CPT code 21160: Midface reconstruction, leFort III advancement with graft2026 Medicare rate & RVUs in Florida
Reports LeFort III advancement of the midface with bone grafting to correct substantial midface retrusion or a related craniofacial deformity.
CMS doesn’t publish an office rate for 21160 in Florida.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
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 in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale, FL | Unavailable | $2,582.14 |
| Miami, FL | Unavailable | $2,761.43 |
| Rest of Florida | Unavailable | $2,477.77 |
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
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
| 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) | 0 | Not permitted. |
| 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 · 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.
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%).
21160 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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