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CPT code 21141: Le Fort I reconstruction, one-piece, without graft2026 Medicare rate & RVUs

Reports reconstruction of the midface using a one-piece Le Fort I maxillary osteotomy, without bone graft, to reposition the maxilla for correction of a skeletal discrepancy.

CMS RVU26DEffective Oct 1, 2026109 payment localities23 Medicare services in 2024

Medicare pays $1,208.44 for 21141 nationally in a facility.

Medicare rate · 21141

Le Fort I reconstruction, one-piece, without graft

Office or facility?

Work RVUs
19.08
Total RVUs
36.18
Global days
090

National rate · 2026

$1,208.44

Facility setting, before claim adjustments.

See every locality for 21141 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 21141 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 21141 covers

A surgeon mobilizes the maxilla with a Le Fort I osteotomy and repositions it as one segment. This approach may address maxillary hypoplasia, malocclusion, or vertical or positional jaw discrepancies as part of orthognathic treatment. Oral and maxillofacial, plastic, or craniofacial surgeons typically perform the operation in a hospital operating room. The one-piece designation describes the number of maxillary segments; it is not a count of teeth or sides.

Report 21141 when the reconstruction uses one maxillary segment and does not include bone grafting. Use the operative report to support the Le Fort I approach, segment configuration, repositioning, and whether grafting was performed. The service has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care. For same-session procedures, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 21141 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

21141 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,108.56
AlaskaUnavailable$1,516.83
ArizonaUnavailable$1,180.32
ArkansasUnavailable$1,096.20
Atlanta, GAUnavailable$1,236.55
Austin, TXUnavailable$1,226.99
Bakersfield, CAUnavailable$1,230.49
Baltimore area, MDUnavailable$1,275.45
Beaumont, TXUnavailable$1,158.79
Brazoria, TXUnavailable$1,188.95

21141 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
21141 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 21141 rate is calculated

Each of 21141’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 21141

RVUs × geographic indexes × conversion factor

Office or facility?

Work19.08

19.08 RVUs× 1.000 GPCI

Practice expense14.34

14.34 RVUs× 1.000 GPCI

Malpractice2.76

2.76 RVUs× 1.000 GPCI

Adjusted RVUs

36.1800

Conversion factor

$33.4009

Medicare rate

$1,208.44

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 21141

21141 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21141

Le Fort I reconstruction, one-piece, without graft

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 21141

Le Fort I reconstruction, one-piece, without graft

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

21141 without 51 · national facility

$1,208.44

Le Fort I reconstruction, one-piece, without graft

21141-51 · Second procedure: 50%

$604.22

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

21141 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 21141

    Le Fort I reconstruction, one-piece, without graft19.08 wRVU

    Not priced

  • 21142

    Le Fort I reconstruction, two-piece, without bone graft19.77 wRVU

    Not priced

  • 21143

    LeFort I reconstruction, three or more pieces20.52 wRVU

    Not priced

  • 21145

    LeFort I reconstruction, single piece with bone graft23.34 wRVU

    Not priced

  • 21150

    Midface reconstruction, leFort II, without graft25.31 wRVU

    Not priced

How to choose

21142Le Fort I reconstructionTwo-piece, without bone graft
Both are Le Fort I reconstructions without grafting; 21141 is for a one-piece maxilla, while 21142 is for two pieces.
21143LeFort I reconstructionThree or more pieces
Use 21143 when the Le Fort I reconstruction divides the maxilla into three or more pieces; 21141 is limited to one piece.
21145LeFort I reconstructionSingle piece with bone graft
Both describe one-piece Le Fort I reconstruction. The distinguishing feature is bone grafting: 21145 includes it, while 21141 does not.
21150Midface reconstructionLeFort II, without graft
21150 describes a Le Fort II midface reconstruction rather than the Le Fort I approach reported with 21141.

Codes related to 21141

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 21141
CodeHow it relatesNational office range
Same family
21142Le Fort I reconstruction, two-piece, without bone graftLe Fort I reconstruction with two maxillary segments.No office rate
21143LeFort I reconstruction, three or more piecesLe Fort I reconstruction with three or more maxillary segments.No office rate
21145LeFort I reconstruction, single piece with bone graftOne-piece Le Fort I reconstruction that includes bone grafting.No office rate
21146Midface reconstruction, two-piece with bone graftTwo-piece Le Fort I reconstruction that includes bone grafting.No office rate
21147Midface reconstruction, three or more pieces, with graftThree-or-more-piece Le Fort I reconstruction that includes bone grafting.No office rate
Used instead
21150Midface reconstruction, leFort II, without graftLe Fort II midface reconstruction for a different osteotomy level and anatomic treatment.No office rate

21141 billing questions

How does 21141 differ from 21142 or 21143?

Choose 21141 when the maxilla is reconstructed as one segment. Codes 21142 and 21143 describe two segments and three or more segments, respectively.

When is 21145 used instead?

Use 21145 for a one-piece Le Fort I reconstruction that includes bone grafting. Code 21141 is for the one-piece reconstruction without grafting.

Does the one-piece service use modifier 50?

No. The CMS bilateral adjustment does not apply to 21141; its descriptor and anatomy make modifier 50 inappropriate.

What postoperative care is included in the global period?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

How does payment change when another procedure is performed in the same session?

The highest-valued procedure is paid in full, and other procedures performed in that session are subject to the standard multiple-procedure reduction.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 21141PPRRVU2026_Oct_nonQPP.csv, line 1,886 (RVU26D)

Open CMS sourceHow we calculate rates

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