CPT code 21245 represents surgical reconstruction of a portion of the maxilla or mandible with application of a metal plate to repair defects that impair jaw function. This procedure is a key component of reconstructive maxillofacial care, addressing structural and functional deficits from trauma, tumor resection, congenital anomalies, or degenerative conditions. Nationally, the code matters because it captures complex surgical repair that often involves multidisciplinary teams and can drive significant resource use, perioperative planning, and post-operative rehabilitation.

Key payers considered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and typical sites of service, plus benchmark expectations and policy considerations relevant to coverage and billing for reconstructive jaw surgery. The publication outlines coding nuances, common modifiers, and associated billing practices where available, and highlights implications for prior authorization, documentation, and claim adjudication. Practical insights include expected care settings, the role of surgical implants (metal plate fixation), and the types of clinical scenarios that commonly generate use of CPT code 21245.

Data not available in the input for associated taxonomies, specific ICD-10 diagnoses, and payer-specific reimbursement rates.