CPT code 21150: Midface reconstruction, leFort II, without graft2026 Medicare rate & RVUs in California

Reports reconstruction of the midface using a LeFort II osteotomy pattern without bone grafting, typically for significant skeletal deformity or reconstruction.

CMS RVU26DEffective Oct 1, 202629 payment localities

CMS doesn’t publish an office rate for 21150 in California.

—Office (non-facility)
$1,415.25–$1,648.38Hospital or facility

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 9 sections
  1. Rate in California
  2. What 21150 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 21150 covers

This service reconstructs the central midface by mobilizing and repositioning facial bones in a LeFort II pattern. It is performed by craniofacial, oral and maxillofacial, or plastic surgeons, generally in a hospital operating room. Clinical indications may include congenital midface deficiency or reconstruction after facial trauma. The code identifies the LeFort II level of reconstruction, rather than a LeFort I or LeFort III pattern.

Report 21150 when the documented reconstruction follows the LeFort II pattern and does not include bone grafting; use 21151 when a bone graft is part of the reconstruction. The operative report should establish the osteotomy pattern, reconstruction performed, and whether grafting was used. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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 multiple-procedure reduction. Assistant-at-surgery services may be paid; co-surgeons and team surgery are not permitted. Modifier 50 is inappropriate for this code.

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 21150 pays more and less in California

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

29 of 29 payment localities

21150 office and facility rates by payment locality
Payment localityOfficeFacility
Bakersfield, CAUnavailable$1,425.94
Chico, CAUnavailable$1,415.25
El Centro, CAUnavailable$1,415.87
Fresno, CAUnavailable$1,415.25
Hanford, CAUnavailable$1,415.25
Los Angeles, CAUnavailable$1,490.17
Madera, CAUnavailable$1,415.25
Marin County, CAUnavailable$1,611.92
Merced, CAUnavailable$1,415.25
Modesto, CAUnavailable$1,415.25

How the 21150 rate is calculated

Each of 21150’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 · 21150

RVUs × geographic indexes × conversion factor

Office or facility?

Work25.31

25.31 RVUs× 1.000 GPCI

Practice expense13.37

13.37 RVUs× 1.000 GPCI

Malpractice3.69

3.69 RVUs× 1.000 GPCI

Adjusted RVUs

42.3700

Conversion factor

$33.4009

Medicare rate

$1,415.20

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

Payment rules and modifiers for 21150

21150 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21150

Midface reconstruction, leFort II, 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)0Not permitted.
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 · 21150

Midface reconstruction, leFort II, 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

21150 without 51 · national facility

$1,415.20

Midface reconstruction, leFort II, without graft

21150-51 · Second procedure: 50%

$707.60

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

21150 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 21150

    Midface reconstruction, leFort II, without graft25.31 wRVU

    Not priced

  • 21151

    Midface reconstruction, leFort II with bone graft28.29 wRVU

    Not priced

  • 21141

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

    Not priced

  • 21143

    LeFort I reconstruction, three or more pieces20.52 wRVU

    Not priced

  • 21154

    Midface reconstruction, le Fort III, no interpositional graft30.51 wRVU

    Not priced

How to choose

21151Midface reconstructionLeFort II with bone graft
Use 21151 for LeFort II reconstruction that includes bone grafting. Code 21150 describes the corresponding reconstruction without grafting.
21141Le Fort I reconstructionOne-piece, without graft
This is a LeFort I reconstruction in one piece. Select by the documented osteotomy pattern, not by a general description of midface surgery.
21143LeFort I reconstructionThree or more pieces
This is a LeFort I reconstruction in three or more pieces; 21150 identifies a LeFort II pattern instead.
21154Midface reconstructionLe Fort III, no interpositional graft
This describes LeFort III reconstruction without LeFort I involvement, a different and more extensive osteotomy pattern than LeFort II.

21150 billing questions

How is 21150 distinguished from 21151?

Both describe LeFort II midface reconstruction. Report 21150 without bone grafting; report 21151 when the reconstruction includes a bone graft.

How does this differ from the LeFort I reconstruction codes?

The osteotomy pattern determines the code: 21150 is for LeFort II reconstruction, while 21141–21147 describe LeFort I reconstruction with distinctions based on segmentation and grafting.

What operative details support reporting 21150?

Document the LeFort II osteotomy pattern, the bones mobilized and repositioned, the reconstructive work, and whether bone grafting was performed.

Can modifier 50 be reported?

No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.

What postoperative care is included in the Medicare 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 services may be paid. Co-surgeons and team surgery are not permitted for this code.

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 21150PPRRVU2026_Oct_nonQPP.csv, line 1,892 (RVU26D)

Open CMS sourceHow we calculate rates

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