CPT 21395 Open treatment of orbital floor fracture; with implant
Last reviewed: May 17, 2026
RVU Values (CMS PFS RVU26C July 2026)
Common Modifiers
-LT, -RT
Related ICD-10 Codes
S02.3XXA
Billing Tips
When billing CPT 21395, ensure your operative note clearly documents the procedure performed, clinical indication, and any complications or additional work that would support modifier usage. Always verify the code against the current AMA CPT Professional Edition before claim submission.
For multi-procedure cases, use our Case Builder to automatically calculate adjusted wRVUs with proper MPPR ranking.
Documentation and Coding Notes
AdSense readiness coding note: CPT 21395 should be treated as an educational starting point, not a final billing instruction. For open treatment of orbital floor fracture; with implant, the operative note or procedure note should clearly support the approach, anatomic site, laterality when relevant, clinical indication, and any separately reportable services.
Before submitting a claim or logging the case, compare CPT 21395 with adjacent codes in the same family, confirm current AMA CPT language, check CMS/NCCI edits, and verify payer-specific bundling rules. Modifier use should be tied to documentation rather than added only to bypass an edit.
Common audit checks for omfs (oral & maxillofacial surgery) cases include whether the documented work matches the code descriptor, whether add-on services are separately supported, whether a global period applies, and whether ICD-10 diagnosis pairing supports medical necessity.
Related CPT Codes in OMFS (Oral & Maxillofacial Surgery)
CPT 21465 — Open treatment of mandibular fracture; compound or complex, CPT 21470 — Open treatment of mandibular fracture; complicated (comminut CPT 21451 — Closed treatment of mandibular fracture; without interdental CPT 21421 — Open treatment of palatal or maxillary fracture (LeFort I) CPT 21422 — Open treatment of palatal or maxillary fracture (LeFort II); CPT 21423 — Open treatment of palatal or maxillary fracture (LeFort III)Use our free interactive decision tree with 500+ codes across 30 specialties
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