CPT 21194 Surgery - Musculoskeletal
Reconst lwr jaw w/graft Cost
Body System: Musculoskeletal
Medicare Facility Rate
$1,280
CMS PFS CY2026
Medicare Non-Facility Rate
$1,280
Office/clinic setting
Hospital Outpatient
$6
OPPS rate
Surgery Center (ASC)
$3
ASC rate
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
21.27
Work RVU
13.97
Facility PE RVU
3.07
Malpractice RVU
38.31
Total RVU
Frequently Asked Questions
How much does Reconst lwr jaw w/graft cost?
The Medicare facility rate is $1,280. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $6. Ambulatory surgery center rate: $3.
How much does Reconst lwr jaw w/graft cost without insurance?
Without insurance, you may pay the hospital's chargemaster rate, which is often 300-500% of Medicare. Ask about cash-pay discounts — many facilities offer 20-40% off for self-pay patients. The Medicare baseline for this procedure is $1,280.