No office rate
21431 is for closed treatment. This code is for open treatment with wiring.
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CMS RVU26D · Effective 2026-10-01
21432 Craniofacial repair Medicare reimbursement rates in Minnesota
Reports open reduction of a craniofacial separation fracture with wire fixation, when the operative approach and fixation match this treatment level. Compare 21432 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 21432 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
No supported rate
Facility setting
$644.26
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.
Maxillofacial surgery
About 21432: Open craniofacial separation repair with wiring
Reports open reduction of a craniofacial separation fracture with wire fixation, when the operative approach and fixation match this treatment level.
This code describes open surgical treatment of a craniofacial separation fracture, commonly associated with a Le Fort III injury that separates the midface from the cranial base. The surgeon exposes and repositions the separated facial bones and uses wiring for fixation. Oral and maxillofacial, plastic, otolaryngology, or craniofacial surgeons may perform the repair in a hospital or other surgical facility, often as part of care for significant facial trauma.
Select this code when the operative report supports open treatment with wiring, rather than closed treatment or a more complicated open approach. Documentation should identify the fracture pattern, surgical exposure, reduction, and fixation method. Medicare assigns a 90-day global period, which 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 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 21432
- 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 RVU8.60 · 43%
- Practice expense (office) RVU9.93 · 49%
- Malpractice RVU1.59 · 8%
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.
21432 compared with similar codes
Office rates for Minnesota, from the same CMS release.
No office rate
21433 describes complicated open treatment using multiple approaches. Choose this code when the documented repair is open treatment with wiring without that multiple-approach complexity.
No office rate
21435 applies to complicated treatment involving an intracranial approach and/or external fixation. This code describes open repair with wiring.
No office rate
21423 concerns open treatment of a complicated palatal or maxillary fracture. This code concerns craniofacial separation, a different fracture pattern involving separation of the midface from the cranial base.
Compare 21432 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
Unavailable
Facility
$644.26
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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 21432 in Minnesota.
PPRRVU2026_Oct_nonQPP.csv
1,978
- Code
- 21432
- Physician work
- 8.60
- Practice expense
- 9.93
- Malpractice
- 1.59
GPCI2026.csv
66
- Locality
- Minnesota
- Physician work
- 1.000
- Practice expense
- 1.029
- Malpractice
- 0.296
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.60 | × 1.000 | 8.6000 |
| Practice expense | 9.93 | × 1.029 | 10.2180 |
| Malpractice | 1.59 | × 0.296 | 0.4706 |
| Total RVUs | 19.2886 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Minnesota$644.26
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.6 | 1 |
| Practice expense | 9.93 | 1.029 |
| Malpractice | 1.59 | 0.296 |
(8.6 × 1 + 9.93 × 1.029 + 1.59 × 0.296) × $33.4009 = $644.26
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.
21432 billing questions
How does this differ from 21431?
21431 describes closed treatment of a craniofacial separation. Use 21432 when the fracture is treated through an open approach with wiring.
When would 21433 be a better fit?
21433 is for a complicated open treatment involving multiple approaches. The operative report should support that added complexity rather than open treatment with wiring alone.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 is not suitable.
Is an assistant surgeon payable?
CMS allows payment for an assistant at surgery. Co-surgeons and team surgery are not permitted for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session handled?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction when performed in the same session.
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.
1,97521422,,Optx palatal/max fracture,A,,8.51,7.92,NA,7.92,,1.24,17.67,17.67,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,97621423,,Optx palatal/max fx comp,A,,10.58,9.07,NA,9.07,,1.96,21.61,21.61,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,97721431,,Cltx craniofacial separation,A,,7.70,10.79,NA,10.79,,0.88,19.37,19.37,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,97821432,,Optx cranfcl sep w/wiring,A,,8.60,9.93,NA,9.93,,1.59,20.12,20.12,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,97921433,,Optx cranfcl sep comp mlt,A,,25.63,15.31,NA,15.31,,4.76,45.70,45.70,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,98021435,,Optx crnfc sep comp int&/xtr,A,,19.75,14.36,NA,14.36,,3.66,37.77,37.77,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,98121436,,Optx crnfcl sep comp mlt int,A,,29.54,19.00,NA,19.00,,5.49,54.03,54.03,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,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