21435 Optx crnfc sep complicated int and/or xtr
Also known as: Le Fort with external fixator, craniofacial separation ORIF with external fixation
Open treatment of craniofacial separation with both internal and external fixation. Surgical management of complex craniofacial separation combining intraoral internal fixation with extraoral external fixation devices for maximum stability.
In Plain Language
complex face fracture with external and internal fixation; upper face reconstruction with multiple fixation types
Clinical Context
Used for severely comminuted or contaminated craniofacial separations where combined fixation provides optimal stability. External fixation aids reduction and maintains alignment during healing while internal fixation addresses specific fracture sites.
RVU Breakdown
| Work RVU | 19.75 |
| Total RVU | 19.75 |
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 19.75, this code ranks in the 82nd percentile among Surgery codes — 2.5x the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 21435?
CPT 21435 (Optx crnfc sep complicated int and/or xtr) is a Surgery code. Open treatment of craniofacial separation with both internal and external fixation. Surgical management of complex craniofacial separation combining intraoral internal fixation with extraoral external fixation devices for maximum stability.
What is the wRVU value for CPT 21435?
The work RVU for CPT 21435 is 19.75. This code is primarily used by Oral Surgery, Otolaryngology, Plastic Surgery. It has a 90-day global period.
When is CPT 21435 used?
Used for severely comminuted or contaminated craniofacial separations where combined fixation provides optimal stability. External fixation aids reduction and maintains alignment during healing while internal fixation addresses specific fracture sites.
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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.