Billing code 21320: Nasal fracture treatmentMedicare rate & RVUs in Oregon
Reports closed reduction of a displaced nasal bone fracture when the clinician manipulates the bones and provides stabilization to maintain alignment.
Medicare pays $217.85–$237.55 for 21320 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 21320 covers
This service treats a displaced nasal bone fracture without surgically opening the fracture site. The clinician repositions the nasal bones by manipulation and stabilizes the reduction, for example with an external splint or internal support when used. Otolaryngologists, facial plastic surgeons, and other clinicians experienced in facial trauma commonly perform the treatment in an office or outpatient facility.
Choose this code when the documented treatment includes both manipulation and stabilization; closed manipulation without stabilization is represented by a different code. The record should identify the nasal fracture and describe the reduction and stabilization performed. The service has a 0-day global period, so same-day preoperative and postoperative care is 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. Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery, and 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 21320 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $237.55 | $83.18 |
| Rest Of Oregon | $217.85 | $79.46 |
How the 21320 rate is calculated
Each of 21320’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 · 21320
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.55Practice expense 4.83Malpractice 0.23
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 21320
The CMS indicators that decide how 21320 is paid alongside other services.
CMS payment indicators · 21320
Nasal fracture treatment
| 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) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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 51 · payment effect
With and without the modifier
21320 without 51 · national office
$220.78
Nasal fracture treatment
21320-51 · Second procedure: 50%
$110.39
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%).
21320 compared with similar codes
Compare codes
21320 vs 21315 vs 21325 vs 21330 vs 21337: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 21315Nasal fracture treatment
- 21315 is for closed manipulation without stabilization. Report 21320 when stabilization is also part of the treatment.
- 21325Nasal fracture repair
- 21325 describes open treatment of an uncomplicated nasal fracture. This code is for treatment by closed manipulation with stabilization.
- 21330Nasal fracture repair
- 21330 involves open treatment with skeletal fixation. This code describes closed reduction with stabilization.
- 21337Septal fracture
- 21337 is for closed treatment involving both nasal and septal fractures; 21320 concerns a nasal bone fracture treated with manipulation and stabilization.
21320 billing questions
How does this differ from 21315?
Use 21320 when the closed nasal fracture reduction includes stabilization. Code 21315 represents manipulation without stabilization.
Can modifier 50 be reported?
No. Modifier 50 is inappropriate for this nasal fracture treatment.
Is same-day postoperative care separately reported?
No. The 0-day global period includes same-day preoperative and postoperative care.
How does Medicare handle another procedure performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50%. The reduced line depends on the relative values.
Can an assistant surgeon or co-surgeon be billed?
Medicare does not pay an assistant at surgery for this code. 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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