Billing code 21452: External fixationMedicare rate & RVUs in Utah
Percutaneous mandibular fracture treatment using external fixation is reported when the surgeon stabilizes the fracture with an externally applied frame.
Medicare pays $723.81 for 21452 in the office in Utah (Utah). 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 21452 covers
Code 21452 describes treatment of a mandibular fracture through a percutaneous approach, using pins connected to an external stabilizing frame. An oral and maxillofacial surgeon or another surgeon managing facial trauma typically performs this operative stabilization in a surgical setting. The defining feature is external fixation placed percutaneously, rather than fracture exposure with internal fixation or stabilization by interdental wiring.
Report the code when the operative documentation identifies the mandibular fracture and supports percutaneous placement and use of external fixation. The 90-day major-surgery global period includes the day-before preoperative visit and 90 days of related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. 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.
21452 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | $723.81 | $435.91 |
How the 21452 rate is calculated
Each of 21452’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 · 21452
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.34Practice expense 20.23Malpractice 0.35
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 21452
21452 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21452
External fixation
| 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 · 21452
External fixation
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
21452 without 51 · national office
$765.55
External fixation
21452-51 · Second procedure: 50%
$382.78
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%).
21452 compared with similar codes
Compare codes
21452 vs 21451 vs 21453 vs 21454 vs 21461: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 21451Mandibular fracture
- 21451 describes closed treatment with manipulation. Choose 21452 when the documented method is percutaneous treatment using external fixation.
- 21453Mandibular fracture care
- 21453 is closed treatment with interdental fixation, such as fixation between teeth. 21452 uses percutaneous external fixation.
- 21454Mandibular fracture repair
- Both involve external fixation, but 21454 is for open treatment. 21452 is for percutaneous treatment.
- 21461Mandibular fracture repair
- 21461 describes open mandibular fracture treatment without interdental fixation. 21452 is distinguished by percutaneous treatment with an external frame.
21452 billing questions
How does 21452 differ from 21454?
21452 is for percutaneous treatment with external fixation. 21454 describes open treatment of a mandibular fracture with external fixation.
When is 21453 a better fit?
Use 21453 for closed treatment with interdental fixation. Code 21452 describes percutaneous stabilization using an external frame.
Are related postoperative visits included?
Yes. The 90-day major-surgery global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be reported?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
What documentation supports reporting 21452?
The operative note should identify the mandibular fracture and describe the percutaneous approach and external fixation used to stabilize it.
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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