Billing code 21335: Nasal fracture repairMedicare rate & RVUs in Illinois
Open repair of fractures involving both the nose and nasal septum, reported when the surgeon surgically exposes and treats both fracture sites.
CMS doesn’t publish an office rate for 21335 in Illinois.
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 21335 covers
This service involves surgically exposing and reducing fractures of the nasal bones and nasal septum during the same repair. Otolaryngologists, facial plastic surgeons, and other surgeons treating facial trauma may perform it in an operating room, commonly after trauma has displaced both the external nasal framework and septum. The operative work addresses both fracture areas rather than an isolated nasal-bone or isolated septal fracture.
Report the code when the operative documentation supports open treatment of both nasal and septal fractures. Record the fracture sites, open approach, reduction performed, and any stabilization. The 90-day global period includes 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% multiple-procedure reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code; 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 21335 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $710.12 |
| East St. Louis | Unavailable | $669.15 |
| Rest Of Illinois | Unavailable | $646.94 |
| Suburban Chicago | Unavailable | $693.73 |
How the 21335 rate is calculated
Each of 21335’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 · 21335
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.79Practice expense 9.31Malpractice 1.33
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 21335
21335 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21335
Nasal fracture repair
| 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) | 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 · 21335
Nasal fracture repair
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
21335 without 51 · national facility
$648.98
Nasal fracture repair
21335-51 · Second procedure: 50%
$324.49
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%).
21335 compared with similar codes
Compare codes
21335 vs 21325 vs 21330 vs 21336 vs 21337: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 21325Nasal fracture repair
- Choose 21325 for open treatment of an uncomplicated nasal fracture alone. This code represents open treatment involving both nasal and septal fractures.
- 21330Nasal fracture repair
- Code 21330 is the open nasal fracture option involving skeletal fixation. This code is distinguished by treatment of both the nasal and septal fracture sites.
- 21336Septal fracture repair
- Code 21336 is for open treatment of a septal fracture, with or without stabilization. This code represents combined treatment of nasal and septal fractures.
- 21337Septal fracture
- Code 21337 describes closed treatment of nasal and septal fractures. Use this code when the documented treatment of both sites is open.
21335 billing questions
When is this code chosen instead of 21325?
Use this code when open treatment addresses both nasal and septal fractures. Code 21325 describes open treatment of an uncomplicated nasal fracture without the combined septal repair represented here.
How does this differ from 21330?
Code 21330 describes open nasal fracture treatment with skeletal fixation. This code is distinguished by treatment of both the nose and septum; select based on the documented fracture treatment and fixation.
Can modifier 50 be reported for fractures on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.
Is an assistant surgeon payable?
No. CMS lists a statutory restriction on assistant-at-surgery payment for this code. Co-surgeons and team surgery are also not permitted.
What documentation supports reporting this code?
The operative report should identify fractures of both the nasal bones and septum and describe the open treatment performed at each site, including any stabilization.
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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