$156.82
Use 21480 for a routine closed reduction of a temporomandibular dislocation. Use 21485 when the closed treatment is complicated, such as recurrent displacement requiring fixation or splinting.
On this page
CMS RVU26D · Effective 2026-10-01
21485 TMJ reduction Medicare reimbursement rates in Iowa
Reports closed reduction of a complicated temporomandibular joint dislocation, such as a recurrent displacement requiring fixation or splinting. Compare 21485 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 21485 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
$918.16
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
Facility setting
$707.28
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.
Oral and maxillofacial surgery
About 21485: Complicated closed TMJ dislocation reduction
Reports closed reduction of a complicated temporomandibular joint dislocation, such as a recurrent displacement requiring fixation or splinting.
This service treats a displaced mandibular condyle without open surgery. A surgeon, commonly an oral and maxillofacial surgeon or another clinician experienced in jaw procedures, repositions the condyle and may use stabilization such as intermaxillary fixation or a splint for a complicated or recurrent dislocation. The service may occur in a hospital or outpatient surgical setting, depending on the patient’s needs and the complexity of reduction.
Choose this code when the record supports a complicated closed reduction, not a routine reduction captured by 21480 or an open procedure. Document the dislocation, why the reduction was complicated, the manipulation performed, and any fixation or splinting used. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment requires medical-necessity documentation; co-surgeons and team surgery are not permitted.
CMS billing rules for 21485
- 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 procedure with modifier 50 is paid at 150%.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU4.65 · 16%
- Practice expense (office) RVU24.67 · 82%
- Malpractice RVU0.67 · 2%
81
Medicare services in 2024 · #5034 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.
21485 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
21490 describes open operative treatment of a temporomandibular dislocation. This code is for closed reduction without an open approach.
$718.53
21451 treats a mandibular fracture, not a displaced temporomandibular joint. Select based on whether the diagnosis is a fracture or a joint dislocation.
Compare 21485 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
$918.16
Facility
$707.28
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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 21485 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
1,994
- Code
- 21485
- Physician work
- 4.65
- Practice expense
- 24.67
- Malpractice
- 0.67
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.65 | × 1.000 | 4.6500 |
| Practice expense | 24.67 | × 0.915 | 22.5731 |
| Malpractice | 0.67 | × 0.397 | 0.2660 |
| Total RVUs | 27.4890 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Iowa$918.16
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.65 | 1 |
| Practice expense | 24.67 | 0.915 |
| Malpractice | 0.67 | 0.397 |
(4.65 × 1 + 24.67 × 0.915 + 0.67 × 0.397) × $33.4009 = $918.16
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.65 | 1 |
| Practice expense | 17.77 | 0.915 |
| Malpractice | 0.67 | 0.397 |
(4.65 × 1 + 17.77 × 0.915 + 0.67 × 0.397) × $33.4009 = $707.28
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.
21485 billing questions
When should 21485 be chosen over 21480?
Use 21485 when the closed reduction is complicated, such as a recurrent dislocation requiring fixation or splinting. A routine closed reduction is generally distinguished by 21480.
Does this code include fixation or splinting?
Fixation or splinting may be part of the complicated treatment described by 21485. Document the method and do not assume a separate fixation code is reportable for work included in the reduction.
How is bilateral treatment reported?
For bilateral dislocations treated in the same session, report modifier 50; CMS pays the bilateral procedure at 150%.
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 payment is allowed only when medical necessity is documented. 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.
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
1,99721499,,Unlisted muscskel px head,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,0,1,1,9,,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