$158.60
21315 is for closed manipulation without stabilization. Report 21320 when stabilization is also part of the treatment.
On this page
CMS RVU26D · Effective 2026-10-01
21320 Nasal fracture treatment Medicare reimbursement rates in Wyoming
Reports closed reduction of a displaced nasal bone fracture when the clinician manipulates the bones and provides stabilization to maintain alignment. Compare 21320 office and facility rates across CMS payment localities in Wyoming.
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 21320 in Wyoming?
Wyoming 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
$218.78
1 of 1 localities have a supported rate.
Payment area: Wyoming**
One mapped payment locality.
Facility setting
$79.83
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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.
Fracture treatment
About 21320: Closed nasal fracture reduction with stabilization
Reports closed reduction of a displaced nasal bone fracture when the clinician manipulates the bones and provides stabilization to maintain alignment.
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.
CMS billing rules for 21320
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU1.55 · 23%
- Practice expense (office) RVU4.83 · 73%
- Malpractice RVU0.23 · 3%
2.3K
Medicare services in 2024 · #2377 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.
21320 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
21325 describes open treatment of an uncomplicated nasal fracture. This code is for treatment by closed manipulation with stabilization.
No office rate
21330 involves open treatment with skeletal fixation. This code describes closed reduction with stabilization.
$422.19
21337 is for closed treatment involving both nasal and septal fractures; 21320 concerns a nasal bone fracture treated with manipulation and stabilization.
Compare 21320 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
Wyoming** →
Office / nonfacility
$218.78
Facility
$79.83
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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 21320 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
1,944
- Code
- 21320
- Physician work
- 1.55
- Practice expense
- 4.83
- Malpractice
- 0.23
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.55 | × 1.000 | 1.5500 |
| Practice expense | 4.83 | × 1.000 | 4.8300 |
| Malpractice | 0.23 | × 0.740 | 0.1702 |
| Total RVUs | 6.5502 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Wyoming**$218.78
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.55 | 1 |
| Practice expense | 4.83 | 1 |
| Malpractice | 0.23 | 0.74 |
(1.55 × 1 + 4.83 × 1 + 0.23 × 0.74) × $33.4009 = $218.78
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.55 | 1 |
| Practice expense | 0.67 | 1 |
| Malpractice | 0.23 | 0.74 |
(1.55 × 1 + 0.67 × 1 + 0.23 × 0.74) × $33.4009 = $79.83
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.
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 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.
1,94121296,,Revision of jaw muscle/bone,A,,4.66,5.74,NA,5.74,,0.67,11.07,11.07,0,090,0.10,0.69,0.21,2,1,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,94221299,,Unlisted cranfcl&maxlfcl px,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
1,94321315,,Clsd tx nsl fx mnpj wo stblj,A,,0.94,3.69,,0.51,,0.16,4.79,1.61,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,94421320,,Clsd tx nsl fx w/mnpj&stablj,A,,1.55,4.83,,0.67,,0.23,6.61,2.45,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,94521325,,Open tx nose fx uncomplicatd,A,,4.08,7.71,NA,7.71,,0.59,12.38,12.38,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,94621330,,Open tx nose fx w/skele fixj,A,,5.65,8.20,NA,8.20,,0.83,14.68,14.68,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,94721335,,Open tx nose & septal fx,A,,8.79,9.31,NA,9.31,,1.33,19.43,19.43,0,090,0.10,0.69,0.21,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,