$1,224.88–$1,300.75
Choose 21246 for reconstruction with an endosteal implant placed within jawbone; choose 21245 when the documented method uses a subperiosteal implant.
On this page
CMS RVU26D · Effective 2026-10-01
21246 Jaw reconstruction Medicare reimbursement rates in Michigan
Reports jaw reconstruction using an endosteal implant, distinguishing it from reconstruction with a subperiosteal implant or other jaw reconstruction methods. Compare 21246 office and facility rates across CMS payment localities in Michigan.
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 21246 in Michigan?
Michigan 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
No supported rate
Facility setting
$750.90–$799.81
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.
Reconstructive surgery
About 21246: Jaw reconstruction with endosteal implant
Reports jaw reconstruction using an endosteal implant, distinguishing it from reconstruction with a subperiosteal implant or other jaw reconstruction methods.
This service reconstructs the mandible or maxilla using an endosteal implant placed within the jawbone. Oral and maxillofacial surgeons and other surgeons performing jaw reconstruction may use it when the operative plan calls for this implant approach. The procedure is generally performed in a surgical facility; the operative report should identify the jaw site, reconstructive need, and implant method.
Select this code when the documented reconstruction uses an endosteal implant, rather than a subperiosteal implant or a different reconstructive method. It has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure case, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% 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 21246
- 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 RVU12.60 · 55%
- Practice expense (office) RVU8.56 · 37%
- Malpractice RVU1.83 · 8%
25
Medicare services in 2024 · #5775 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.
21246 compared with similar codes
Office rates for Michigan, from the same CMS release.
$981.35–$1,038.47
21248 identifies endosteal implant reconstruction for a partially edentulous arch; this code describes jaw reconstruction with an endosteal implant without that arch qualifier.
$1,352.16–$1,432.37
21249 identifies endosteal implant reconstruction for a completely edentulous arch; use this code when the documented reconstruction does not fit that specified circumstance.
21247
No office rateLower jaw reconstruction
21247 is the bone-graft reconstruction approach. This code is selected when the operative method is reconstruction with an endosteal implant.
Compare 21246 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
Detroit →
Office / nonfacility
Unavailable
Facility
$799.81
Rest Of Michigan →
Office / nonfacility
Unavailable
Facility
$750.90
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21246 billing questions
How does this differ from 21245?
This code is for jaw reconstruction using an endosteal implant placed within bone. Code 21245 is for reconstruction using a subperiosteal implant.
When should 21248 or 21249 be considered instead?
Those codes address endosteal implant reconstruction based on whether the arch is partially or completely edentulous. Use the code that matches the documented clinical situation and the applicable descriptor.
What documentation supports this code?
The operative report should establish the jaw site, the reconstructive purpose, and use of an endosteal implant. Document the specific method clearly enough to distinguish it from subperiosteal implant reconstruction.
Can modifier 50 be used for bilateral jaw work?
Modifier 50 is inappropriate for this code. Report the service according to the code descriptor and the documented procedure.
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 co-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.
1,92221243,,Reconstruction of jaw joint,A,,23.92,16.40,NA,16.40,,3.28,43.60,43.60,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,92321244,,Reconstruction of lower jaw,A,,13.28,11.65,NA,11.65,,1.94,26.87,26.87,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,92421245,,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