CPT code 21159: Midface reconstruction, leFort III advancement, no graft2026 Medicare rate & RVUs in New Mexico
Reports LeFort III midface reconstruction with advancement and no bone graft, commonly performed to correct severe midface retrusion in craniofacial conditions.
In New Mexico, Medicare pays $2,201.64 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.
On this page 11 sections
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 New Mexico 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. New Mexico pays $2,201.64. The RVUs are the same everywhere; the geographic indexes change the dollars.
- New Mexico · this page$2,201.64
- Los Angeles, CA · California$2,308.49+$106.85
- Washington, DC area · District of Columbia$2,415.99+$214.35
- Miami, FL · Florida$2,548.81+$347.17
- Chicago, IL · Illinois$2,488.98+$287.34
- Manhattan, NY · New York$2,517.60+$315.96
- Alaska · Alaska$2,859.32+$657.68
Other areas in New Mexico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $2,046.00 |
| ArkansasArkansas | — | $2,025.93 |
| ArizonaArizona | — | $2,161.96 |
| Bakersfield, CACalifornia | — | $2,214.10 |
| Chico, CACalifornia | — | $2,196.30 |
| El Centro, CACalifornia | — | $2,197.32 |
| Fresno, CACalifornia | — | $2,196.30 |
| Hanford, CACalifornia | — | $2,196.30 |
| Madera, CACalifornia | — | $2,196.30 |
| Merced, CACalifornia | — | $2,196.30 |
| Modesto, CACalifornia | — | $2,196.30 |
| Napa, CACalifornia | — | $2,388.34 |
| Oxnard, CACalifornia | — | $2,281.21 |
| Redding, CACalifornia | — | $2,196.30 |
| Rest of CaliforniaCalifornia | — | $2,196.30 |
| Riverside, CACalifornia | — | $2,262.82 |
| Sacramento, CACalifornia | — | $2,263.18 |
| Salinas, CACalifornia | — | $2,253.76 |
| San Diego, CACalifornia | — | $2,275.78 |
| Marin County, CACalifornia | — | $2,478.42 |
| San Francisco, CACalifornia | — | $2,471.43 |
| San Benito County, CACalifornia | — | $2,534.50 |
| Santa Clara County, CACalifornia | — | $2,505.95 |
| San Luis Obispo, CACalifornia | — | $2,222.09 |
| Santa Cruz, CACalifornia | — | $2,273.30 |
| Santa Maria, CACalifornia | — | $2,253.74 |
| Santa Rosa, CACalifornia | — | $2,293.74 |
| Stockton, CACalifornia | — | $2,196.30 |
| Vallejo, CACalifornia | — | $2,378.27 |
| Visalia, CACalifornia | — | $2,196.30 |
| Yuba City, CACalifornia | — | $2,196.30 |
| ColoradoColorado | — | $2,220.40 |
| ConnecticutConnecticut | — | $2,327.56 |
| DelawareDelaware | — | $2,189.22 |
| Fort Lauderdale, FLFlorida | — | $2,383.91 |
| Rest of FloridaFlorida | — | $2,287.07 |
| Atlanta, GAGeorgia | — | $2,265.24 |
| Rest of GeorgiaGeorgia | — | $2,184.79 |
| Hawaii, Guam, HIHawaii | — | $2,205.84 |
| IowaIowa | — | $2,035.28 |
| IdahoIdaho | — | $2,053.89 |
| East St. Louis, ILIllinois | — | $2,370.44 |
| Rest of IllinoisIllinois | — | $2,273.60 |
| Suburban Chicago, ILIllinois | — | $2,394.75 |
| IndianaIndiana | — | $2,060.76 |
| KansasKansas | — | $2,050.66 |
| KentuckyKentucky | — | $2,126.09 |
| New Orleans, LALouisiana | — | $2,202.68 |
| Rest of LouisianaLouisiana | — | $2,132.52 |
| Metropolitan Boston, MAMassachusetts | — | $2,361.52 |
| Rest of MassachusettsMassachusetts | — | $2,222.71 |
| Baltimore area, MDMaryland | — | $2,325.09 |
| Rest of MarylandMaryland | — | $2,214.54 |
| Rest of MaineMaine | — | $2,084.50 |
| Southern Maine, MEMaine | — | $2,128.94 |
| Detroit, MIMichigan | — | $2,330.06 |
| Rest of MichiganMichigan | — | $2,184.45 |
| MinnesotaMinnesota | — | $2,082.92 |
| Metropolitan Kansas City, MOMissouri | — | $2,168.82 |
| Metropolitan St. Louis, MOMissouri | — | $2,181.75 |
| Rest of MissouriMissouri | — | $2,122.01 |
| MississippiMississippi | — | $2,073.14 |
| MontanaMontana | — | $2,209.73 |
| North CarolinaNorth Carolina | — | $2,095.79 |
| North DakotaNorth Dakota | — | $2,088.12 |
| NebraskaNebraska | — | $2,036.18 |
| New HampshireNew Hampshire | — | $2,209.06 |
| Northern New JerseyNew Jersey | — | $2,408.59 |
| Rest of New JerseyNew Jersey | — | $2,341.45 |
| NevadaNevada | — | $2,176.43 |
| NYC suburbs and Long Island, NYNew York | — | $2,589.47 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $2,373.48 |
| Queens, NYNew York | — | $2,500.02 |
| Rest of New YorkNew York | — | $2,119.14 |
| OhioOhio | — | $2,159.59 |
| OklahomaOklahoma | — | $2,100.14 |
| Portland, OROregon | — | $2,246.62 |
| Rest of OregonOregon | — | $2,146.73 |
| Metropolitan Philadelphia, PAPennsylvania | — | $2,299.66 |
| Rest of PennsylvaniaPennsylvania | — | $2,149.65 |
| Puerto RicoPuerto Rico | — | $2,213.66 |
| Rhode IslandRhode Island | — | $2,234.44 |
| South CarolinaSouth Carolina | — | $2,133.73 |
| South DakotaSouth Dakota | — | $2,073.74 |
| TennesseeTennessee | — | $2,060.44 |
| Austin, TXTexas | — | $2,224.32 |
| Beaumont, TXTexas | — | $2,141.56 |
| Brazoria, TXTexas | — | $2,170.79 |
| Dallas, TXTexas | — | $2,191.21 |
| Fort Worth, TXTexas | — | $2,187.88 |
| Galveston, TXTexas | — | $2,181.85 |
| Houston, TXTexas | — | $2,294.41 |
| Rest of TexasTexas | — | $2,159.62 |
| UtahUtah | — | $2,153.19 |
| VirginiaVirginia | — | $2,139.55 |
| Virgin Islands, VIUnited States Virgin Islands | — | $2,213.66 |
| VermontVermont | — | $2,102.66 |
| Rest of WashingtonWashington | — | $2,211.10 |
| King County, WAWashington | — | $2,378.96 |
| WisconsinWisconsin | — | $2,042.80 |
| West VirginiaWest Virginia | — | $2,220.09 |
| WyomingWyoming | — | $2,156.73 |
21159 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 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.
How the rate is built · 21159
RVUs × geographic indexes × conversion factor
Work42.06
42.06 RVUs× 1.000 GPCI
Practice expense17.96
17.96 RVUs× 1.000 GPCI
Malpractice6.15
6.15 RVUs× 1.000 GPCI
Adjusted RVUs
66.1700
Conversion factor
$33.4009
Medicare rate
$2,210.14
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact New Mexico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
1,896
- Code
- 21159
- Physician work
- 42.06
- Practice expense
- 17.96
- Malpractice
- 6.15
GPCI2026.csv
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 42.06 | × 1.000 | 42.0600 |
| Practice expense | 17.96 | × 0.917 | 16.4693 |
| Malpractice | 6.15 | × 1.201 | 7.3862 |
| Total RVUs | 65.9155 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, New Mexico$2201.64
Facility: (42.06 × 1 + 17.96 × 0.917 + 6.15 × 1.201) × $33.4009 = $2201.64
Payment rules and modifiers for 21159
21159 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21159
Midface reconstruction, leFort III advancement, no 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) | 1 | Permitted with supporting documentation. |
| 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 · 21159
Midface reconstruction, leFort III advancement, no 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
21159 without 51 · national facility
$2,210.14
Midface reconstruction, leFort III advancement, no graft
21159-51 · Second procedure: 50%
$1,105.07
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 21159 has changed in New Mexico
21159 · 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 | $2,201.64 | RVU26D |
| 2026-07-01 | Not available in this setting | $2,201.64 | RVU26C |
| 2026-04-01 | Not available in this setting | $2,201.64 | RVU26B |
| 2026-01-01 | Not available in this setting | $2,201.64 | RVU26A |
| 2025-10-01 | Not available in this setting | $2,459.15 | RVU25D |
| 2025-07-01 | Not available in this setting | $2,459.15 | RVU25C |
| 2025-04-01 | Not available in this setting | $2,459.15 | RVU25B |
| 2025-01-01 | Not available in this setting | $2,459.15 | RVU25A |
| 2024-10-01 | Not available in this setting | $2,528.62 | RVU24D |
| 2024-07-01 | Not available in this setting | $2,528.62 | RVU24C |
| 2024-04-01 | Not available in this setting | $2,528.62 | RVU24B |
| 2024-03-09 | Not available in this setting | $2,528.62 | RVU24AR |
| 2024-01-01 | Not available in this setting | $2,487.35 | RVU24A |
| 2023-10-01 | Not available in this setting | $2,562.94 | RVU23D |
| 2023-07-01 | Not available in this setting | $2,562.94 | RVU23C |
| 2023-04-01 | Not available in this setting | $2,562.94 | RVU23B |
| 2023-01-01 | Not available in this setting | $2,562.94 | RVU23A |
| 2022-10-01 | Not available in this setting | $2,585.21 | RVU22D |
| 2022-07-01 | Not available in this setting | $2,585.21 | RVU22C |
| 2022-04-01 | Not available in this setting | $2,585.21 | RVU22B |
| 2022-01-01 | Not available in this setting | $2,585.21 | RVU22A |
| 2021-10-01 | Not available in this setting | $2,579.84 | RVU21D |
| 2021-07-01 | Not available in this setting | $2,579.84 | RVU21C |
| 2021-04-01 | Not available in this setting | $2,579.84 | RVU21B |
| 2021-01-01 | Not available in this setting | $2,579.84 | RVU21A |
| 2020-10-01 | Not available in this setting | $2,651.17 | RVU20D |
| 2020-07-01 | Not available in this setting | $2,651.17 | RVU20C |
| 2020-04-01 | Not available in this setting | $2,651.17 | RVU20B |
| 2020-01-01 | Not available in this setting | $2,651.17 | RVU20A |
| 2019-10-01 | Not available in this setting | $2,688.17 | RVU19D |
| 2019-07-01 | Not available in this setting | $2,688.17 | RVU19C |
| 2019-04-01 | Not available in this setting | $2,688.17 | RVU19B |
| 2019-01-01 | Not available in this setting | $2,688.17 | RVU19A |
| 2018-10-01 | Not available in this setting | $2,674.13 | RVU18D |
| 2018-07-01 | Not available in this setting | $2,674.13 | RVU18C |
| 2018-04-01 | Not available in this setting | $2,674.13 | RVU18B |
| 2018-01-01 | Not available in this setting | $2,674.13 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $2,687.27 | RVU17D |
| 2017-07-01 | Not available in this setting | $2,687.27 | RVU17C |
| 2017-04-01 | Not available in this setting | $2,687.27 | RVU17B |
| 2017-01-01 | Not available in this setting | $2,687.27 | RVU17A |
| 2016-10-01 | Not available in this setting | $2,557.18 | RVU16D |
| 2016-07-01 | Not available in this setting | $2,557.18 | RVU16C |
| 2016-04-01 | Not available in this setting | $2,557.18 | RVU16B |
| 2016-01-01 | Not available in this setting | $2,557.18 | RVU16A |
| 2015-10-01 | Not available in this setting | $2,442.28 | RVU15D |
| 2015-07-01 | Not available in this setting | $2,442.28 | RVU15C |
| 2015-04-01 | Not available in this setting | $2,430.12 | RVU15B |
| 2015-01-01 | Not available in this setting | $2,430.12 | RVU15A |
| 2014-10-01 | Not available in this setting | $2,514.78 | RVU14D |
| 2014-07-01 | Not available in this setting | $2,514.78 | RVU14C |
| 2014-04-01 | Not available in this setting | $2,514.78 | RVU14B |
| 2014-01-01 | Not available in this setting | $2,514.78 | RVU14A |
| 2013-10-01 | Not available in this setting | $2,512.69 | RVU13D |
| 2013-07-01 | Not available in this setting | $2,512.69 | RVU13C |
| 2013-04-01 | Not available in this setting | $2,512.69 | RVU13B |
| 2013-01-01 | Not available in this setting | $2,512.69 | RVU13AR |
Where the New Mexico rate applies
New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.
- Abeytas
- Abiquiu
- Acomita Lake
- Adelino
- Agua Fria
- Alamillo
- Alamo
- Alamogordo
21159 billing questions
How does 21159 differ from 21154?
21159 describes LeFort III reconstruction with advancement and no bone graft. 21154 is the LeFort III reconstruction code without the advancement distinction.
When should 21160 be reported instead?
Use 21160 when the LeFort III advancement includes a bone graft. The operative report should establish whether a graft was used.
Can modifier 50 be used for bilateral work?
No. Modifier 50 is inappropriate for this code; the descriptor and anatomy do not support bilateral adjustment.
Is an assistant at surgery payable?
CMS permits assistant-at-surgery payment for this procedure. Co-surgeon payment requires supporting documentation, while team surgery is not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days after surgery.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures in the same session are subject to the standard 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
Fee sheets · Coming soon
Put 21159 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist