$643.07–$690.61
Choose 21120 for chin augmentation without a sliding osteotomy. 21123 involves moving the chin segment and augmenting it with an interpositional graft.
On this page
CMS RVU26D · Effective 2026-10-01
21123 Chin augmentation Medicare reimbursement rates in Missouri
Sliding genioplasty with an interpositional bone graft repositions the chin segment while adding projection or height for selected chin deficiencies. Compare 21123 office and facility rates across CMS payment localities in Missouri.
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 21123 in Missouri?
Missouri has 3 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 3 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$727.56–$760.99
3 of 3 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.
Where 21123 pays more and less in Missouri
Craniofacial surgery
About 21123: Sliding genioplasty with interpositional graft
Sliding genioplasty with an interpositional bone graft repositions the chin segment while adding projection or height for selected chin deficiencies.
A surgeon cuts and moves the chin portion of the mandible, then places bone between the repositioned segment and the remaining jaw to augment the chin. This approach may be selected when sliding the bone alone would leave a gap or provide insufficient projection or height. Oral and maxillofacial, plastic, or craniofacial surgeons typically perform the operation in a hospital or ambulatory surgical setting.
Report 21123 when the operative record supports both a sliding chin osteotomy and augmentation with an interpositional graft. Document the osteotomy, the segment’s repositioning, and the graft placement; simple augmentation without sliding or a sliding osteotomy without grafting points to a different code. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team-surgery payment is not permitted.
CMS billing rules for 21123
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU11.06 · 47%
- Practice expense (office) RVU10.62 · 46%
- Malpractice RVU1.61 · 7%
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.
21123 compared with similar codes
Office rates for Missouri, from the same CMS release.
$598.62–$632.44
21121 is a single-piece sliding genioplasty without the graft augmentation represented by 21123.
No office rate
21122 describes sliding genioplasty with two or more osteotomies. 21123 is distinguished by interpositional graft augmentation.
$2,290.46–$2,489.90
21125 addresses augmentation of the mandibular body or angle; 21123 is for sliding repositioning and graft augmentation of the chin.
Compare 21123 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.
3 of 3 payment localities
Metropolitan Kansas City →
Office / nonfacility
Unavailable
Facility
$755.03
Metropolitan St. Louis →
Office / nonfacility
Unavailable
Facility
$760.99
Rest Of Missouri →
Office / nonfacility
Unavailable
Facility
$727.56
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21123 billing questions
How is 21123 different from 21121?
21123 describes a sliding chin osteotomy with interpositional graft augmentation. Use 21121 for a single-piece sliding genioplasty without that graft augmentation.
Can 21123 be reported with 21120 for the same chin?
Do not report a second genioplasty code for the same chin work simply to represent the graft. Choose the code that matches the operation performed.
Should modifier 50 be appended for work on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 does not describe the midline chin procedure.
What documentation supports reporting 21123?
The operative report should identify the sliding osteotomy, how the chin segment was repositioned, and placement of an interpositional bone graft for augmentation.
How does the 90-day global period affect postoperative visits?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team-surgery payment 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.
1,87721120,,Genioplasty augmentation,A,,4.97,15.53,,8.74,,0.92,21.42,14.63,0,090,0.10,0.69,0.21,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,87821121,,Geniop sldg osteot 1,A,,7.61,10.98,,6.10,,0.87,19.46,14.58,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,87921122,,Geniop sldg osteot 2/>,A,,8.49,10.90,NA,10.90,,1.57,20.96,20.96,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,88021123,,Geniop sldg augmentation,A,,11.06,10.62,NA,10.62,,1.61,23.29,23.29,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,88121125,,Augmentation mndblr prostc,A,,10.53,65.97,,6.39,,1.21,77.71,18.13,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,88221127,,Augmentation mndblr b1 grf,A,,12.13,105.28,,7.31,,1.39,118.80,20.83,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,88321137,,Rdctj forehead cntrg only,A,,9.98,8.68,NA,8.68,,1.85,20.51,20.51,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00