Billing code 21230: Rib cartilage graftMedicare rate & RVUs in Oregon
Reports placement of a patient's rib cartilage as a graft to reconstruct or augment the face, chin, nose, or ear.
CMS doesn’t publish an office rate for 21230 in Oregon.
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 21230 covers
This service uses cartilage taken from the patient's rib and shaped for placement in a facial site, such as the nose, chin, face, or ear. Plastic surgeons, otolaryngologists, and oral and maxillofacial surgeons may use it to restore support or contour in reconstructive procedures, including nasal reconstruction after trauma or correction of structural deformity. The operative report should identify the cartilage as autogenous, the recipient site, and the graft's role in the reconstruction.
Report this code for a rib-cartilage graft, not an ear-cartilage graft or a bone graft. It has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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 multiple-procedure reduction. Modifier 50 is inappropriate. 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.
Where 21230 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $676.88 |
| Rest Of Oregon | Unavailable | $641.36 |
How the 21230 rate is calculated
Each of 21230’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 · 21230
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 10.89Practice expense 7.11Malpractice 1.75
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 21230
21230 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21230
Rib cartilage graft
| 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 · 21230
Rib cartilage graft
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
21230 without 51 · national facility
$659.67
Rib cartilage graft
21230-51 · Second procedure: 50%
$329.84
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%).
21230 compared with similar codes
Compare codes
21230 vs 21235 vs 21210 vs 21215: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 21235Cartilage graft
- Choose 21230 for autogenous rib cartilage. Choose 21235 when the graft is autogenous ear cartilage placed in the nose or ear.
- 21210Facial bone graft
- 21230 concerns autogenous rib cartilage placed at a facial site; 21210 concerns a bone graft to the face.
- 21215Bone graft
- 21215 describes a bone graft to the lower jaw. Use 21230 when the graft material is autogenous rib cartilage.
21230 billing questions
When should this code be chosen over 21235?
Use this code when the graft is autogenous rib cartilage. Code 21235 describes an autogenous ear-cartilage graft to the nose or ear.
How does this differ from a facial bone graft?
This code describes a cartilage graft from the patient's rib. Facial or mandibular bone graft codes describe bone grafting rather than costal cartilage.
Can modifier 50 be used for grafts to both sides?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
What documentation supports reporting this code?
Document the autogenous rib-cartilage source, the facial recipient site, and how the graft was used in the reconstruction.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.
Can an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment is allowed only with documentation of medical necessity. 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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