CPT code 21155: Midface reconstruction, leFort III, with interpositional graft2026 Medicare rate & RVUs

Medicare pays $1,851.41 for 21155 nationally in a facility.

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

What 21155 covers

This procedure reconstructs the midface at the LeFort III level, mobilizing the central and lateral midfacial skeleton and placing an interpositional bone graft between repositioned segments. Craniofacial, plastic, or oral and maxillofacial surgeons may perform it for substantial midface deficiency, including deficiency associated with craniosynostosis or other craniofacial conditions. It is a major reconstructive operation generally performed in a hospital setting.

Select this code when the documented LeFort III reconstruction includes an interpositional bone graft; the operative report should identify the reconstruction level, repositioning performed, and graft placement. The 90-day global period includes 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 50% multiple-procedure reduction. Modifier 50 is inappropriate for this descriptor and anatomy. An assistant at surgery may be paid; 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.

Where 21155 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

21155 rates by state

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

How the 21155 rate is calculated

Each of 21155’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 21155

21155 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

21155 compared with similar codes

How to choose

21154Midface reconstructionLe Fort III, no interpositional graft

Use 21154 for LeFort III midface reconstruction without an interpositional bone graft; 21155 includes the interpositional graft.

21159Midface reconstructionLeFort III advancement, no graft

21159 is the LeFort III advancement option without an interpositional graft. This code is for LeFort III reconstruction with an interpositional graft when the advancement-specific code does not describe the procedure.

21160Midface reconstructionLeFort III advancement with graft

21160 describes LeFort III advancement with an interpositional graft. Use 21155 for the corresponding grafted LeFort III reconstruction when the procedure is not the advancement-specific service.

21151Midface reconstructionLeFort II with bone graft

21151 is a LeFort II reconstruction with a bone graft. The operative level is LeFort III for 21155.

Codes related to 21155

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

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