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CPT code 21143: LeFort I reconstruction, three or more pieces2026 Medicare rate & RVUs

Reconstructs the midface with a LeFort I osteotomy divided into three or more segments, without bone grafting, to reposition the maxilla.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $1,273.58 for 21143 nationally in a facility.

Medicare rate · 21143

LeFort I reconstruction, three or more pieces

Office or facility?

Work RVUs
20.52
Total RVUs
38.13
Global days
090

National rate · 2026

$1,273.58

Facility setting, before claim adjustments.

See every locality for 21143 →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 21143 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 21143 covers

This operation repositions the maxilla after a LeFort I osteotomy that divides it into at least three pieces. Oral and maxillofacial surgeons, plastic surgeons, or craniofacial surgeons may perform it for skeletal maxillary deformity, such as a significant jaw discrepancy affecting facial balance or bite. It is generally performed in an operating room under general anesthesia. The distinguishing features are the LeFort I level, the number of segments, and the absence of bone grafting.

Report 21143 when the operative record supports three or more maxillary pieces and the reconstruction does not include bone grafting; the one-piece and two-piece versions are separate family codes. The operative note should identify the osteotomy, segment count, repositioning, and whether grafting was performed. The 90-day global includes the day-before preoperative visit and related postoperative care for 90 days. In a same-session multiple-procedure situation, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 is inappropriate for this service. An assistant may be paid; 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 21143 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

21143 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,169.30
AlaskaUnavailable$1,603.34
ArizonaUnavailable$1,244.10
ArkansasUnavailable$1,156.40
Atlanta, GAUnavailable$1,303.46
Austin, TXUnavailable$1,291.94
Bakersfield, CAUnavailable$1,294.59
Baltimore area, MDUnavailable$1,343.80
Beaumont, TXUnavailable$1,222.53
Brazoria, TXUnavailable$1,252.76

21143 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
21143 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 21143 rate is calculated

Each of 21143’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 · 21143

RVUs × geographic indexes × conversion factor

Office or facility?

Work20.52

20.52 RVUs× 1.000 GPCI

Practice expense14.63

14.63 RVUs× 1.000 GPCI

Malpractice2.98

2.98 RVUs× 1.000 GPCI

Adjusted RVUs

38.1300

Conversion factor

$33.4009

Medicare rate

$1,273.58

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

Payment rules and modifiers for 21143

21143 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21143

LeFort I reconstruction, three or more pieces

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 · 21143

LeFort I reconstruction, three or more pieces

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

21143 without 51 · national facility

$1,273.58

LeFort I reconstruction, three or more pieces

21143-51 · Second procedure: 50%

$636.79

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

21143 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 21143

    LeFort I reconstruction, three or more pieces20.52 wRVU

    Not priced

  • 21142

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

    Not priced

  • 21147

    Midface reconstruction, three or more pieces, with graft25.81 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
Use 21142 when the LeFort I reconstruction divides the maxilla into two pieces; 21143 requires three or more.
21147Midface reconstructionThree or more pieces, with graft
Both describe three-or-more-piece LeFort I reconstruction. 21147 is the grafting version; 21143 is without bone grafting.
21150Midface reconstructionLeFort II, without graft
21150 describes a LeFort II-level midface reconstruction, not the LeFort I osteotomy represented by 21143.

Codes related to 21143

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

Codes related to 21143
CodeHow it relatesNational office range
Same family
21141Le Fort I reconstruction, one-piece, without graftLeFort I reconstruction for a single-piece maxilla.No office rate
21142Le Fort I reconstruction, two-piece, without bone graftLeFort I reconstruction for a two-piece maxilla.No office rate
21145LeFort I reconstruction, single piece with bone graftSingle-piece LeFort I reconstruction with bone grafting.No office rate
21146Midface reconstruction, two-piece with bone graftTwo-piece LeFort I reconstruction with bone grafting.No office rate
21147Midface reconstruction, three or more pieces, with graftThree-or-more-piece LeFort I reconstruction with bone grafting.No office rate
Used instead
21150Midface reconstruction, leFort II, without graftA LeFort II-level midface reconstruction for a different osteotomy pattern.No office rate

21143 billing questions

How does 21143 differ from 21142?

21143 is for a LeFort I reconstruction in which the maxilla is divided into three or more pieces. 21142 describes the two-piece version.

When is 21147 reported instead?

Use 21147 for the three-or-more-piece LeFort I reconstruction when bone grafting is part of the reconstruction. This code, 21143, is the corresponding version without bone grafting.

What operative documentation supports 21143?

Document the LeFort I osteotomy, the number of maxillary segments, their repositioning, and whether bone grafting was performed.

Can modifier 50 be appended?

No. The CMS bilateral adjustment does not apply to this midface reconstruction, and modifier 50 is inappropriate.

How are other procedures in the same session paid?

Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

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 21143PPRRVU2026_Oct_nonQPP.csv, line 1,888 (RVU26D)

Open CMS sourceHow we calculate rates

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