Billing code 21116: TMJ arthrographyMedicare rate & RVUs in Oregon
Contrast injection into a temporomandibular joint with radiographic assessment is reported to evaluate suspected intra-articular TMJ pathology.
Medicare pays $220.49–$243.16 for 21116 in the office in Oregon, from Rest Of Oregon to Portland. 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 21116 covers
This service places contrast material into a temporomandibular joint so radiographic imaging can outline the joint space and help assess internal derangement, such as suspected disc-related dysfunction. It is generally performed by a radiologist or an oral and maxillofacial surgeon in an imaging suite or equipped office, with the injection and arthrographic imaging interpreted as part of the service. Clinical use may follow persistent joint pain, clicking, or restricted jaw movement when an arthrogram is selected to investigate an intra-articular problem.
Report 21116 for the joint arthrography procedure, documenting the indication, side, contrast injection, and resulting images or findings. Same-day preoperative and postoperative care is included under its 0-day global period. When this and other procedures are performed in one session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple-procedure reduction. For bilateral work, modifier 50 is paid at 150%. Medicare does not pay an assistant at surgery for this service; 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.
Where 21116 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $243.16 | $39.07 |
| Rest Of Oregon | $220.49 | $37.52 |
How the 21116 rate is calculated
Each of 21116’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 · 21116
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.79Practice expense 5.75Malpractice 0.12
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 21116
The CMS indicators that decide how 21116 is paid alongside other services.
CMS payment indicators · 21116
TMJ arthrography
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
21116 without 50 · national office
$222.45
TMJ arthrography
21116-50 · Bilateral: 150%
$333.68
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
21116 compared with similar codes
Compare codes
21116 vs 70332 vs 70330 vs 70336: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 70332TMJ imaging
- This code describes radiographic examination of TMJ arthrography. Code 21116 describes the contrast-injection procedure and includes its radiographic supervision and interpretation.
- 70330TMJ X-ray
- Use 70330 for bilateral TMJ radiographs without an arthrographic contrast injection; use 21116 when the joint is injected for arthrography.
- 70336Jaw joint MRI
- 70336 describes MRI of the temporomandibular joint or joints. It is a different imaging method from the contrast-injection arthrography represented by 21116.
21116 billing questions
When should 21116 be chosen instead of plain TMJ radiographs?
Use 21116 when contrast is injected into the joint for arthrographic evaluation. Plain TMJ radiographs, such as 70328 or 70330, do not describe that contrast-injection procedure.
Does 21116 include the arthrographic imaging?
The service includes radiographic supervision and interpretation associated with the TMJ arthrography. Document the injection and the resulting images or findings; do not assume the same arthrogram imaging is separately reportable.
How is bilateral TMJ work reported?
For bilateral work, report modifier 50; CMS pays the bilateral procedure at 150%.
What happens when 21116 is performed with other procedures in the same session?
The highest-valued procedure is paid in full, and the other procedures are subject to the standard 50% multiple-procedure reduction.
Can an assistant or co-surgeon be reported for 21116?
Medicare does not pay an assistant at surgery for this service. 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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