CPT 21210
Global 090 ActiveFace bone graft
CPT 21210 Billing & Documentation Guide
CPT code 21210 (Face bone graft) is classified under Surgery (Musculoskeletal) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 11.4, a non-facility practice expense RVU of 40.96, and a malpractice RVU of 1.34, a total non-facility RVU of 53.7 and facility RVU of 20.75. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $1854.66, though rates vary from $1579.02 to $2419.45 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 21210, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 21210 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
90-day global period (major surgery: 1 day pre-op + procedure + 90 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 2 units of 21210 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 21210
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 11.4 | 11.4 |
| Practice Expense RVU | 40.96 | 8.01 |
| Malpractice RVU | 1.34 | 1.34 |
| Total RVU | 53.7 | 20.75 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 21210
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $2037.53 | $735.26 | $1910.67 - $2419.45 | 29 |
| Florida | $1840.56 | $736.33 | $1755.94 - $1918.15 | 3 |
| Georgia | $1740.07 | $690.13 | $1654.47 - $1825.66 | 2 |
| Illinois | $1789.56 | $726.15 | $1699.8 - $1867.79 | 4 |
| Michigan | $1728.42 | $694.99 | $1680.38 - $1776.45 | 2 |
| North Carolina | $1685.81 | $658.99 | $1685.81 - $1685.81 | 1 |
| New York | $1985.92 | $758.14 | $1711.93 - $2114.93 | 5 |
| Ohio | $1674.96 | $670.15 | $1674.96 - $1674.96 | 1 |
| Pennsylvania | $1772.1 | $694.1 | $1678.98 - $1865.21 | 2 |
| Texas | $1771.33 | $687.83 | $1667.32 - $1868.64 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 21210
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 21210 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0904T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 21210
What does CPT code 21210 mean? +
CPT code 21210 represents: Face bone graft. It's in the Surgery (Musculoskeletal) category with a global period of 090.
What is the Medicare reimbursement for CPT 21210? +
The 2026 Medicare national average non-facility payment for CPT 21210 is $1854.66. Rates range from $1579.02 to $2419.45 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 21210? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 21210? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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