CPT 21195 Surgery - Musculoskeletal
Reconst lwr jaw w/o fixation Cost
Body System: Musculoskeletal
Medicare Facility Rate
$1,217
CMS PFS CY2026
Medicare Non-Facility Rate
$1,217
Office/clinic setting
Hospital Outpatient
$6
OPPS rate
Surgery Center (ASC)
$4
ASC rate
Relative Value Units (RVUs)
Medicare payment = Total RVU × Conversion Factor ($33.40 for CY 2026)
18.68
Work RVU
15.06
Facility PE RVU
2.71
Malpractice RVU
36.45
Total RVU
Frequently Asked Questions
How much does Reconst lwr jaw w/o fixation cost?
The Medicare facility rate is $1,217. Commercial insurance typically pays 150-250% of Medicare rates (varies). Hospital outpatient rate: $6. Ambulatory surgery center rate: $4.
How much does Reconst lwr jaw w/o fixation 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 $1,217.