Oral & Maxillofacial Surgery reimbursement rates by service line
Compare payer-published oral & maxillofacial surgery benchmarks for jaw surgery; reconstruction; lesion procedures; office visits.
Compare national oral & maxillofacial surgery rates by payer
Use the reference codes to compare payer benchmarks, then explore jaw surgery; reconstruction; lesion procedures; office visits. Each rate represents a specific billing code and comparison cohort, rather than a complete episode of care.
Aetna state variation for 21196
National 21196 rate distribution
Each marker shows the national median published rate across billing entities for that payer.
National 21196 rates by payer
| Payer | Rate period | Provider entities | P25 | Median | P75 | P90 | Average |
|---|---|---|---|---|---|---|---|
| Aetna | Jun–Jul 2026 | 1,238 | $1,484.14 | $1,820.50 | |||
| Cigna | Jun–Jul 2026 | 840 | $2,206.85 | $2,770.82 | |||
| United | Jun–Jul 2026 | 899 | $2,155.36 | $2,620.27 | |||
| Anthem | Jun–Jul 2026 | 751 | $2,446.10 | $3,189.30 |
- Source
- Negotiated or fee-schedule amounts published directly by payers in their machine-readable files.
- Rate shown
- Published commercial rate for bilateral sagittal split mandibular osteotomy (21196).
- Method
- Eligible rates are grouped by payer and billing entity so the benchmarks use a consistent service and billing basis.
The state map uses one consistent Aetna reference series; it does not average already-aggregated payer values. The service-line table keeps unlike codes, settings, and billing units in separate comparisons.
How do specific oral & maxillofacial surgery providers compare?
Compare named provider rates with the selected payer's median and percentile distribution.
National: Oral & Maxillofacial Surgery provider benchmarks (CPT 21196)
| Provider entity | State | Size | $ per service | Gap to median | Position in Aetna range |
|---|---|---|---|---|---|
| BISTATE ORAL AND FACIAL SURGERY LLCNPI 1891938296 · Tax ID 811152961 | IL | 6 | $1,207 | -$277.14 | Below P25 |
| UNMC PHYSICIANSNPI 1891753067 · Tax ID 470785575 | NE | 5,358 | $1,339.14 | -$145 | Below P25 |
| DENTAL MANAGEMENT GROUP LLCNPI 1679539514 · Tax ID 261598988 | CO | 5 | $1,429.24 | -$54.91 | P25 to median |
| SKY DENTAL SIAMAK JAFARI DENTAL CORPORATIONNPI 1346397221 · Tax ID 201258020 | CA | 47 | Median to P75 | ||
| SOUTHERN MAINE ORAL AND MAXILLOFACIAL SURGERY PANPI 1841208519 · Tax ID 010450893 | ME | 10 | Median to P75 | ||
| NUVANCE HEALTH MEDICAL PRACTICE CT INCNPI 1285029322 · Tax ID 061137531 | NY | 1,922 | Above P75 |
Choose one state to replace the mixed-state examples with payer-specific provider rates across all three preview codes.
No trial or data preparation required.Explore oral & maxillofacial surgery services
Compare codes within the same billing context. A reported billing unit may describe a timed service, supply quantity, daily service or procedure; it does not always mean one visit.
| Service line / billing code | Aetna | Cigna | United | Anthem |
|---|---|---|---|---|
$ per reported billing unit · 13 codes | ||||
21196Bilateral sagittal split mandibular osteotomy | $1,820.50 | $2,770.82 | $2,620.27 | $3,189.30 |
21215Mandibular bone graft | $3,072.34 | $5,223.43 | $7,211.86 | $4,946.23 |
21210Reconstruction With Bone Graft | $1,701.65 | $2,740.14 | $3,553.49 | $3,064.18 |
21040Excision of benign cyst or tumor of mandible | $544.35 | $826.35 | $900.82 | $930.38 |
21145Reconstruction Midface | $1,882.90 | $2,940.47 | $2,814.94 | $3,343.70 |
21141Reconstruction Midface | $1,724.30 | $2,584.86 | $2,433.55 | $2,984.78 |
21085Prepare Mouth Prosthesis | $759.20 | $1,206.37 | $1,293.38 | $1,360.74 |
21147LeFort I osteotomy in multiple pieces with graft | $2,100.63 | $3,209.95 | $3,083.31 | $3,659.53 |
21030Excision of benign tumor or cyst of maxilla or zygoma by enucleation and curettage | $538.99 | $838.69 | $894.98 | $965.78 |
40812Excision of lesion of mucosa and submucosa of vestibule of mouth | $299.30 | $452.16 | $516.04 | $552.60 |
21046Remove Mandible Cyst Complex | $1,286.47 | $1,979.30 | $1,898.57 | $2,220.42 |
21248Reconstruct Jaw And Teeth | $1,122.45 | $1,779.53 | $1,876.39 | $2,039.64 |
29804Jaw Joint Surgery With A Scope | $774.67 | $1,188.48 | $1,152.92 | $1,380.96 |
$ per reported billing unit · 6 codes | ||||
99202New patient office visit, level 2 | $67.73 | $105.28 | $117.34 | $128.50 |
99203New patient office visit, level 3 | $101 | $162.98 | $171.37 | $189.68 |
99204New patient office visit, level 4 | $157.71 | $251.13 | $258.96 | $286.43 |
99213Established patient office visit, level 3 | $72.83 | $119.88 | $121.80 | $133.42 |
99214Established patient office visit, level 4 | $106.76 | $174.83 | $175.75 | $189.77 |
99205New patient office visit, level 5 | $202.75 | $328.31 | $330.41 | $365.86 |
Tell us the services, payers, states, and networks you need. We'll confirm available coverage and scope the comparison on a 20-minute call.
Book a 20-min scoping call No trial or data preparation required.How to interpret these benchmarks
Payer-published rates provide market context. They do not establish a practice's contracted rate or the total cost of care.
- Source and periodRates come from the specialty's national report. The displayed period follows the processed data included in the latest published snapshot and updates when that snapshot is refreshed.
- Comparable ratesComparisons use positive professional fee-for-service negotiated and fee-schedule dollar amounts. Percentages, bundled arrangements and per-diem rate types are excluded. Modifier cohorts and code-specific amounts remain separate.
- CalculationRates are reduced to one modal value per NPI and TIN entity, averaging tied modes. Two percent per tail is targeted for trimming while keeping boundary ties. Benchmarks require at least 10 included entities and are not weighted by patient volume.
- CoverageNational report coverage does not guarantee every payer or state is available for every code. Anthem represents the displayed Anthem cohort, rather than all regional Blue plans. Missing benchmarks are not zero rates.
- Billing contextMatch the exact code, billing unit, modifier, setting and network. Equipment rentals and supplies require their own interval and quantity checks. Professional rates exclude facility charges; anesthesia conversion factors are outside these comparisons.
Get the oral & maxillofacial surgery reimbursement data you're looking for
Choose the services, payers, states, networks, and provider entities relevant to your question. We'll confirm the available coverage and prepare the comparison.
- Tell us your marketShare the specialty, geography, payers, networks, and providers.
- We find comparable ratesPayerPrice aligns billing codes, services, settings, and units.
- Get your market viewSee relevant payer and provider rates organized around your question.
We'll tell you what the data can support, where the gaps are, and the clearest way to structure the comparison.
Trusted by teams that need defensible reimbursement data
Explore oral & maxillofacial surgery rates by state
Choose a state to compare payer reference averages for common services.
Questions about oral & maxillofacial surgery benchmarks
How to interpret the selected market and payer-published rates.
What does the national benchmark compare?
The headline uses Bilateral sagittal split mandibular osteotomy (21196). The other reference codes and service lines provide separate comparisons rather than combining unlike services.
Why is a payer or state missing?
A benchmark appears only when the selected code and cohort meet the publication rules, including at least 10 entities after trimming. Report-wide coverage can be broader than an individual comparison.
Will the reporting period change?
Yes. The period displayed with the benchmark follows the processed source data when the publication snapshot is refreshed.