$1,370.96
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 Minnesota
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 Minnesota.
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 Minnesota?
Minnesota 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
$1004.08
1 of 1 localities have a supported rate.
Payment area: Minnesota
One mapped payment locality.
Facility setting
$697.51
1 of 1 localities have a supported rate.
Payment area: Minnesota
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.
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 Minnesota, 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.
$4,193.41
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.
1 of 1 payment localities
Minnesota →
Office / nonfacility
$1004.08
Facility
$697.51
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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 21248 in Minnesota.
PPRRVU2026_Oct_nonQPP.csv
1,927
- Code
- 21248
- Physician work
- 12.42
- Practice expense
- 16.71
- Malpractice
- 1.51
GPCI2026.csv
66
- Locality
- Minnesota
- Physician work
- 1.000
- Practice expense
- 1.029
- Malpractice
- 0.296
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 12.42 | × 1.000 | 12.4200 |
| Practice expense | 16.71 | × 1.029 | 17.1946 |
| Malpractice | 1.51 | × 0.296 | 0.4470 |
| Total RVUs | 30.0616 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Minnesota$1004.08
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 12.42 | 1 |
| Practice expense | 16.71 | 1.029 |
| Malpractice | 1.51 | 0.296 |
(12.42 × 1 + 16.71 × 1.029 + 1.51 × 0.296) × $33.4009 = $1004.08
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 12.42 | 1 |
| Practice expense | 7.79 | 1.029 |
| Malpractice | 1.51 | 0.296 |
(12.42 × 1 + 7.79 × 1.029 + 1.51 × 0.296) × $33.4009 = $697.51
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.
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
6314212,MA,99,REST OF MASSACHUSETTS,1.016,1.053,0.797
6408202,MI,01,DETROIT,1.000,0.965,1.686
6508202,MI,99,REST OF MICHIGAN,1.000,0.913,1.129
6606202,MN,00,MINNESOTA,1.000,1.029,0.296
6707302,MS,00,MISSISSIPPI,1.000,0.861,0.739
6805302,MO,02,METROPOLITAN KANSAS CITY,1.000,0.939,0.977
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002