$1,436.58–$1,560.01
21248 describes partial jaw reconstruction with an endosteal implant; 21249 is the complete-reconstruction counterpart.
On this page
CMS RVU26D · Effective 2026-10-01
21248 Jaw reconstruction Medicare reimbursement rates in Massachusetts
Reconstructs part of the mandible or maxilla with an implant placed in the jawbone, generally to support restoration of a missing or deficient segment. Compare 21248 office and facility rates across CMS payment localities in Massachusetts.
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 21248 in Massachusetts?
Massachusetts 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
$1049.38–$1143.14
2 of 2 localities have a supported rate.
Facility setting
$735.66–$787.41
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.
Oral and maxillofacial surgery
About 21248: Partial endosteal jaw reconstruction
Reconstructs part of the mandible or maxilla with an implant placed in the jawbone, generally to support restoration of a missing or deficient segment.
This procedure reconstructs a partial area of the mandible or maxilla by placing an endosteal implant within the jawbone to support oral rehabilitation. Oral and maxillofacial surgeons commonly perform it; other surgeons with the appropriate training may perform it in an office or surgical facility. The operative report should establish the jaw involved, the partial extent of reconstruction, and the implant work performed.
Report this code for partial reconstruction; use 21249 when the documented reconstruction is complete. The 90-day global period includes 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 multiple-procedure reduction. Modifier 50 is inappropriate for this code. CMS does not pay an assistant at surgery, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 21248
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU12.42 · 41%
- Practice expense (office) RVU16.71 · 55%
- Malpractice RVU1.51 · 5%
238
Medicare services in 2024 · #4170 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.
21248 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
No office rate
21244 describes mandibular reconstruction using a transosteal bone plate. Choose 21248 when the documented reconstruction uses an endosteal implant instead.
$4,311.57–$4,844.05
21215 reports mandibular bone grafting, not endosteal implant reconstruction. It may be relevant when a separate graft is performed during the same operative session.
Compare 21248 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
Metropolitan Boston →
Office / nonfacility
$1143.14
Facility
$787.41
Rest Of Massachusetts →
Office / nonfacility
$1049.38
Facility
$735.66
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21248 billing questions
How do I choose between 21248 and 21249?
Use 21248 for partial jaw reconstruction and 21249 for complete reconstruction. The operative documentation should support the extent performed.
Can I append modifier 50 for implants on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.
Does the 90-day global include postoperative visits?
It includes related postoperative care for 90 days, as well as the day-before preoperative visit.
Can an assistant surgeon or co-surgeon be billed?
CMS does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What should the operative report document?
Document the mandible or maxilla treated, why reconstruction was needed, the partial extent of reconstruction, and the endosteal implant work performed.
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.
1,92421245,,Reconstruction of jaw,A,,12.79,23.87,,11.31,,1.85,38.51,25.95,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,92521246,,Reconstruction of jaw,A,,12.60,8.56,NA,8.56,,1.83,22.99,22.99,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,92621247,,Reconstruct lower jaw bone,A,,23.76,15.28,NA,15.28,,3.45,42.49,42.49,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,92721248,,Reconstruction of jaw,A,,12.42,16.71,,7.79,,1.51,30.64,21.72,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,92821249,,Reconstruction of jaw,A,,18.30,21.44,,9.64,,2.31,42.05,30.25,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,92921255,,Reconstruct lower jaw bone,A,,18.00,15.95,NA,15.95,,2.61,36.56,36.56,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,93021256,,Reconstruction of orbit,A,,17.22,12.97,NA,12.97,,3.19,33.38,33.38,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00