Billing code 21127: Mandibular augmentationMedicare rate & RVUs in Washington
Reports surgical augmentation of the mandibular body or angle using a bone graft to address deficient jaw size or contour.
Medicare pays $4,148.57–$4,778.02 for 21127 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). 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 21127 covers
This procedure adds bone graft material to the mandibular body or angle to augment jaw size or contour. Oral and maxillofacial, plastic, or craniofacial surgeons may perform it as a reconstructive operation in a hospital or other surgical setting. The operative report should identify the mandibular site, the reason for augmentation, and the graft used and its placement.
Choose this code when the augmentation is performed with a bone graft, rather than prosthetic material or a chin osteotomy. The service has a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are 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. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation, and team surgery is 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 21127 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $4,148.57 | $702.85 |
| Seattle (King Cnty) | $4,778.02 | $762.93 |
How the 21127 rate is calculated
Each of 21127’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 · 21127
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 12.13Practice expense 105.28Malpractice 1.39
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 21127
21127 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21127
Mandibular augmentation
| 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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 · 21127
Mandibular augmentation
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
21127 without 51 · national office
$3,968.03
Mandibular augmentation
21127-51 · Second procedure: 50%
$1,984.02
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%).
21127 compared with similar codes
Compare codes
21127 vs 21125 vs 21120 vs 21121: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 21125Mandibular augmentation
- The material distinguishes these mandibular augmentation codes: 21127 uses a bone graft, while 21125 uses prosthetic material.
- 21120Chin augmentation
- Code 21120 describes augmentation genioplasty at the chin. Use 21127 for bone-graft augmentation of the mandibular body or angle.
- 21121Sliding genioplasty
- Code 21121 is a sliding genioplasty that repositions the chin; 21127 augments the mandibular body or angle with a bone graft.
21127 billing questions
How do I distinguish this code from 21125?
Use 21127 for mandibular augmentation with a bone graft. Code 21125 describes augmentation using prosthetic material.
Is this the code for chin augmentation?
Not when the service is a genioplasty focused on the chin. Code 21120 is for genioplasty augmentation; 21127 concerns augmentation of the mandibular body or angle with a bone graft.
What should the operative report document?
Document the mandibular body or angle being augmented, the clinical reason for the augmentation, and the bone graft and its placement. These details support selection over prosthetic augmentation or a chin osteotomy.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How is this handled with other procedures in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation.
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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