$533.59–$575.67
Use 21450 for closed mandibular fracture treatment without manipulation or interdental fixation. The use of interdental fixation distinguishes 21453.
On this page
CMS RVU26D · Effective 2026-10-01
21453 Mandibular fracture care Medicare reimbursement rates in Missouri
Closed treatment of a mandibular fracture using interdental fixation, such as arch bars or wiring, when the fracture is managed without surgical exposure. Compare 21453 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 21453 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
$999.45–$1078.82
3 of 3 localities have a supported rate.
Facility setting
$802.22–$861.01
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 21453 pays more and less in Missouri
3 payment localities
$999.45 to $1078.82
Oral and maxillofacial surgery
About 21453: Closed mandibular fracture treatment with interdental fixation
Closed treatment of a mandibular fracture using interdental fixation, such as arch bars or wiring, when the fracture is managed without surgical exposure.
This service treats a broken lower jaw without surgically exposing the fracture site. The clinician aligns or stabilizes the fracture by securing the teeth or dental arches together with interdental fixation, commonly using arch bars or wiring. Oral and maxillofacial surgeons most often perform the procedure; surgeons in related specialties may also manage mandibular fractures in hospital or surgical settings.
Report 21453 when the documented treatment is closed and uses interdental fixation. Distinguish it from closed care without fixation and from procedures that use external fixation or open exposure. The note should identify the mandibular fracture and describe the closed reduction or stabilization and the interdental fixation used. 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. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 21453
- 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU6.47 · 19%
- Practice expense (office) RVU26.10 · 78%
- Malpractice RVU0.98 · 3%
247
Medicare services in 2024 · #4147 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.
21453 compared with similar codes
Office rates for Missouri, from the same CMS release.
$700.00–$752.34
Use 21451 for closed treatment with manipulation when interdental fixation is not used. Report 21453 when interdental fixation is part of the treatment.
$672.00–$733.14
21452 describes percutaneous treatment using external fixation. 21453 is closed treatment stabilized with interdental fixation.
$1,809.46–$1,957.00
21462 is open treatment with interdental fixation, while 21453 is used when the fracture is treated closed.
Compare 21453 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
$1066.67
Facility
$851.83
Metropolitan St. Louis →
Office / nonfacility
$1078.82
Facility
$861.01
Rest Of Missouri →
Office / nonfacility
$999.45
Facility
$802.22
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21453 billing questions
How is 21453 different from 21450 or 21451?
21453 includes interdental fixation as the method of stabilizing the mandibular fracture. Codes 21450 and 21451 describe closed treatment without that fixation, with the distinction between them based on whether manipulation is performed.
Can 21453 be reported with open mandibular fracture treatment?
The treatment approach determines the code: 21453 is for closed treatment with interdental fixation. Open treatment codes apply when the fracture is surgically exposed and treated.
Should modifier 50 be used for bilateral mandibular fractures?
No. CMS identifies bilateral adjustment as inappropriate for 21453, so modifier 50 should not be used.
What documentation supports 21453?
Document the mandibular fracture and the closed treatment performed, including the use of interdental fixation. The record should make the treatment method distinguishable from closed care without fixation or open treatment.
How does the 90-day global period affect postoperative visits?
The global period includes the day-before preoperative visit and 90 days of related postoperative care. Those related services are included in the surgical global package.
When can an assistant-at-surgery be paid?
CMS allows assistant-at-surgery payment only when medical necessity is documented. Co-surgeons and team surgery are not permitted for this code.
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.
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