Billing code 21246: Jaw reconstructionMedicare rate & RVUs in Nevada
Reports jaw reconstruction using an endosteal implant, distinguishing it from reconstruction with a subperiosteal implant or other jaw reconstruction methods.
CMS doesn’t publish an office rate for 21246 in Nevada.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 21246 covers
This service reconstructs the mandible or maxilla using an endosteal implant placed within the jawbone. Oral and maxillofacial surgeons and other surgeons performing jaw reconstruction may use it when the operative plan calls for this implant approach. The procedure is generally performed in a surgical facility; the operative report should identify the jaw site, reconstructive need, and implant method.
Select this code when the documented reconstruction uses an endosteal implant, rather than a subperiosteal implant or a different reconstructive method. It has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure case, 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.
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.
21246 in Nevada**
| Payment locality | Office | Facility |
|---|---|---|
| Nevada** | Unavailable | $757.96 |
How the 21246 rate is calculated
Each of 21246’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 21246
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 12.60Practice expense 8.56Malpractice 1.83
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 21246
21246 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21246
Jaw reconstruction
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 21246
Jaw reconstruction
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
21246 without 51 · national facility
$767.89
Jaw reconstruction
21246-51 · Second procedure: 50%
$383.95
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
21246 compared with similar codes
Compare codes
21246 vs 21245 vs 21248 vs 21249 vs 21247: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 21245Jaw reconstruction
- Choose 21246 for reconstruction with an endosteal implant placed within jawbone; choose 21245 when the documented method uses a subperiosteal implant.
- 21248Jaw reconstruction
- 21248 identifies endosteal implant reconstruction for a partially edentulous arch; this code describes jaw reconstruction with an endosteal implant without that arch qualifier.
- 21249Jaw reconstruction
- 21249 identifies endosteal implant reconstruction for a completely edentulous arch; use this code when the documented reconstruction does not fit that specified circumstance.
- 21247Lower jaw reconstruction
- 21247 is the bone-graft reconstruction approach. This code is selected when the operative method is reconstruction with an endosteal implant.
21246 billing questions
How does this differ from 21245?
This code is for jaw reconstruction using an endosteal implant placed within bone. Code 21245 is for reconstruction using a subperiosteal implant.
When should 21248 or 21249 be considered instead?
Those codes address endosteal implant reconstruction based on whether the arch is partially or completely edentulous. Use the code that matches the documented clinical situation and the applicable descriptor.
What documentation supports this code?
The operative report should establish the jaw site, the reconstructive purpose, and use of an endosteal implant. Document the specific method clearly enough to distinguish it from subperiosteal implant reconstruction.
Can modifier 50 be used for bilateral jaw work?
Modifier 50 is inappropriate for this code. Report the service according to the code descriptor and the documented procedure.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons and team surgery are not permitted for this code under the CMS rules provided.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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