No office rate
Both describe open nasal-fracture treatment, but 21330 is the choice when skeletal fixation is performed; 21325 is for uncomplicated treatment without that fixation.
On this page
CMS RVU26D · Effective 2026-10-01
21325 Nasal fracture repair Medicare reimbursement rates in Kansas
An otolaryngologist or facial trauma surgeon reports this procedure for operative exposure and reduction of an uncomplicated nasal fracture without skeletal fixation. Compare 21325 office and facility rates across CMS payment localities in Kansas.
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 21325 in Kansas?
Kansas 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
$379.01
1 of 1 localities have a supported rate.
Payment area: Kansas
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 surgery
About 21325: Open treatment of uncomplicated nasal fracture
An otolaryngologist or facial trauma surgeon reports this procedure for operative exposure and reduction of an uncomplicated nasal fracture without skeletal fixation.
Code 21325 represents operative treatment of an uncomplicated nasal fracture through surgical exposure and reduction. It is typically performed by an otolaryngologist, plastic surgeon, or facial trauma surgeon in an operating room. “Open” describes the operative approach, not whether the fracture broke through the skin. This code is distinct from nasal-fracture treatment that includes skeletal fixation or treatment of an associated septal fracture.
Choose the code based on the fracture anatomy and procedure documented in the operative report. Documentation should identify the nasal fracture and describe the open approach and reduction; specify whether skeletal fixation or septal repair was performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care through day 90. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures at 50%. Bilateral adjustment is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 21325
- 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
- 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 RVU4.08 · 33%
- Practice expense (office) RVU7.71 · 62%
- Malpractice RVU0.59 · 5%
54
Medicare services in 2024 · #5309 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.
21325 compared with similar codes
Office rates for Kansas, from the same CMS release.
$145.51
21315 describes closed treatment without stabilization. Choose 21325 when the surgeon uses an open operative approach to treat the nasal fracture.
No office rate
21335 addresses an open fracture treatment involving both the nose and septum. Code 21325 is for uncomplicated nasal-fracture treatment without the combined septal injury.
Compare 21325 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
Kansas →
Office / nonfacility
Unavailable
Facility
$379.01
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 21325 in Kansas.
PPRRVU2026_Oct_nonQPP.csv
1,945
- Code
- 21325
- Physician work
- 4.08
- Practice expense
- 7.71
- Malpractice
- 0.59
GPCI2026.csv
54
- Locality
- Kansas
- Physician work
- 1.000
- Practice expense
- 0.904
- Malpractice
- 0.504
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.08 | × 1.000 | 4.0800 |
| Practice expense | 7.71 | × 0.904 | 6.9698 |
| Malpractice | 0.59 | × 0.504 | 0.2974 |
| Total RVUs | 11.3472 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kansas$379.01
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.08 | 1 |
| Practice expense | 7.71 | 0.904 |
| Malpractice | 0.59 | 0.504 |
(4.08 × 1 + 7.71 × 0.904 + 0.59 × 0.504) × $33.4009 = $379.01
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.
21325 billing questions
When should 21330 be used instead?
Use 21330 when the open treatment includes skeletal fixation. The operative report should make the fixation part of the procedure clear.
How does 21325 differ from closed nasal fracture treatment?
Code 21325 describes operative exposure and reduction. Codes 21315 and 21320 describe closed treatment, with stabilization distinguishing 21320.
Does modifier 50 apply to bilateral nasal fractures?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 is not used to report bilateral treatment.
What care is included in the global period?
The day-before preoperative visit and 90 days of related postoperative care are included in the 90-day global period.
Can an assistant 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.
1,94221299,,Unlisted cranfcl&maxlfcl px,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
1,94321315,,Clsd tx nsl fx mnpj wo stblj,A,,0.94,3.69,,0.51,,0.16,4.79,1.61,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,94421320,,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
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
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958