$1,541.16–$1,629.70
21209 reduces facial bone prominence; 21208 addresses facial bone augmentation. Select based on whether the operation removes or reshapes bone to reduce prominence or adds volume.
On this page
CMS RVU26D · Effective 2026-10-01
21209 Facial bone reduction Medicare reimbursement rates in Maine
Reports operative reshaping that reduces facial bone prominence, such as contouring an overprominent facial bone rather than augmenting or grafting it. Compare 21209 office and facility rates across CMS payment localities in Maine.
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 21209 in Maine?
Maine has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$748.90–$785.85
2 of 2 localities have a supported rate.
Facility setting
$520.28–$539.58
2 of 2 localities have a supported rate.
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 bone surgery
About 21209: Reduction of facial bone prominence
Reports operative reshaping that reduces facial bone prominence, such as contouring an overprominent facial bone rather than augmenting or grafting it.
A surgeon reduces a prominent facial bone by removing or reshaping bone to change its contour. Plastic surgeons and oral and maxillofacial surgeons may perform this as facial skeletal contouring when the operative goal is to decrease bony prominence, rather than reconstruct a jaw or add volume with graft or implant material. The operative report should identify the bone treated and describe the reduction performed.
Report the service for the documented reduction, not for facial bone augmentation or bone grafting. Documentation should establish the treated site, the bony work performed, and the reason for contour reduction. Medicare assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. 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 multiple-procedure reduction. Modifier 50 is inappropriate for this code. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 21209
- 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 RVU7.62 · 32%
- Practice expense (office) RVU15.46 · 64%
- Malpractice RVU0.93 · 4%
702
Medicare services in 2024 · #3257 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.
21209 compared with similar codes
Office rates for Maine, from the same CMS release.
$1,024.47–$1,074.32
21270 is for cheekbone augmentation. Use 21209 when the documented procedure reduces facial bone prominence rather than augmenting the cheekbone.
No office rate
21206 describes reconstruction of the upper jaw. It is distinct from reduction performed to contour a facial bone without reconstructing the maxilla.
Compare 21209 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.
2 of 2 payment localities
Rest Of Maine →
Office / nonfacility
$748.90
Facility
$520.28
Southern Maine →
Office / nonfacility
$785.85
Facility
$539.58
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.
21209 billing questions
How is reduction distinguished from facial bone augmentation?
Use 21209 when the operative goal is to reduce bony prominence. Code 21208 describes augmentation of facial bones, an opposite contouring goal.
Should modifier 50 be reported for reduction on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.
What documentation supports reporting 21209?
The operative report should identify the facial bone treated and describe the bone removal or reshaping that reduced its prominence.
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 another surgeon be reported?
An assistant at surgery may be paid. Co-surgeons and team surgery are not permitted for this code under the CMS rules provided.
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.
1,91221199,,Reconstr lwr jaw w/advance,A,,16.31,8.45,NA,8.45,,2.37,27.13,27.13,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,91321206,,Reconstruct upper jaw bone,A,,15.20,9.19,NA,9.19,,1.76,26.15,26.15,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,91421208,,Augmentation of facial bones,A,,11.13,37.17,,7.64,,1.31,49.61,20.08,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,91521209,,Reduction of facial bones,A,,7.62,15.46,,8.02,,0.93,24.01,16.57,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,91621210,,Face bone graft,A,,11.40,40.96,,8.01,,1.34,53.70,20.75,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,91721215,,Lower jaw bone graft,A,,11.92,110.02,,8.24,,1.41,123.35,21.57,0,090,0.10,0.69,0.21,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,91821230,,Rib cartilage graft,A,,10.89,7.11,NA,7.11,,1.75,19.75,19.75,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00