$1,900.55–$2,014.88
Both describe open treatment of mandibular fractures. Choose 21462 when interdental fixation is used; 21461 is for treatment without it.
On this page
CMS RVU26D · Effective 2026-10-01
21461 Mandibular fracture repair Medicare reimbursement rates in Michigan
Reports operative reduction and stabilization of a mandibular fracture when the surgeon treats it openly without using interdental fixation. Compare 21461 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 21461 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
$1671.28–$1770.76
2 of 2 localities have a supported rate.
Facility setting
$921.72–$978.50
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 21461: Open mandibular fracture treatment without interdental fixation
Reports operative reduction and stabilization of a mandibular fracture when the surgeon treats it openly without using interdental fixation.
This service covers operative exposure, alignment, and stabilization of a fractured mandible without fastening the teeth or dental arches together for fixation. Oral and maxillofacial surgeons, otolaryngologists, and plastic surgeons may perform it in an operating room, commonly for fractures requiring open reduction and stabilization. Plate-and-screw fixation may be used; the key distinction from the related interdental-fixation code is that fixation between the teeth is not used.
Select the code from the operative report’s fracture treatment and fixation method, not simply from the fracture diagnosis. Document the mandibular fracture site and pattern, the open approach, reduction and stabilization performed, and whether interdental fixation was used. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are subject to the standard reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 21461
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.08 · 17%
- Practice expense (office) RVU43.24 · 81%
- Malpractice RVU1.31 · 2%
210
Medicare services in 2024 · #4273 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.
21461 compared with similar codes
Office rates for Michigan, from the same CMS release.
$1,048.98–$1,112.54
21453 describes closed treatment with interdental fixation. This code describes open treatment without interdental fixation.
No office rate
21454 is the open-treatment option when external fixation is used. This code is for open treatment without interdental fixation.
No office rate
21470 describes open treatment of a complicated mandibular fracture; 21461 is for open treatment without interdental fixation when the complicated-fracture code is not indicated.
Compare 21461 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
$1770.76
Facility
$978.50
Rest Of Michigan →
Office / nonfacility
$1671.28
Facility
$921.72
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21461 billing questions
How does this differ from 21462?
21461 describes open mandibular fracture treatment without interdental fixation. Use 21462 when interdental fixation is part of the open treatment.
Can the surgeon use plates and screws with this code?
Yes. The distinguishing point is that fixation between the teeth is not used; document the stabilization method in the operative report.
How does this differ from 21453?
21453 is for closed treatment with interdental fixation. This code represents open treatment without interdental fixation.
Is modifier 50 appropriate for fractures on both sides?
No. CMS identifies bilateral adjustment as inapplicable to this code; modifier 50 is inappropriate.
Can an assistant surgeon or co-surgeon be paid?
Medicare does not pay an assistant at surgery for this code. Co-surgeon payment is limited to cases supported by documentation; team surgery is 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.
1,98621452,,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
1,98821454,,Optx mndblr fx xtrnl fixj,A,,7.18,5.49,NA,5.49,,0.82,13.49,13.49,0,090,0.10,0.69,0.21,2,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,98921461,,Optx mndblr fx wo ntrdntl,A,,9.08,43.24,,18.66,,1.31,53.63,29.05,0,090,0.10,0.69,0.21,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,99021462,,Optx mndblr fx w/ntrdntl,A,,10.73,48.58,,20.79,,1.61,60.92,33.13,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,99121465,,Optx mndblr cndylr fx,A,,12.79,7.42,NA,7.42,,1.46,21.67,21.67,0,090,0.10,0.69,0.21,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,99221470,,Optx complicated mndblr fx,A,,17.10,11.46,NA,11.46,,2.56,31.12,31.12,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00