Billing code 21127: Mandibular augmentationMedicare rate & RVUs in Oregon

Reports surgical augmentation of the mandibular body or angle using a bone graft to address deficient jaw size or contour.

CMS RVU26DEffective Oct 1, 20262 payment localities75 Medicare services in 2024

Medicare pays $3,940.17–$4,352.95 for 21127 in the office in Oregon, from Rest Of Oregon to Portland. Which amount applies depends on the service address.

$3,940.17–$4,352.95Office (non-facility)
$680.98–$717.44Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 21127 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Oregon
  2. What 21127 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 21127 covers

This procedure adds bone graft material to the mandibular body or angle to augment jaw size or contour. Oral and maxillofacial, plastic, or craniofacial surgeons may perform it as a reconstructive operation in a hospital or other surgical setting. The operative report should identify the mandibular site, the reason for augmentation, and the graft used and its placement.

Choose this code when the augmentation is performed with a bone graft, rather than prosthetic material or a chin osteotomy. The service has a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is 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 21127 pays more and less in Oregon

21127 office and facility rates by payment locality
Payment localityOfficeFacility
Portland$4,352.95$717.44
Rest Of Oregon$3,940.17$680.98

How the 21127 rate is calculated

Each of 21127’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 · 21127

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 12.13Practice expense 105.28Malpractice 1.39

118.8000 adjusted RVUs×$33.4009 conversion factor=$3,968.03

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 21127

21127 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21127

Mandibular augmentation

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 21127

Mandibular augmentation

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

21127 without 51 · national office

$3,968.03

Mandibular augmentation

21127-51 · Second procedure: 50%

$1,984.02

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%).

When to use modifier 51

21127 compared with similar codes

Compare codes

21127 vs 21125 vs 21120 vs 21121: national Medicare rates

Swap in your local Medicare rate.

  • 21127
    Mandibular augmentation · 12.13 wRVU
    $3,968.03
  • 21125
    Mandibular augmentation · 10.53 wRVU
    $2,595.58−$1,372.45
  • 21120
    Chin augmentation · 4.97 wRVU
    $715.45−$3,252.58
  • 21121
    Sliding genioplasty · 7.61 wRVU
    $649.98−$3,318.05

How to choose

21125Mandibular augmentation
The material distinguishes these mandibular augmentation codes: 21127 uses a bone graft, while 21125 uses prosthetic material.
21120Chin augmentation
Code 21120 describes augmentation genioplasty at the chin. Use 21127 for bone-graft augmentation of the mandibular body or angle.
21121Sliding genioplasty
Code 21121 is a sliding genioplasty that repositions the chin; 21127 augments the mandibular body or angle with a bone graft.

21127 billing questions

How do I distinguish this code from 21125?

Use 21127 for mandibular augmentation with a bone graft. Code 21125 describes augmentation using prosthetic material.

Is this the code for chin augmentation?

Not when the service is a genioplasty focused on the chin. Code 21120 is for genioplasty augmentation; 21127 concerns augmentation of the mandibular body or angle with a bone graft.

What should the operative report document?

Document the mandibular body or angle being augmented, the clinical reason for the augmentation, and the bone graft and its placement. These details support selection over prosthetic augmentation or a chin osteotomy.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

How is this handled with other procedures in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation.

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
RVUs for 21127PPRRVU2026_Oct_nonQPP.csv, line 1,882 (RVU26D)

Open CMS sourceHow we calculate rates

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