CPT code 21147: Midface reconstruction, three or more pieces, with graft2026 Medicare rate & RVUs in Minnesota
Reconstructs the maxilla through a LeFort I osteotomy in three or more segments with bone grafting for complex midface deformity correction.
In Minnesota, Medicare pays $1,452.85 for 21147 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 21147 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 21147 covers
This service reconstructs the midface by mobilizing the maxilla with a LeFort I osteotomy, dividing it into three or more pieces, and using bone grafting as part of the reconstruction. Oral and maxillofacial surgeons, plastic surgeons, or craniofacial surgeons may perform it in an operating room for complex maxillary deformity, such as a developmental midface discrepancy requiring segmental repositioning.
Select this code when the operative report supports both three or more maxillary segments and bone grafting; the number of segments and graft use distinguish it from neighboring LeFort I codes. The record should describe the osteotomy, segment configuration, reconstruction, and grafting. This major surgery has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeons and team surgery are 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 Minnesota compares for 21147
Across 109 of 109 payment localities, the facility rate for 21147 runs from $1,388.80 in Arkansas to $1,935.19 in Alaska. Minnesota pays $1,452.85. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Minnesota · this page$1,452.85
- Los Angeles, CA · California$1,617.15+$164.30
- Washington, DC area · District of Columbia$1,681.90+$229.05
- Miami, FL · Florida$1,738.99+$286.14
- Chicago, IL · Illinois$1,696.35+$243.50
- Manhattan, NY · New York$1,741.16+$288.31
- Alaska · Alaska$1,935.19+$482.34
Other areas in Minnesota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $1,403.80 |
| ArkansasArkansas | — | $1,388.80 |
| ArizonaArizona | — | $1,490.70 |
| Bakersfield, CACalifornia | — | $1,544.48 |
| Chico, CACalifornia | — | $1,533.61 |
| El Centro, CACalifornia | — | $1,534.24 |
| Fresno, CACalifornia | — | $1,533.61 |
| Hanford, CACalifornia | — | $1,533.61 |
| Madera, CACalifornia | — | $1,533.61 |
| Merced, CACalifornia | — | $1,533.61 |
| Modesto, CACalifornia | — | $1,533.61 |
| Napa, CACalifornia | — | $1,689.22 |
| Oxnard, CACalifornia | — | $1,600.27 |
| Redding, CACalifornia | — | $1,533.61 |
| Rest of CaliforniaCalifornia | — | $1,533.61 |
| Riverside, CACalifornia | — | $1,574.18 |
| Sacramento, CACalifornia | — | $1,586.04 |
| Salinas, CACalifornia | — | $1,579.58 |
| San Diego, CACalifornia | — | $1,599.38 |
| Marin County, CACalifornia | — | $1,760.17 |
| San Francisco, CACalifornia | — | $1,755.91 |
| San Benito County, CACalifornia | — | $1,799.97 |
| Santa Clara County, CACalifornia | — | $1,782.55 |
| San Luis Obispo, CACalifornia | — | $1,556.75 |
| Santa Cruz, CACalifornia | — | $1,601.09 |
| Santa Maria, CACalifornia | — | $1,580.76 |
| Santa Rosa, CACalifornia | — | $1,615.85 |
| Stockton, CACalifornia | — | $1,533.61 |
| Vallejo, CACalifornia | — | $1,683.08 |
| Visalia, CACalifornia | — | $1,533.61 |
| Yuba City, CACalifornia | — | $1,533.61 |
| ColoradoColorado | — | $1,542.77 |
| ConnecticutConnecticut | — | $1,610.40 |
| DelawareDelaware | — | $1,510.62 |
| Fort Lauderdale, FLFlorida | — | $1,633.62 |
| Rest of FloridaFlorida | — | $1,564.75 |
| Atlanta, GAGeorgia | — | $1,561.79 |
| Rest of GeorgiaGeorgia | — | $1,491.35 |
| Hawaii, Guam, HIHawaii | — | $1,546.41 |
| IowaIowa | — | $1,404.15 |
| IdahoIdaho | — | $1,416.36 |
| East St. Louis, ILIllinois | — | $1,609.38 |
| Rest of IllinoisIllinois | — | $1,549.12 |
| Suburban Chicago, ILIllinois | — | $1,642.68 |
| IndianaIndiana | — | $1,421.76 |
| KansasKansas | — | $1,411.64 |
| KentuckyKentucky | — | $1,455.04 |
| New Orleans, LALouisiana | — | $1,510.71 |
| Rest of LouisianaLouisiana | — | $1,458.28 |
| Metropolitan Boston, MAMassachusetts | — | $1,651.38 |
| Rest of MassachusettsMassachusetts | — | $1,542.30 |
| Baltimore area, MDMaryland | — | $1,608.18 |
| Rest of MarylandMaryland | — | $1,530.23 |
| Rest of MaineMaine | — | $1,435.03 |
| Southern Maine, MEMaine | — | $1,474.36 |
| Detroit, MIMichigan | — | $1,592.51 |
| Rest of MichiganMichigan | — | $1,494.76 |
| Metropolitan Kansas City, MOMissouri | — | $1,489.71 |
| Metropolitan St. Louis, MOMissouri | — | $1,499.84 |
| Rest of MissouriMissouri | — | $1,447.91 |
| MississippiMississippi | — | $1,417.93 |
| MontanaMontana | — | $1,525.17 |
| North CarolinaNorth Carolina | — | $1,444.15 |
| North DakotaNorth Dakota | — | $1,451.02 |
| NebraskaNebraska | — | $1,406.08 |
| New HampshireNew Hampshire | — | $1,531.82 |
| Northern New JerseyNew Jersey | — | $1,674.34 |
| Rest of New JerseyNew Jersey | — | $1,621.56 |
| New MexicoNew Mexico | — | $1,505.93 |
| NevadaNevada | — | $1,505.04 |
| NYC suburbs and Long Island, NYNew York | — | $1,789.63 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $1,641.63 |
| Queens, NYNew York | — | $1,733.89 |
| Rest of New YorkNew York | — | $1,461.31 |
| OhioOhio | — | $1,479.61 |
| OklahomaOklahoma | — | $1,439.91 |
| Portland, OROregon | — | $1,566.88 |
| Rest of OregonOregon | — | $1,486.07 |
| Metropolitan Philadelphia, PAPennsylvania | — | $1,587.17 |
| Rest of PennsylvaniaPennsylvania | — | $1,474.41 |
| Puerto RicoPuerto Rico | — | $1,529.46 |
| Rhode IslandRhode Island | — | $1,546.03 |
| South CarolinaSouth Carolina | — | $1,465.74 |
| South DakotaSouth Dakota | — | $1,442.25 |
| TennesseeTennessee | — | $1,418.46 |
| Austin, TXTexas | — | $1,544.07 |
| Beaumont, TXTexas | — | $1,468.10 |
| Brazoria, TXTexas | — | $1,499.92 |
| Dallas, TXTexas | — | $1,513.24 |
| Fort Worth, TXTexas | — | $1,509.49 |
| Galveston, TXTexas | — | $1,507.01 |
| Houston, TXTexas | — | $1,575.64 |
| Rest of TexasTexas | — | $1,485.83 |
| UtahUtah | — | $1,480.36 |
| VirginiaVirginia | — | $1,479.45 |
| Virgin Islands, VIUnited States Virgin Islands | — | $1,529.46 |
| VermontVermont | — | $1,458.16 |
| Rest of WashingtonWashington | — | $1,535.21 |
| King County, WAWashington | — | $1,667.75 |
| WisconsinWisconsin | — | $1,416.14 |
| West VirginiaWest Virginia | — | $1,508.91 |
| WyomingWyoming | — | $1,492.85 |
21147 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 21147 rate is calculated
Each of 21147’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 · 21147
RVUs × geographic indexes × conversion factor
Work25.81
25.81 RVUs× 1.000 GPCI
Practice expense16.11
16.11 RVUs× 1.000 GPCI
Malpractice3.75
3.75 RVUs× 1.000 GPCI
Adjusted RVUs
45.6700
Conversion factor
$33.4009
Medicare rate
$1,525.42
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Minnesota inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
1,891
- Code
- 21147
- Physician work
- 25.81
- Practice expense
- 16.11
- Malpractice
- 3.75
GPCI2026.csv
66
- Locality
- Minnesota
- Physician work
- 1.000
- Practice expense
- 1.029
- Malpractice
- 0.296
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 25.81 | × 1.000 | 25.8100 |
| Practice expense | 16.11 | × 1.029 | 16.5772 |
| Malpractice | 3.75 | × 0.296 | 1.1100 |
| Total RVUs | 43.4972 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Minnesota$1452.85
Facility: (25.81 × 1 + 16.11 × 1.029 + 3.75 × 0.296) × $33.4009 = $1452.85
Payment rules and modifiers for 21147
21147 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21147
Midface reconstruction, three or more pieces, with graft
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 21147
Midface reconstruction, three or more pieces, with 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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
21147 without 51 · national facility
$1,525.42
Midface reconstruction, three or more pieces, with graft
21147-51 · Second procedure: 50%
$762.71
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%).
How 21147 has changed in Minnesota
21147 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $1,452.85 | RVU26D |
| 2026-07-01 | Not available in this setting | $1,452.85 | RVU26C |
| 2026-04-01 | Not available in this setting | $1,452.85 | RVU26B |
| 2026-01-01 | Not available in this setting | $1,452.85 | RVU26A |
| 2025-10-01 | Not available in this setting | $1,610.31 | RVU25D |
| 2025-07-01 | Not available in this setting | $1,610.31 | RVU25C |
| 2025-04-01 | Not available in this setting | $1,610.31 | RVU25B |
| 2025-01-01 | Not available in this setting | $1,610.31 | RVU25A |
| 2024-10-01 | Not available in this setting | $1,642.88 | RVU24D |
| 2024-07-01 | Not available in this setting | $1,642.88 | RVU24C |
| 2024-04-01 | Not available in this setting | $1,642.88 | RVU24B |
| 2024-03-09 | Not available in this setting | $1,642.88 | RVU24AR |
| 2024-01-01 | Not available in this setting | $1,616.07 | RVU24A |
| 2023-10-01 | Not available in this setting | $1,675.12 | RVU23D |
| 2023-07-01 | Not available in this setting | $1,675.12 | RVU23C |
| 2023-04-01 | Not available in this setting | $1,675.12 | RVU23B |
| 2023-01-01 | Not available in this setting | $1,675.12 | RVU23A |
| 2022-10-01 | Not available in this setting | $1,692.47 | RVU22D |
| 2022-07-01 | Not available in this setting | $1,692.47 | RVU22C |
| 2022-04-01 | Not available in this setting | $1,692.47 | RVU22B |
| 2022-01-01 | Not available in this setting | $1,692.47 | RVU22A |
| 2021-10-01 | Not available in this setting | $1,700.09 | RVU21D |
| 2021-07-01 | Not available in this setting | $1,700.09 | RVU21C |
| 2021-04-01 | Not available in this setting | $1,700.09 | RVU21B |
| 2021-01-01 | Not available in this setting | $1,700.09 | RVU21A |
| 2020-10-01 | Not available in this setting | $1,735.57 | RVU20D |
| 2020-07-01 | Not available in this setting | $1,735.57 | RVU20C |
| 2020-04-01 | Not available in this setting | $1,735.57 | RVU20B |
| 2020-01-01 | Not available in this setting | $1,735.57 | RVU20A |
| 2019-10-01 | Not available in this setting | $1,736.40 | RVU19D |
| 2019-07-01 | Not available in this setting | $1,736.40 | RVU19C |
| 2019-04-01 | Not available in this setting | $1,736.40 | RVU19B |
| 2019-01-01 | Not available in this setting | $1,736.40 | RVU19A |
| 2018-10-01 | Not available in this setting | $1,726.20 | RVU18D |
| 2018-07-01 | Not available in this setting | $1,726.20 | RVU18C |
| 2018-04-01 | Not available in this setting | $1,726.20 | RVU18B |
| 2018-01-01 | Not available in this setting | $1,726.20 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $1,654.05 | RVU17D |
| 2017-07-01 | Not available in this setting | $1,654.05 | RVU17C |
| 2017-04-01 | Not available in this setting | $1,654.05 | RVU17B |
| 2017-01-01 | Not available in this setting | $1,654.05 | RVU17A |
| 2016-10-01 | Not available in this setting | $1,720.39 | RVU16D |
| 2016-07-01 | Not available in this setting | $1,720.39 | RVU16C |
| 2016-04-01 | Not available in this setting | $1,720.39 | RVU16B |
| 2016-01-01 | Not available in this setting | $1,720.39 | RVU16A |
| 2015-10-01 | Not available in this setting | $1,774.80 | RVU15D |
| 2015-07-01 | Not available in this setting | $1,774.80 | RVU15C |
| 2015-04-01 | Not available in this setting | $1,765.97 | RVU15B |
| 2015-01-01 | Not available in this setting | $1,765.97 | RVU15A |
| 2014-10-01 | Not available in this setting | $1,520.86 | RVU14D |
| 2014-07-01 | Not available in this setting | $1,520.86 | RVU14C |
| 2014-04-01 | Not available in this setting | $1,520.86 | RVU14B |
| 2014-01-01 | Not available in this setting | $1,520.86 | RVU14A |
| 2013-10-01 | Not available in this setting | $1,715.02 | RVU13D |
| 2013-07-01 | Not available in this setting | Rate data unavailable | RVU13C |
| 2013-04-01 | Not available in this setting | Rate data unavailable | RVU13B |
| 2013-01-01 | Not available in this setting | Rate data unavailable | RVU13AR |
Where the Minnesota rate applies
Minnesota is a Medicare payment area, not a city. Our Census mapping connects it to 916 cities and communities in Minnesota. Some span more than one payment area; confirm with the service ZIP.
- Ada
- Adams
- Adrian
- Afton
- Aitkin
- Akeley
- Albany
- Albert Lea
21147 billing questions
How does this differ from 21143?
Both describe a LeFort I reconstruction in three or more pieces. This code is for the reconstruction with bone grafting; 21143 is the corresponding option without grafting.
How many segments support this code?
The maxilla must be divided into three or more pieces. The operative report should document the segment configuration rather than relying only on a general description of a LeFort I procedure.
Can the bone graft be reported separately?
Bone grafting is part of the service represented by this code. Do not separately report the same grafting work; assess any distinct graft-harvesting work under applicable coding instructions.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 or an assistant surgeon be reported?
Modifier 50 is inappropriate for this code. Assistant-at-surgery payment may be made, while co-surgeons and team surgery are not permitted.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard 50% 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
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