No office rate
Both address nasoethmoid complex fractures, but 21338 is for open treatment without internal fixation; 21340 is for percutaneous treatment.
On this page
CMS RVU26D · Effective 2026-10-01
21340 Nasoethmoid fracture Medicare reimbursement rates in Rhode Island
Reports percutaneous treatment of a nasoethmoid complex fracture when the surgeon manipulates the fracture through a percutaneous approach rather than open exposure. Compare 21340 office and facility rates across CMS payment localities in Rhode Island.
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 21340 in Rhode Island?
Rhode Island has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$668.87
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
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.
Facial fracture treatment
About 21340: Percutaneous nasoethmoid fracture treatment
Reports percutaneous treatment of a nasoethmoid complex fracture when the surgeon manipulates the fracture through a percutaneous approach rather than open exposure.
This code represents treatment of a fracture involving the nasoethmoid complex through a percutaneous approach, with fracture manipulation and stabilization as part of the treatment. It is distinct from open repair, which requires surgical exposure of the fracture. Otolaryngologists, facial plastic surgeons, plastic surgeons, and oral and maxillofacial surgeons may perform this work, often in an operating room after facial trauma such as a motor vehicle collision.
Choose the code based on the documented fracture site and treatment approach, not simply the presence of a nasal fracture. The operative report should identify the nasoethmoid injury and describe the percutaneous manipulation and stabilization performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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. An assistant is payable only when medical necessity is documented; co-surgeons and team surgery are not permitted.
CMS billing rules for 21340
- 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 is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU11.20 · 57%
- Practice expense (office) RVU6.93 · 35%
- Malpractice RVU1.63 · 8%
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.
21340 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
21339 describes open treatment with internal fixation. Choose 21340 when the documented treatment is percutaneous rather than open.
$164.08
21315 concerns closed treatment of a nasal fracture. Use 21340 when the treated injury is a nasoethmoid complex fracture managed percutaneously.
$226.26
21320 is for closed nasal fracture treatment with manipulation and stabilization; 21340 identifies percutaneous treatment of a nasoethmoid complex fracture.
Compare 21340 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.
1 of 1 payment localities
Rhode Island →
Office / nonfacility
Unavailable
Facility
$668.87
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 21340 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
1,952
- Code
- 21340
- Physician work
- 11.20
- Practice expense
- 6.93
- Malpractice
- 1.63
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 11.20 | × 1.019 | 11.4128 |
| Practice expense | 6.93 | × 1.033 | 7.1587 |
| Malpractice | 1.63 | × 0.892 | 1.4540 |
| Total RVUs | 20.0254 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$668.87
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 11.2 | 1.019 |
| Practice expense | 6.93 | 1.033 |
| Malpractice | 1.63 | 0.892 |
(11.2 × 1.019 + 6.93 × 1.033 + 1.63 × 0.892) × $33.4009 = $668.87
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
21340 billing questions
How does this differ from codes 21338 and 21339?
21340 describes percutaneous treatment of a nasoethmoid complex fracture. Codes 21338 and 21339 describe open treatment, with 21339 involving internal fixation.
Can this be reported for an isolated nasal bone fracture?
Use this code for a nasoethmoid complex fracture treated percutaneously, not merely because the nose is fractured. Codes 21315 and 21320 concern closed treatment of nasal fractures.
Is modifier 50 appropriate when both sides are involved?
No. CMS does not apply a bilateral adjustment to this code, and modifier 50 is inappropriate.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
When can an assistant be reported?
CMS pays an assistant at surgery only when the record documents medical necessity. Co-surgeons and team surgery are not permitted.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures in the session are subject to the standard multiple procedure reduction.
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.
1,94921337,,Closed tx septal&nose fx,A,,3.31,8.96,,4.63,,0.50,12.77,8.44,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,95021338,,Open nasoethmoid fx w/o fixj,A,,6.70,11.08,NA,11.08,,0.99,18.77,18.77,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,95121339,,Open nasoethmoid fx w/ fixj,A,,8.29,11.46,NA,11.46,,1.21,20.96,20.96,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,95221340,,Perq tx nasoethmoid fx,A,,11.20,6.93,NA,6.93,,1.63,19.76,19.76,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,95321343,,Open tx dprsd front sinus fx,A,,13.96,13.17,NA,13.17,,2.05,29.18,29.18,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,95421344,,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
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537