CPT code 21215: Bone graft2026 Medicare rate & RVUs in Guam
Reports placement of a bone graft in the lower jaw to rebuild a mandibular defect or deficient area, including obtaining the graft as part of the operation.
Medicare pays $4,603.62 for 21215 in the office in Guam (Hawaii, Guam). 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 21215 covers
CPT 21215 represents placement of bone graft material in the mandible to rebuild a defect or deficient area, such as after trauma, resection, or substantial ridge loss. The service includes obtaining the graft when it is harvested as part of the operation, so that donor-site work is not separately reported under this code. Oral and maxillofacial surgeons and reconstructive surgeons commonly perform the procedure in an operating room or another equipped surgical setting.
Report the code when the graft is placed in the lower jaw itself; a graft to the nasal, maxillary, or malar region is a different service. Document the mandibular site, the defect or reason for grafting, and the graft placement and harvest performed. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and the others are reduced to 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery; co-surgeons require supporting documentation, and team surgery is 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.
21215 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $4,603.62 | $738.34 |
How the 21215 rate is calculated
Each of 21215’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 · 21215
RVUs × geographic indexes × conversion factor
Work11.92
11.92 RVUs× 1.000 GPCI
Practice expense110.02
110.02 RVUs× 1.000 GPCI
Malpractice1.41
1.41 RVUs× 1.000 GPCI
Adjusted RVUs
123.3500
Conversion factor
$33.4009
Medicare rate
$4,120.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 21215
21215 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21215
Bone graft
| 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 21215
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
21215 without 51 · national office
$4,120.00
Bone graft
21215-51 · Second procedure: 50%
$2,060.00
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%).
21215 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 21210Facial bone graft
- Choose 21215 for a graft placed in the mandible; choose 21210 for grafting in the nasal, maxillary, or malar region.
- 21244Jaw reconstruction
- 21215 describes graft placement in the mandible. 21244 is for mandibular reconstruction using a transosteal bone plate.
- 21247Lower jaw reconstruction
- Both concern the lower jaw, but 21247 is a reconstruction service. Use 21215 when the documented procedure is mandibular bone graft placement.
21215 billing questions
How is 21215 distinguished from 21210?
21215 is for graft placement in the mandible. 21210 is used for grafting in the nasal, maxillary, or malar region.
Is graft harvest separately reportable?
No. Obtaining the graft as part of the operation is included in 21215; document the harvest and recipient site.
Should modifier 50 be used for grafting both sides of the mandible?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.
Can an assistant surgeon be paid for this service?
Medicare does not pay an assistant at surgery for 21215 under the stated statutory restriction.
How does the multiple-procedure rule affect payment?
For procedures performed in the same session, the highest-valued procedure is paid in full and the other procedures are paid at 50%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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