CPT 21110Surgery

Interdental fixation

CPT code 21110 covers interdental fixation, a procedure where the upper and lower teeth are wired or banded together to stabilize a broken jaw or facial bones while they heal.

Showing rates for

National Average

Base Medicare rate

$825.81

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

5.99

PE RVU (NF)

18.94

MP RVU

0.6

Total RVU

25.53

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Verify place of service and use correct rate (non-facility $825.81 vs facility $685.75)
Impact: $140.06 difference between settings - ensure POS code matches actual location
Document whether arch bars are pre-fabricated or custom-bent, and number of teeth involved in fixation
Impact: Insufficient documentation is primary denial reason; detailed operative note prevents $825.81 payment loss
When billing with open reduction codes (21421-21423), ensure fixation is separately identifiable and not included in fracture repair
Impact: Unbundling violations can trigger audits; use modifier 59 only when truly distinct and documented separately
For removal of interdental fixation, bill appropriate E/M or use 20670 if hardware removal is separately performed
Impact: 21110 includes initial placement only; removal during global period may not be separately reimbursable
Verify trauma diagnosis codes (S02.6xx series for mandibular fracture) are documented with appropriate seventh character for encounter type
Impact: Incomplete ICD-10 codes trigger automated denials delaying payment by 30-60 days
For emergency department procedures, ensure facility bills separately and physician bills only professional component
Impact: Duplicate billing between facility and professional can result in recoupment of entire $825.81

Common denials

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 21110 in 2025?

The 2025 Medicare national average reimbursement for CPT 21110 is $825.81 for non-facility settings and $685.75 for facility settings, based on 25.53 total RVUs and a conversion factor of 32.3465.

Can CPT 21110 be billed with jaw fracture repair codes?

CPT 21110 may be billed with open reduction codes (21421-21470) only when interdental fixation is performed as a distinctly separate procedure beyond the fracture repair itself. Documentation must clearly show both procedures were medically necessary and performed on different anatomical structures. Modifier 59 may be required, and many payers consider interdental fixation bundled into ORIF codes.

What diagnosis codes support medical necessity for CPT 21110?

Primary diagnosis codes include mandibular fracture (S02.609-S02.65x), maxillary fracture (S02.40x-S02.42x), multiple facial fractures (S02.7xx), or temporomandibular joint disorders requiring immobilization (M26.6x). The seventh character indicating episode of care (A for initial, D for subsequent) is required for trauma codes.

How do you bill for removal of interdental fixation?

Removal of interdental fixation is typically included in the global period of 21110 and not separately billable. If removal requires return to operating room or is significantly complex, code 20670 (removal of implant) may be appropriate with modifier 78. Simple office-based removal during follow-up is usually included in post-operative care.

What is the global period for CPT 21110?

CPT 21110 has a 90-day global period, meaning routine follow-up care including fixation removal (if performed within 90 days) is included in the reimbursement. Complications or unrelated services during this period may be billed separately with appropriate modifiers 24 (E/M) or 79 (unrelated procedure).

What are the RVU values for CPT code 21110?

For 2025, CPT 21110 has a work RVU of 5.99, non-facility practice expense RVU of 18.94, facility practice expense RVU of 14.61, and malpractice RVU of 0.6, totaling 25.53 RVUs for non-facility settings.

Can emergency department physicians bill CPT 21110?

Yes, emergency department physicians can bill CPT 21110 when they personally perform interdental fixation, but they must bill only the professional component using the facility rate ($685.75). The hospital bills separately for the facility component. Documentation must meet same standards as when performed by oral surgeons, including detailed operative note and medical necessity.