$730.04
21451 describes closed treatment with manipulation. Choose 21452 when the documented method is percutaneous treatment using external fixation.
On this page
CMS RVU26D · Effective 2026-10-01
21452 External fixation Medicare reimbursement rates in Ohio
Percutaneous mandibular fracture treatment using external fixation is reported when the surgeon stabilizes the fracture with an externally applied frame. Compare 21452 office and facility rates across CMS payment localities in Ohio.
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 21452 in Ohio?
Ohio 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
$706.86
1 of 1 localities have a supported rate.
Payment area: Ohio
One mapped payment locality.
Facility setting
$427.22
1 of 1 localities have a supported rate.
Payment area: Ohio
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.
Oral and maxillofacial surgery
About 21452: Percutaneous mandibular fracture external fixation
Percutaneous mandibular fracture treatment using external fixation is reported when the surgeon stabilizes the fracture with an externally applied frame.
Code 21452 describes treatment of a mandibular fracture through a percutaneous approach, using pins connected to an external stabilizing frame. An oral and maxillofacial surgeon or another surgeon managing facial trauma typically performs this operative stabilization in a surgical setting. The defining feature is external fixation placed percutaneously, rather than fracture exposure with internal fixation or stabilization by interdental wiring.
Report the code when the operative documentation identifies the mandibular fracture and supports percutaneous placement and use of external fixation. The 90-day major-surgery global period includes the day-before preoperative visit and 90 days of related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 21452
- 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 RVU2.34 · 10%
- Practice expense (office) RVU20.23 · 88%
- Malpractice RVU0.35 · 2%
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.
21452 compared with similar codes
Office rates for Ohio, from the same CMS release.
$1,045.02
21453 is closed treatment with interdental fixation, such as fixation between teeth. 21452 uses percutaneous external fixation.
No office rate
Both involve external fixation, but 21454 is for open treatment. 21452 is for percutaneous treatment.
$1,665.99
21461 describes open mandibular fracture treatment without interdental fixation. 21452 is distinguished by percutaneous treatment with an external frame.
Compare 21452 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
Ohio →
Office / nonfacility
$706.86
Facility
$427.22
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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 21452 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
1,986
- Code
- 21452
- Physician work
- 2.34
- Practice expense
- 20.23
- Malpractice
- 0.35
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.34 | × 1.000 | 2.3400 |
| Practice expense | 20.23 | × 0.913 | 18.4700 |
| Malpractice | 0.35 | × 1.008 | 0.3528 |
| Total RVUs | 21.1628 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Ohio$706.86
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.34 | 1 |
| Practice expense | 20.23 | 0.913 |
| Malpractice | 0.35 | 1.008 |
(2.34 × 1 + 20.23 × 0.913 + 0.35 × 1.008) × $33.4009 = $706.86
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.34 | 1 |
| Practice expense | 11.06 | 0.913 |
| Malpractice | 0.35 | 1.008 |
(2.34 × 1 + 11.06 × 0.913 + 0.35 × 1.008) × $33.4009 = $427.22
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.
21452 billing questions
How does 21452 differ from 21454?
21452 is for percutaneous treatment with external fixation. 21454 describes open treatment of a mandibular fracture with external fixation.
When is 21453 a better fit?
Use 21453 for closed treatment with interdental fixation. Code 21452 describes percutaneous stabilization using an external frame.
Are related postoperative visits included?
Yes. The 90-day major-surgery global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be reported?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
What documentation supports reporting 21452?
The operative note should identify the mandibular fracture and describe the percutaneous approach and external fixation used to stabilize it.
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.
1,98321445,,Optx mndblr/max alv ridge fx,A,,6.10,15.76,,10.18,,0.69,22.55,16.97,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,98421450,,Cltx mndblr fx w/o mnpj,A,,3.62,13.87,,9.74,,0.41,17.90,13.77,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,98521451,,Cltx mndblr fx w/mnpj,A,,5.51,17.22,,12.08,,0.62,23.35,18.21,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,98621452,,Perq tx mndblr fx xtrnl fixj,A,,2.34,20.23,,11.06,,0.35,22.92,13.75,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,98721453,,Cltx mndblr fx ntrdntl fixj,A,,6.47,26.10,,19.25,,0.98,33.55,26.70,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,98821454,,Optx mndblr fx xtrnl fixj,A,,7.18,5.49,NA,5.49,,0.82,13.49,13.49,0,090,0.10,0.69,0.21,2,0,0,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,98921461,,Optx mndblr fx wo ntrdntl,A,,9.08,43.24,,18.66,,1.31,53.63,29.05,0,090,0.10,0.69,0.21,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703