21423 Optx palatal/max fracture complicated
Also known as: complex maxilla fracture ORIF, palate fracture complex reconstruction
Open treatment of palatal and maxillary fracture with complex reconstruction. Surgical fixation of complicated palatal and maxillary fractures with extensive comminution or bone loss requiring sophisticated reconstruction techniques.
In Plain Language
complex upper jaw fracture surgery; major palate and jaw reconstruction
Clinical Context
Used for high-complexity palatal and maxillary injuries with multiple fracture lines, comminution, or associated soft tissue trauma. Requires advanced fixation techniques and often multidisciplinary approach for optimal functional and aesthetic outcomes.
RVU Breakdown
| Work RVU | 10.58 |
| Total RVU | 10.58 |
Est. Medicare Payment
National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).
Billing & Documentation
As a surgical CPT code, proper documentation must include the operative report detailing the procedure performed, patient positioning, approach, findings, and any complications. This code has a 90-day global period, which includes the day of the procedure, 1 day preoperative, and 90 days of postoperative care. Ensure the diagnosis code (ICD-10) supports medical necessity for the procedure.
How This Code Compares
With a work RVU of 10.58, this code ranks in the 61st percentile among Surgery codes — 1.3x the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 21423?
CPT 21423 (Optx palatal/max fracture complicated) is a Surgery code. Open treatment of palatal and maxillary fracture with complex reconstruction. Surgical fixation of complicated palatal and maxillary fractures with extensive comminution or bone loss requiring sophisticated reconstruction techniques.
What is the wRVU value for CPT 21423?
The work RVU for CPT 21423 is 10.58. This code is primarily used by Oral Surgery, Otolaryngology, Plastic Surgery. It has a 90-day global period.
When is CPT 21423 used?
Used for high-complexity palatal and maxillary injuries with multiple fracture lines, comminution, or associated soft tissue trauma. Requires advanced fixation techniques and often multidisciplinary approach for optimal functional and aesthetic outcomes.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.