CPT code 21159: Midface reconstruction, leFort III advancement, no graft2026 Medicare rate & RVUs in Delaware

In Delaware, Medicare pays $2,189.22 for 21159 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 21159 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 21159 covers

This operation mobilizes and advances the midface at the LeFort III level without a bone graft. Craniofacial, oral and maxillofacial, or plastic surgeons may perform it for substantial midface retrusion, including deformity associated with syndromic craniosynostosis. It is a major reconstructive procedure generally performed in a hospital operating room.

Select this code when the operative report supports LeFort III reconstruction with advancement and documents that no bone graft was used. Distinguish it from the non-advancement LeFort III codes and from the advancement code that includes grafting. The 90-day global period includes the day-before preoperative visit and related postoperative care during the following 90 days. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this service. An assistant at surgery 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.

How Delaware compares for 21159

Across 109 of 109 payment localities, the facility rate for 21159 runs from $2,025.93 in Arkansas to $2,859.32 in Alaska. Delaware pays $2,189.22. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

21159 rates by state

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

See 21159 in every payment locality

How the 21159 rate is calculated

Each of 21159’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 21159

21159 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 21159

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

How 21159 has changed in Delaware

Price 21159 for an earlier date of service

Where the Delaware rate applies

Delaware is a Medicare payment area, not a city. Our Census mapping connects it to 79 cities and communities in Delaware. Some span more than one payment area; confirm with the service ZIP.

• Arden
• Ardencroft
• Ardentown
• Bear
• Bellefonte
• Bethany Beach
• Bethel
• Blades

Browse all communities in Delaware

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