$718.95
21440 describes closed treatment of the mandibular or maxillary alveolar ridge fracture. Choose 21445 when the surgeon uses an open approach.
On this page
CMS RVU26D · Effective 2026-10-01
21445 Alveolar fracture Medicare reimbursement rates in Kentucky
Report open surgical reduction and stabilization of a fracture involving the tooth-bearing alveolar ridge of the mandible or maxilla. Compare 21445 office and facility rates across CMS payment localities in Kentucky.
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 21445 in Kentucky?
Kentucky 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
$692.80
1 of 1 localities have a supported rate.
Payment area: Kentucky
One mapped payment locality.
Facility setting
$527.11
1 of 1 localities have a supported rate.
Payment area: Kentucky
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 21445: Open treatment of alveolar ridge fracture
Report open surgical reduction and stabilization of a fracture involving the tooth-bearing alveolar ridge of the mandible or maxilla.
This service treats a fracture of the tooth-bearing alveolar ridge in the mandible or maxilla through an open surgical approach. The surgeon exposes the fracture, restores the position of the bone and associated dental segment, and stabilizes it; interdental fixation may be used. Oral and maxillofacial surgeons commonly perform the procedure, generally in an operating-room setting. The code concerns the alveolar ridge, not a broader mandibular fracture or a fracture elsewhere in the facial skeleton.
Select 21445 when the operative report supports open exposure and treatment of the alveolar ridge fracture. Document the affected jaw and fracture site, the open approach, reduction and stabilization performed, and any fixation used. Interdental fixation is included when used. 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% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeons and team surgery are not permitted.
CMS billing rules for 21445
- 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 may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU6.10 · 27%
- Practice expense (office) RVU15.76 · 70%
- Malpractice RVU0.69 · 3%
18
Medicare services in 2024 · #5963 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.
21445 compared with similar codes
Office rates for Kentucky, from the same CMS release.
$1,627.26
21461 applies to open treatment of a mandibular fracture without interdental fixation. 21445 is specific to an alveolar ridge fracture.
$1,850.10
21462 applies to open treatment of a mandibular fracture with interdental fixation. Use 21445 when the fracture is of the alveolar ridge.
Compare 21445 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
Kentucky →
Office / nonfacility
$692.80
Facility
$527.11
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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 21445 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
1,983
- Code
- 21445
- Physician work
- 6.10
- Practice expense
- 15.76
- Malpractice
- 0.69
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.10 | × 1.000 | 6.1000 |
| Practice expense | 15.76 | × 0.889 | 14.0106 |
| Malpractice | 0.69 | × 0.915 | 0.6313 |
| Total RVUs | 20.7420 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$692.80
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.1 | 1 |
| Practice expense | 15.76 | 0.889 |
| Malpractice | 0.69 | 0.915 |
(6.1 × 1 + 15.76 × 0.889 + 0.69 × 0.915) × $33.4009 = $692.80
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.1 | 1 |
| Practice expense | 10.18 | 0.889 |
| Malpractice | 0.69 | 0.915 |
(6.1 × 1 + 10.18 × 0.889 + 0.69 × 0.915) × $33.4009 = $527.11
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.
21445 billing questions
How does 21445 differ from 21440?
21445 is for open surgical treatment of the alveolar ridge fracture. Use 21440 when the fracture is treated closed.
Is interdental fixation separately reported with 21445?
Interdental fixation used to stabilize the alveolar ridge fracture is included in 21445. Document the fixation method in the operative report.
When should a mandibular fracture code be considered instead?
Use a mandibular fracture code when the treated fracture involves a broader part of the mandible rather than the alveolar ridge. The operative documentation should identify the fracture site and treatment approach.
Can modifier 50 be reported for fractures on both sides?
No. The CMS bilateral adjustment does not apply to 21445, and modifier 50 is inappropriate for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
1,98021435,,Optx crnfc sep comp int&/xtr,A,,19.75,14.36,NA,14.36,,3.66,37.77,37.77,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,98121436,,Optx crnfcl sep comp mlt int,A,,29.54,19.00,NA,19.00,,5.49,54.03,54.03,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,98221440,,Cltx mndblr/max alv ridge fx,A,,3.35,19.95,,14.18,,0.48,23.78,18.01,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,98321445,,Optx mndblr/max alv ridge fx,A,,6.10,15.76,,10.18,,0.69,22.55,16.97,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,98421450,,Cltx mndblr fx w/o mnpj,A,,3.62,13.87,,9.74,,0.41,17.90,13.77,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,98521451,,Cltx mndblr fx w/mnpj,A,,5.51,17.22,,12.08,,0.62,23.35,18.21,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,98621452,,Perq tx mndblr fx xtrnl fixj,A,,2.34,20.23,,11.06,,0.35,22.92,13.75,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631