21196
Reconst lwr jaw w/fixation
Code typePrimary
Payment statusActive (A)
Global period90-day
Whole-Procedure Pricing
Line
Qty
Global fee
Pro fee
Primary21196Reconst lwr jaw w/fixation
1
$1,296.62
$1,296.62
RVU Breakdown
Component
Office
Facility
Work
20.31
20.31
Practice expense
15.56
15.56
Malpractice
2.95
2.95
Total RVU
38.82
38.82
Payment Policy & Modifiers
Allowed adjustments
Bilateral -50Built in
The fee already assumes a bilateral service — modifier 50 doesn't change payment.
Multiple procedure MPPRApplies
When billed with other procedures the same day: highest-valued paid 100%, the rest 50%.
Assistant surgeon -80/81/8216%
Assistant at surgery (mod 80/81/82) is paid at 16% of the fee schedule amount.
Co-surgeons -6262.5% each
Co-surgeons paid (62.5% each) if medical necessity is documented.
Not applicable to this code
Team surgeon -66Prof / tech split