$714.31
Choose 21450 when no manipulation is performed. Choose 21451 when the clinician manipulates the fracture during closed treatment.
On this page
CMS RVU26D · Effective 2026-10-01
21450 Mandibular fracture care Medicare reimbursement rates in Kentucky
Reports closed care of a mandibular fracture when the treating clinician manages the fracture without manipulating its alignment or using interdental fixation. Compare 21450 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 21450 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
$545.29
1 of 1 localities have a supported rate.
Payment area: Kentucky
One mapped payment locality.
Facility setting
$422.66
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.
Fracture treatment
About 21450: Closed mandibular fracture care without manipulation
Reports closed care of a mandibular fracture when the treating clinician manages the fracture without manipulating its alignment or using interdental fixation.
This service covers closed management of a mandibular fracture without manipulating the fracture fragments. It is typically performed by an oral and maxillofacial surgeon or another clinician qualified to manage facial fractures, with care directed by the fracture’s location, stability, and clinical findings. The fracture is managed without surgical exposure; treatment and follow-up may occur across outpatient and facility settings.
Report the code when the clinician provides fracture care without manipulation, rather than simply evaluating the injury or providing routine advice. The record should identify the mandibular fracture and document the treatment plan and that manipulation or interdental fixation was not performed. A 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others are subject to a 50% reduction. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 21450
- 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 RVU3.62 · 20%
- Practice expense (office) RVU13.87 · 77%
- Malpractice RVU0.41 · 2%
45
Medicare services in 2024 · #5409 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.
21450 compared with similar codes
Office rates for Kentucky, from the same CMS release.
$1,021.05
21453 includes interdental fixation as part of closed fracture treatment; 21450 describes treatment without that fixation.
$1,627.26
21461 is open treatment without interdental fixation. This code is for closed management without manipulation.
$1,850.10
21462 is open treatment with interdental fixation. This code is for closed management without manipulation or interdental fixation.
Compare 21450 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
$545.29
Facility
$422.66
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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 21450 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
1,984
- Code
- 21450
- Physician work
- 3.62
- Practice expense
- 13.87
- Malpractice
- 0.41
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.62 | × 1.000 | 3.6200 |
| Practice expense | 13.87 | × 0.889 | 12.3304 |
| Malpractice | 0.41 | × 0.915 | 0.3751 |
| Total RVUs | 16.3256 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$545.29
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.62 | 1 |
| Practice expense | 13.87 | 0.889 |
| Malpractice | 0.41 | 0.915 |
(3.62 × 1 + 13.87 × 0.889 + 0.41 × 0.915) × $33.4009 = $545.29
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.62 | 1 |
| Practice expense | 9.74 | 0.889 |
| Malpractice | 0.41 | 0.915 |
(3.62 × 1 + 9.74 × 0.889 + 0.41 × 0.915) × $33.4009 = $422.66
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.
21450 billing questions
How does this differ from 21451?
Use 21450 when the fracture is treated without manipulation. Code 21451 describes closed treatment that includes manipulation.
When is 21453 a better fit?
Code 21453 is for closed mandibular fracture treatment with interdental fixation. This code represents treatment without manipulation.
Can modifier 50 be reported for fractures on both sides?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.
Are related fracture-care visits separately reported during the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon be paid for this service?
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.
1,98121436,,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
1,98721453,,Cltx mndblr fx ntrdntl fixj,A,,6.47,26.10,,19.25,,0.98,33.55,26.70,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,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