CPT code 21146: Midface reconstruction, two-piece with bone graft2026 Medicare rate & RVUs in Montana

In Montana, Medicare pays $1,452.70 for 21146 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 21146 nationwide

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

What 21146 covers

This procedure reconstructs the midface through a LeFort I approach, mobilizing and repositioning the maxilla as two segments and incorporating bone graft. Oral and maxillofacial surgeons and craniofacial or plastic surgeons typically perform it in an operating room for selected maxillary deformities requiring segmental reconstruction. The operative report should support the LeFort I level, two-piece configuration, and grafting performed.

Select this code when the reconstruction uses two maxillary segments with bone graft; the segment count and graft distinguish it from nearby LeFort I codes. The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery services may be paid; co-surgeon payment requires supporting documentation. 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.

How Montana compares for 21146

Across 109 of 109 payment localities, the facility rate for 21146 runs from $1,321.95 in Arkansas to $1,839.46 in Alaska. Montana pays $1,452.70. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

21146 rates by state

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

See 21146 in every payment locality

How the 21146 rate is calculated

Each of 21146’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.

Payment rules and modifiers for 21146

21146 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

Codes related to 21146

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

How 21146 has changed in Montana

Price 21146 for an earlier date of service

Where the Montana rate applies

Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.

• Absarokee
• Acton
• Alberton
• Alder
• Alzada
• Amsterdam
• Anaconda-Deer Lodge County
• Antelope

Browse all communities in Montana

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

Open CMS sourceHow we calculate rates