No office rate
Use 21347 when multiple operative approaches are used. Code 21346 describes open nasomaxillary fracture repair with fixation.
On this page
CMS RVU26D · Effective 2026-10-01
21347 Nasomaxillary fracture repair Medicare reimbursement rates in Pennsylvania
Reports open repair of a LeFort II-pattern nasomaxillary fracture when the surgeon uses multiple surgical approaches to expose and reduce the fracture. Compare 21347 office and facility rates across CMS payment localities in Pennsylvania.
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 21347 in Pennsylvania?
Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$900.07–$977.36
2 of 2 localities have a supported rate.
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.
Maxillofacial fracture surgery
About 21347: Open nasomaxillary fracture repair, multiple approaches
Reports open repair of a LeFort II-pattern nasomaxillary fracture when the surgeon uses multiple surgical approaches to expose and reduce the fracture.
This service is open surgical repair of a LeFort II-pattern fracture involving the central midface, including the nasal and maxillary structures. The surgeon exposes and reduces the fracture through multiple operative approaches. Oral and maxillofacial surgeons, facial plastic surgeons, and otolaryngologists may perform the repair, commonly in a hospital operating room after significant facial trauma.
Choose this code when the operative report supports the fracture pattern and use of multiple approaches; the number of approaches, not simply the number of fracture lines, distinguishes it from related repair codes. Document the injury, reduction, and approaches used. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 21347
- 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 may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU13.19 · 47%
- Practice expense (office) RVU13.01 · 46%
- Malpractice RVU1.92 · 7%
55
Medicare services in 2024 · #5293 by national volume
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.
21347 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
Code 21348 is the related open repair when bone grafting distinguishes the service; 21347 is identified by multiple approaches.
$759.09–$831.82
Code 21345 describes closed treatment of a nasomaxillary fracture. Use 21347 for the documented open repair with multiple approaches.
Compare 21347 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.
2 of 2 payment localities
Metropolitan Philadelphia →
Office / nonfacility
Unavailable
Facility
$977.36
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$900.07
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21347 billing questions
How is 21347 distinguished from 21346?
21347 is selected when the open repair uses multiple surgical approaches. Code 21346 describes a related open repair with fixation; follow the specific operative service documented.
Does multiple approaches mean multiple fracture lines?
No. The distinction is the use of multiple operative approaches to expose and repair the nasomaxillary fracture, not merely the presence of multiple fracture lines.
Can modifier 50 be reported when both sides are involved?
No. CMS identifies bilateral adjustment as inappropriate for this code, even when the injury involves both sides.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is 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 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.
1,95421344,,Open tx compl front sinus fx,A,,21.03,12.31,NA,12.31,,3.05,36.39,36.39,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,95521345,,Closed tx nose/jaw fx,A,,8.83,13.81,,6.89,,1.29,23.93,17.01,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,95621346,,Opn tx nasomax fx w/fixj,A,,11.16,14.57,NA,14.57,,1.63,27.36,27.36,0,090,0.10,0.69,0.21,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,95721347,,Opn tx nasomax fx multple,A,,13.19,13.01,NA,13.01,,1.92,28.12,28.12,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,95821348,,Opn tx nasomax fx w/graft,A,,17.08,8.81,NA,8.81,,2.49,28.38,28.38,0,090,0.10,0.69,0.21,2,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,95921355,,Perq tx malar fracture,A,,4.34,8.38,,3.85,,0.62,13.34,8.81,0,010,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,96021356,,Opn tx dprsd zygomatic arch,A,,4.71,12.17,,5.78,,0.88,17.76,11.37,0,010,0.10,0.80,0.10,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00