No office rate
Use 21194 when the lower-jaw reconstruction includes a bone graft; 21193 is the no-graft variant.
On this page
CMS RVU26D · Effective 2026-10-01
21193 Mandibular reconstruction Medicare reimbursement rates in Indiana
Reports operative reconstruction of the lower jaw when the documented procedure is performed without a bone graft. Compare 21193 office and facility rates across CMS payment localities in Indiana.
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 21193 in Indiana?
Indiana 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
$1033.11
1 of 1 localities have a supported rate.
Payment area: Indiana
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 21193: Lower jaw reconstruction without bone graft
Reports operative reconstruction of the lower jaw when the documented procedure is performed without a bone graft.
CPT 21193 covers operative reconstruction of the lower jaw without a bone graft. Oral and maxillofacial, plastic, or craniofacial surgeons may perform this work to restore mandibular form or function after a defect or deformity. The operative report should identify the mandibular reconstruction performed and establish that a bone graft was not used as part of that reconstruction.
Choose this code based on the documented procedure and graft use, not simply the diagnosis or the fact that the mandible is involved. The code 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. The code is priced as bilateral, so modifier 50 does not increase payment. Assistant-at-surgery services may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 21193
- 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
- The code is already priced as bilateral; modifier 50 does not increase payment.
- 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 RVU18.43 · 56%
- Practice expense (office) RVU12.08 · 36%
- Malpractice RVU2.68 · 8%
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.
21193 compared with similar codes
Office rates for Indiana, from the same CMS release.
No office rate
This lower-jaw reconstruction variant is specified as without fixation. Select based on the operative technique documented rather than treating it as interchangeable with 21193.
No office rate
This lower-jaw reconstruction variant is specified as with fixation. The operative report's description of the procedure determines whether it fits instead of 21193.
No office rate
21199 identifies lower-jaw reconstruction involving advancement; 21193 is distinguished by reconstruction without a bone graft.
Compare 21193 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
Indiana →
Office / nonfacility
Unavailable
Facility
$1033.11
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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 21193 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
1,907
- Code
- 21193
- Physician work
- 18.43
- Practice expense
- 12.08
- Malpractice
- 2.68
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 18.43 | × 1.000 | 18.4300 |
| Practice expense | 12.08 | × 0.927 | 11.1982 |
| Malpractice | 2.68 | × 0.486 | 1.3025 |
| Total RVUs | 30.9306 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Indiana$1033.11
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 18.43 | 1 |
| Practice expense | 12.08 | 0.927 |
| Malpractice | 2.68 | 0.486 |
(18.43 × 1 + 12.08 × 0.927 + 2.68 × 0.486) × $33.4009 = $1033.11
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.
21193 billing questions
How do I distinguish 21193 from 21194?
The key distinction is whether a bone graft is used in the lower-jaw reconstruction. Use 21193 for reconstruction without a graft and 21194 when the reconstruction includes a graft.
Does modifier 50 increase payment for 21193?
No. CMS prices 21193 as bilateral, so modifier 50 does not increase payment.
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-surgeons are paid only when supporting documentation is provided.
How does payment work when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction.
What documentation supports selecting 21193?
The operative report should describe the lower-jaw reconstruction and make clear that no bone graft was used as part of it.
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.
1,90421183,,Reconstruct cranial bone,A,,34.81,18.81,NA,18.81,,6.46,60.08,60.08,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,90521184,,Reconstruct cranial bone,A,,37.65,19.84,NA,19.84,,7.01,64.50,64.50,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,90621188,,Reconstruction of midface,A,,22.57,16.94,NA,16.94,,3.27,42.78,42.78,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,90721193,,Reconst lwr jaw w/o graft,A,,18.43,12.08,NA,12.08,,2.68,33.19,33.19,0,090,0.10,0.69,0.21,2,2,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,90821194,,Reconst lwr jaw w/graft,A,,21.27,13.97,NA,13.97,,3.07,38.31,38.31,0,090,0.10,0.69,0.21,2,2,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,90921195,,Reconst lwr jaw w/o fixation,A,,18.68,15.06,NA,15.06,,2.71,36.45,36.45,0,090,0.10,0.69,0.21,2,2,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,91021196,,Reconst lwr jaw w/fixation,A,,20.31,15.56,NA,15.56,,2.95,38.82,38.82,0,090,0.10,0.69,0.21,2,2,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915