the day-before preoperative visit and related postoperative care for 90 days. Unrelated services are not included solely because they occur during that period.
When may an assistant-at-surgery be paid?
Assistant-at-surgery payment is allowed only when the record documents medical necessity. Co-surgeons and team surgery are not permitted for this code.
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
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