Summary & Overview
CPT 21445: Alveolar Ridge Fracture Repair
CPT code 21445 denotes open surgical treatment of fractures to the mandibular and maxillary alveolar ridge—the bony ridge that contains the tooth sockets—typically performed after blunt-force facial trauma. Nationally, this code matters because it captures a specific oral and maxillofacial surgical service tied to trauma care, reconstruction, and dental arch stability, with implications for surgical resource use and post-acute dental rehabilitation.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The content provides a concise clinical context for the procedure, outlines common payer coverage considerations, and identifies where readers can expect to find benchmarking and policy update information.
Readers will learn what services CPT code 21445 represents, the typical settings where the procedure is performed, and the clinical rationale for intervention. The publication also summarizes payer coverage patterns and common billing modifiers used with the code. Data not available in the input is noted where applicable; the focus remains on national clinical and billing context relevant to providers, coders, and policy analysts.
Billing Code Overview
CPT code 21445 describes open treatment of fractures of the mandibular and maxillary alveolar ridge through a surgical incision. This procedure addresses fractures of the bone that supports the tooth sockets after blunt force trauma and involves direct access to the fracture for reduction and stabilization.
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Service type: Surgical repair of alveolar ridge fractures
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Typical site of service: Operating room or outpatient surgical facility (oral and maxillofacial surgery setting)
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult male who presents to the emergency department after an assault with blunt facial trauma. He reports pain, bleeding of the gingiva, mobility of several anterior teeth, and malocclusion. Examination and maxillofacial CT confirm an alveolar ridge fracture of the mandible involving tooth-bearing bone. The patient is consented for operative repair under general anesthesia. In the operating room the oral and maxillofacial surgeon performs an intraoral incision to access the fracture, reduces displaced bone segments, stabilizes the alveolar ridge with fixation (wires, plates, or splints), and repairs soft tissues. Postoperative workflow includes radiographic confirmation of reduction, dental follow-up for tooth stabilization or extraction decisions, pain control, tetanus status review, and instructions for a soft diet and oral hygiene. Typical sites of service include the hospital operating room or an ambulatory surgery center. The service type is operative repair of the mandibular or maxillary alveolar ridge accessed through an incision (21445).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased Procedural Service | Use when the work required is substantially greater than typically required (extensive dissection, prolonged operative time). |