No office rate
Choose 21325 for open treatment of an uncomplicated nasal fracture alone. This code represents open treatment involving both nasal and septal fractures.
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CMS RVU26D · Effective 2026-10-01
21335 Nasal fracture repair Medicare reimbursement rates in Iowa
Open repair of fractures involving both the nose and nasal septum, reported when the surgeon surgically exposes and treats both fracture sites. Compare 21335 office and facility rates across CMS payment localities in Iowa.
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 21335 in Iowa?
Iowa 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
$595.76
1 of 1 localities have a supported rate.
Payment area: Iowa
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.
Facial fracture treatment
About 21335: Open nasal and septal fracture repair
Open repair of fractures involving both the nose and nasal septum, reported when the surgeon surgically exposes and treats both fracture sites.
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.
CMS billing rules for 21335
- 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
- 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 RVU8.79 · 45%
- Practice expense (office) RVU9.31 · 48%
- Malpractice RVU1.33 · 7%
234
Medicare services in 2024 · #4186 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.
21335 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
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.
No office rate
Code 21336 is for open treatment of a septal fracture, with or without stabilization. This code represents combined treatment of nasal and septal fractures.
$391.02
Code 21337 describes closed treatment of nasal and septal fractures. Use this code when the documented treatment of both sites is open.
Compare 21335 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
Iowa →
Office / nonfacility
Unavailable
Facility
$595.76
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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 21335 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
1,947
- Code
- 21335
- Physician work
- 8.79
- Practice expense
- 9.31
- Malpractice
- 1.33
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.79 | × 1.000 | 8.7900 |
| Practice expense | 9.31 | × 0.915 | 8.5187 |
| Malpractice | 1.33 | × 0.397 | 0.5280 |
| Total RVUs | 17.8367 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$595.76
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.79 | 1 |
| Practice expense | 9.31 | 0.915 |
| Malpractice | 1.33 | 0.397 |
(8.79 × 1 + 9.31 × 0.915 + 1.33 × 0.397) × $33.4009 = $595.76
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.
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 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.
1,94421320,,Clsd tx nsl fx w/mnpj&stablj,A,,1.55,4.83,,0.67,,0.23,6.61,2.45,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,94521325,,Open tx nose fx uncomplicatd,A,,4.08,7.71,NA,7.71,,0.59,12.38,12.38,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,94621330,,Open tx nose fx w/skele fixj,A,,5.65,8.20,NA,8.20,,0.83,14.68,14.68,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,94721335,,Open tx nose & septal fx,A,,8.79,9.31,NA,9.31,,1.33,19.43,19.43,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,94821336,,Open tx septal fx w/wo stabj,A,,6.60,9.88,NA,9.88,,0.98,17.46,17.46,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,94921337,,Closed tx septal&nose fx,A,,3.31,8.96,,4.63,,0.50,12.77,8.44,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,95021338,,Open nasoethmoid fx w/o fixj,A,,6.70,11.08,NA,11.08,,0.99,18.77,18.77,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136