Billing code 21450: Mandibular fracture careMedicare rate & RVUs in Ohio
Reports closed care of a mandibular fracture when the treating clinician manages the fracture without manipulating its alignment or using interdental fixation.
Medicare pays $557.68 for 21450 in the office in Ohio (Ohio). Which amount applies depends on the service address.
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 21450 covers
This service covers closed management of a mandibular fracture without manipulating the fracture fragments. It is typically performed by an oral and maxillofacial surgeon or another clinician qualified to manage facial fractures, with care directed by the fracture’s location, stability, and clinical findings. The fracture is managed without surgical exposure; treatment and follow-up may occur across outpatient and facility settings.
Report the code when the clinician provides fracture care without manipulation, rather than simply evaluating the injury or providing routine advice. The record should identify the mandibular fracture and document the treatment plan and that manipulation or interdental fixation was not performed. A 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others are subject to a 50% reduction. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment requires documented medical necessity; 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.
21450 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | $557.68 | $431.74 |
How the 21450 rate is calculated
Each of 21450’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 · 21450
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 3.62Practice expense 13.87Malpractice 0.41
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 21450
21450 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21450
Mandibular fracture care
| 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) | 0 | Not paid without supporting documentation. |
| 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 · 21450
Mandibular fracture care
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
21450 without 51 · national office
$597.88
Mandibular fracture care
21450-51 · Second procedure: 50%
$298.94
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%).
21450 compared with similar codes
Compare codes
21450 vs 21451 vs 21453 vs 21461 vs 21462: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 21451Mandibular fracture
- Choose 21450 when no manipulation is performed. Choose 21451 when the clinician manipulates the fracture during closed treatment.
- 21453Mandibular fracture care
- 21453 includes interdental fixation as part of closed fracture treatment; 21450 describes treatment without that fixation.
- 21461Mandibular fracture repair
- 21461 is open treatment without interdental fixation. This code is for closed management without manipulation.
- 21462Mandibular fracture repair
- 21462 is open treatment with interdental fixation. This code is for closed management without manipulation or interdental fixation.
21450 billing questions
How does this differ from 21451?
Use 21450 when the fracture is treated without manipulation. Code 21451 describes closed treatment that includes manipulation.
When is 21453 a better fit?
Code 21453 is for closed mandibular fracture treatment with interdental fixation. This code represents treatment without manipulation.
Can modifier 50 be reported for fractures on both sides?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.
Are related fracture-care visits separately reported during the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon be paid for this service?
Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are 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 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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