$1,369.48
Use 21244 for extraoral mandibular reconstruction with a transosteal plate. Code 21245 is a bone-graft reconstruction option that includes obtaining the graft.
On this page
CMS RVU26D · Effective 2026-10-01
21244 Jaw reconstruction Medicare reimbursement rates in Hawaii
Report this service for extraoral reconstruction of the mandible using a transosteal plate, such as when restoring a defect after resection or trauma. Compare 21244 office and facility rates across CMS payment localities in Hawaii.
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 21244 in Hawaii?
Hawaii 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
No supported rate
Facility setting
$923.51
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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 21244: Extraoral mandibular plate reconstruction
Report this service for extraoral reconstruction of the mandible using a transosteal plate, such as when restoring a defect after resection or trauma.
This operation rebuilds the mandible through an extraoral approach using a transosteal bone plate to support the lower jaw. Oral and maxillofacial surgeons, plastic surgeons, and head-and-neck surgeons may perform it for a mandibular defect, including one following tumor removal or significant trauma. The operative report should establish the mandibular site and defect, the extraoral approach, and the plate-based reconstruction performed.
Report the code for the plate reconstruction rather than a jaw-joint procedure or a bone-graft service alone. Documentation should describe the indication, operative work, and materials used. CMS assigns 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 for this code. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 21244
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU13.28 · 49%
- Practice expense (office) RVU11.65 · 43%
- Malpractice RVU1.94 · 7%
716
Medicare services in 2024 · #3238 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.
21244 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
21244 describes plate-based reconstruction; 21246 describes mandibular reconstruction with a bone graft when graft procurement is not included.
$4,603.62
21215 describes a mandibular bone-graft service. Choose 21244 when the documented work is extraoral plate-based reconstruction.
No office rate
21240 addresses reconstruction of the temporomandibular joint. Code 21244 is for reconstruction of the mandible with a transosteal plate.
Compare 21244 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
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$923.51
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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 21244 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
1,923
- Code
- 21244
- Physician work
- 13.28
- Practice expense
- 11.65
- Malpractice
- 1.94
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.28 | × 1.000 | 13.2800 |
| Practice expense | 11.65 | × 1.137 | 13.2461 |
| Malpractice | 1.94 | × 0.579 | 1.1233 |
| Total RVUs | 27.6493 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$923.51
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.28 | 1 |
| Practice expense | 11.65 | 1.137 |
| Malpractice | 1.94 | 0.579 |
(13.28 × 1 + 11.65 × 1.137 + 1.94 × 0.579) × $33.4009 = $923.51
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.
21244 billing questions
How is 21244 different from 21245 or 21246?
21244 describes extraoral mandibular reconstruction with a transosteal plate. Codes 21245 and 21246 are bone-graft reconstruction options; select based on the graft service and whether graft procurement is included.
Is this a jaw-joint reconstruction code?
No. This code addresses reconstruction of the mandible with a plate. A procedure focused on reconstructing the temporomandibular joint belongs to the TMJ reconstruction family, such as 21240.
Can modifier 50 be used for bilateral reconstruction?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How does the multiple-procedure reduction affect another procedure in the same session?
The highest-valued procedure is paid in full, and other procedures in that session are subject to the standard 50% multiple-procedure reduction.
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.
1,92021240,,Reconstruction of jaw joint,A,,15.67,10.48,NA,10.48,,2.10,28.25,28.25,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,92121242,,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
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014