2025 CPT code 21421

Closed treatment of palatal or maxillary fracture (LeFort I type), with interdental wire fixation or fixation of denture or splint.

For operative repair of skull fracture, see 62000-62010. To report closed treatment of skull fracture, use the appropriate Evaluation and Management code. If a cast is removed by someone other than the physician who applied it, report cast removal code 29700, 29705, or 29710.

Modifiers may be applicable. Refer to current CPT guidelines.

Medical necessity is established by the presence of a palatal or maxillary fracture requiring reduction and stabilization.

After preparing and anesthetizing the patient, the provider examines the patient and ensures a clear airway. They manually manipulate the bones into their proper positions. Wires, dentures, or splints, secured to the teeth, are then used to stabilize the fractured bones and hold them in place.

In simple words: The doctor treats a broken upper jaw or roof of the mouth without surgery. They move the bones back into place and then use wires, a denture, or a splint attached to the teeth to hold the bones steady while they heal.

Closed treatment of palatal or maxillary fracture (LeFort I type), with interdental wire fixation or fixation of denture or splint. This involves manipulating the fractured bones back into their correct anatomical position without a surgical incision and then using wires, a denture, or a splint to maintain the reduction and stabilize the fracture.

Example 1: A patient presents with a LeFort I fracture following a motor vehicle accident. The surgeon performs closed reduction of the fracture and stabilizes it with interdental wiring., A patient sustains a maxillary fracture during a fall and presents to the ER. The physician performs closed reduction and applies a splint to stabilize the fracture., A patient with a fractured palate has their existing denture modified and used as a splint by the dentist to facilitate healing following closed reduction.

Documentation should include details of the injury, the type of fracture, the method of reduction, the type of fixation used (wires, denture, or splint), and any associated injuries.

** Codes that specify a LeFort I type fracture are not reserved exclusively for textbook LeFort I fractures. Choose the code that most closely resembles the repair performed.

  • Specialties:Oral & Maxillofacial Surgery, Maxillofacial Prosthodontics
  • Place of Service:Emergency Room - Hospital, Office, Outpatient Hospital, Inpatient Hospital
** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.