$930.04
Both describe closed treatment of a temporomandibular dislocation. Choose 21485 when the case meets the complicated-treatment distinction; otherwise use 21480.
On this page
CMS RVU26D · Effective 2026-10-01
21480 TMJ dislocation treatment Medicare reimbursement rates in Indiana
Reports closed manipulation to treat a temporomandibular joint dislocation, whether the reduction is performed during initial or subsequent treatment. Compare 21480 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 21480 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
$158.98
1 of 1 localities have a supported rate.
Payment area: Indiana
One mapped payment locality.
Facility setting
$27.70
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 21480: Closed temporomandibular dislocation treatment
Reports closed manipulation to treat a temporomandibular joint dislocation, whether the reduction is performed during initial or subsequent treatment.
This code covers closed treatment of a dislocated temporomandibular joint by manipulation, without open surgical exposure. It is used when a clinician reduces the displaced jaw joint, commonly in an emergency department or office setting. Oral and maxillofacial surgeons, otolaryngologists, and other physicians performing the reduction may report it. The code encompasses initial or subsequent closed treatment; it is not limited to the first encounter for the dislocation.
Select this code for a closed reduction, and use the complicated-treatment code when the case meets that distinction. Document the dislocation, the joint or joints treated, the closed manipulation performed, and whether treatment was initial or subsequent. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 identifies bilateral treatment and is paid at 150%. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
CMS billing rules for 21480
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU0.59 · 11%
- Practice expense (office) RVU4.43 · 86%
- Malpractice RVU0.13 · 3%
731
Medicare services in 2024 · #3224 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.
21480 compared with similar codes
Office rates for Indiana, from the same CMS release.
No office rate
21490 is for open treatment of the dislocation. Use 21480 when the joint is treated by closed manipulation without open surgical exposure.
$399.61
21073 describes therapeutic TMJ manipulation requiring general anesthesia, such as for restricted joint motion. 21480 is for closed treatment of a dislocation.
Compare 21480 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
$158.98
Facility
$27.70
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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 21480 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
1,993
- Code
- 21480
- Physician work
- 0.59
- Practice expense
- 4.43
- Malpractice
- 0.13
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.59 | × 1.000 | 0.5900 |
| Practice expense | 4.43 | × 0.927 | 4.1066 |
| Malpractice | 0.13 | × 0.486 | 0.0632 |
| Total RVUs | 4.7598 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Indiana$158.98
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.59 | 1 |
| Practice expense | 4.43 | 0.927 |
| Malpractice | 0.13 | 0.486 |
(0.59 × 1 + 4.43 × 0.927 + 0.13 × 0.486) × $33.4009 = $158.98
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.59 | 1 |
| Practice expense | 0.19 | 0.927 |
| Malpractice | 0.13 | 0.486 |
(0.59 × 1 + 0.19 × 0.927 + 0.13 × 0.486) × $33.4009 = $27.70
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.
21480 billing questions
When should 21480 be used instead of 21485?
Use 21480 for closed treatment of a temporomandibular dislocation that is not classified as complicated. Use 21485 when the treatment meets the complicated-dislocation distinction.
Does 21480 cover initial and follow-up closed treatment?
Yes. The code covers closed treatment whether it is initial or subsequent; document the encounter and the reduction or other closed treatment performed.
Can modifier 50 be reported for bilateral dislocations?
When both temporomandibular joints are treated bilaterally, modifier 50 identifies the bilateral procedure. CMS pays it at 150%.
Is same-day evaluation and postoperative care separately included?
The 0-day global period includes same-day preoperative and postoperative care. The code does not include care on later dates solely by virtue of that global period.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for 21480. Co-surgeons and team surgery are not permitted.
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.
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1,99121465,,Optx mndblr cndylr fx,A,,12.79,7.42,NA,7.42,,1.46,21.67,21.67,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,99221470,,Optx complicated mndblr fx,A,,17.10,11.46,NA,11.46,,2.56,31.12,31.12,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,99321480,,Cltx tmprmand dislc 1st/sbsq,A,,0.59,4.43,,0.19,,0.13,5.15,0.91,0,000,0.00,0.00,0.00,2,1,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,99421485,,Cltx tmprmand dislc comp,A,,4.65,24.67,,17.77,,0.67,29.99,23.09,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,99521490,,Optx tmprmand dislocation,A,,12.63,7.29,NA,7.29,,1.44,21.36,21.36,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,99621497,,Interdental wirg oth/thn fx,A,,4.52,16.45,,11.80,,0.50,21.47,16.82,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,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