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CPT code 21160: Midface reconstruction, leFort III advancement with graft2026 Medicare rate & RVUs

Reports LeFort III advancement of the midface with bone grafting to correct substantial midface retrusion or a related craniofacial deformity.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $2,392.84 for 21160 nationally in a facility.

Medicare rate · 21160

Midface reconstruction, leFort III advancement with graft

Office or facility?

Work RVUs
46.01
Total RVUs
71.64
Global days
090

National rate · 2026

$2,392.84

Facility setting, before claim adjustments.

See every locality for 21160 →Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 21160 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 21160 covers

This operation mobilizes and advances the midface at the LeFort III level, with bone grafting to support the reconstruction. Craniofacial plastic surgeons and oral and maxillofacial surgeons typically perform it in an operating room, often for severe midface retrusion associated with congenital craniofacial conditions or craniosynostosis. The operative record should establish the LeFort III advancement and describe the graft used and its role in the reconstruction.

Select this code when the documented reconstruction includes both LeFort III advancement and bone grafting; distinguish it from related LeFort III procedures based on whether advancement and grafting are performed. CMS 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 others at 50%. Modifier 50 is inappropriate for this code. 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 21160 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

21160 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$2,216.58
AlaskaUnavailable$3,101.67
ArizonaUnavailable$2,340.98
ArkansasUnavailable$2,195.04
Atlanta, GAUnavailable$2,452.61
Austin, TXUnavailable$2,407.02
Bakersfield, CAUnavailable$2,395.07
Baltimore area, MDUnavailable$2,516.68
Beaumont, TXUnavailable$2,320.05
Brazoria, TXUnavailable$2,350.14

21160 rates by state

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

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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
21160 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 21160 rate is calculated

Each of 21160’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 · 21160

RVUs × geographic indexes × conversion factor

Office or facility?

Work46.01

46.01 RVUs× 1.000 GPCI

Practice expense18.92

18.92 RVUs× 1.000 GPCI

Malpractice6.71

6.71 RVUs× 1.000 GPCI

Adjusted RVUs

71.6400

Conversion factor

$33.4009

Medicare rate

$2,392.84

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

Payment rules and modifiers for 21160

21160 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21160

Midface reconstruction, leFort III advancement with 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 · 21160

Midface reconstruction, leFort III advancement 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.

  • 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

21160 without 51 · national facility

$2,392.84

Midface reconstruction, leFort III advancement with graft

21160-51 · Second procedure: 50%

$1,196.42

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

21160 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 21160

    Midface reconstruction, leFort III advancement with graft46.01 wRVU

    Not priced

  • 21159

    Midface reconstruction, leFort III advancement, no graft42.06 wRVU

    Not priced

  • 21155

    Midface reconstruction, leFort III, with interpositional graft34.34 wRVU

    Not priced

  • 21145

    LeFort I reconstruction, single piece with bone graft23.34 wRVU

    Not priced

How to choose

21159Midface reconstructionLeFort III advancement, no graft
Both involve LeFort III advancement; 21160 is the choice when bone grafting is also performed, while 21159 is for advancement without grafting.
21155Midface reconstructionLeFort III, with interpositional graft
Both include bone grafting at the LeFort III level. Choose 21160 when the documented reconstruction specifically includes advancement.
21145LeFort I reconstructionSingle piece with bone graft
This is a LeFort I reconstruction with bone grafting. Code 21160 represents advancement at the LeFort III level.

Codes related to 21160

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

Codes related to 21160
CodeHow it relatesNational office range
Same family
21159Midface reconstruction, leFort III advancement, no graftLeFort III advancement without the bone grafting represented by 21160.No office rate
21155Midface reconstruction, leFort III, with interpositional graftLeFort III reconstruction with bone grafting, without the advancement distinction.No office rate
21154Midface reconstruction, le Fort III, no interpositional graftLeFort III reconstruction without bone grafting or the advancement distinction.No office rate
21145LeFort I reconstruction, single piece with bone graftLeFort I midface reconstruction with bone grafting, rather than LeFort III advancement.No office rate

21160 billing questions

How does this differ from 21159?

Both describe LeFort III advancement, but 21160 is the grafted service. Use 21159 when the advancement is performed without bone grafting.

How does this differ from 21155?

21155 describes LeFort III reconstruction with bone grafting without the advancement distinction in 21160. The operative documentation should support the specific procedure performed.

Can the bone graft be reported separately?

Bone grafting is part of the service represented by 21160. Do not separately report the same graft work as though it were a separate reconstruction.

Does modifier 50 apply?

No. CMS identifies bilateral adjustment as inappropriate for this code.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

May an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeons and team surgery are not permitted.

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 21160PPRRVU2026_Oct_nonQPP.csv, line 1,897 (RVU26D)

Open CMS sourceHow we calculate rates

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