CPT code 21172: Forehead reconstruction, supraorbital rim and lower forehead2026 Medicare rate & RVUs in New Mexico

Reconstructs the supraorbital rim and lower forehead, commonly to correct a craniofacial deformity requiring reshaping of the upper facial skeleton.

CMS RVU26DEffective Oct 1, 2026One payment locality35 Medicare services in 2024

In New Mexico, Medicare pays $2,102.38 for 21172 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)

$2,102.38Hospital or facility

Check a contract rate as a % of Medicare · 21172 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

Rate in New Mexico
What 21172 covers
Compared with other areas
Rate map
How it’s calculated
Payment rules
Related codes
Rate history
Where it applies
Billing questions
Sources

What 21172 covers

This operation reshapes the bony framework of the lower forehead and supraorbital rim. It is typically performed by a craniofacial, plastic, or oral and maxillofacial surgeon in an operating room, often for a congenital craniofacial deformity such as craniosynostosis. The surgeon’s operative report should identify the reconstructed anatomy and describe the bony work performed.

Report the code when the documented procedure matches reconstruction of the supraorbital rim and lower forehead, rather than a broader bifrontal reconstruction or a different forehead reconstruction. Medicare assigns a 90-day global period; the day-before preoperative visit and related postoperative care during that period are included. 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 multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery services 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 21172

Across 109 of 109 payment localities, the facility rate for 21172 runs from $1,787.38 in Nebraska to $2,715.24 in Miami, FL. New Mexico pays $2,102.38. The RVUs are the same everywhere; the geographic indexes change the dollars.

21172 in New Mexico vs other payment areas

New Mexico · this page$2,102.38
Los Angeles, CA · California$2,139.52+$37.14
Washington, DC area · District of Columbia$2,321.96+$219.58
Miami, FL · Florida$2,715.24+$612.86
Chicago, IL · Illinois$2,602.61+$500.23
Manhattan, NY · New York$2,502.37+$399.99
Alaska · Alaska$2,424.92+$322.54

Other areas in New Mexico first, then benchmark localities. Bars start at $0.

Every other payment area

21172 in every other Medicare payment locality
Payment locality	Office	Facility
AlabamaAlabama	—	$1,822.86
ArkansasArkansas	—	$1,790.53
ArizonaArizona	—	$2,009.04
Bakersfield, CACalifornia	—	$2,029.89
Chico, CACalifornia	—	$1,999.70
El Centro, CACalifornia	—	$2,001.64
Fresno, CACalifornia	—	$1,999.70
Hanford, CACalifornia	—	$1,999.70
Madera, CACalifornia	—	$1,999.70
Merced, CACalifornia	—	$1,999.70
Modesto, CACalifornia	—	$1,999.70
Napa, CACalifornia	—	$2,204.73
Oxnard, CACalifornia	—	$2,110.87
Redding, CACalifornia	—	$1,999.70
Rest of CaliforniaCalifornia	—	$1,999.70
Riverside, CACalifornia	—	$2,123.75
Sacramento, CACalifornia	—	$2,069.56
Salinas, CACalifornia	—	$2,061.84
San Diego, CACalifornia	—	$2,092.19
Marin County, CACalifornia	—	$2,287.06
San Francisco, CACalifornia	—	$2,273.85
San Benito County, CACalifornia	—	$2,355.78
Santa Clara County, CACalifornia	—	$2,301.78
San Luis Obispo, CACalifornia	—	$2,033.33
Santa Cruz, CACalifornia	—	$2,096.46
Santa Maria, CACalifornia	—	$2,064.56
Santa Rosa, CACalifornia	—	$2,114.89
Stockton, CACalifornia	—	$1,999.70
Vallejo, CACalifornia	—	$2,185.70
Visalia, CACalifornia	—	$1,999.70
Yuba City, CACalifornia	—	$1,999.70
ColoradoColorado	—	$2,065.24
ConnecticutConnecticut	—	$2,249.40
DelawareDelaware	—	$2,045.20
Fort Lauderdale, FLFlorida	—	$2,413.27
Rest of FloridaFlorida	—	$2,250.20
Atlanta, GAGeorgia	—	$2,182.58
Rest of GeorgiaGeorgia	—	$2,079.33
Hawaii, Guam, HIHawaii	—	$2,032.86
IowaIowa	—	$1,788.50
IdahoIdaho	—	$1,821.93
East St. Louis, ILIllinois	—	$2,420.54
Rest of IllinoisIllinois	—	$2,239.87
Suburban Chicago, ILIllinois	—	$2,416.66
IndianaIndiana	—	$1,832.46
KansasKansas	—	$1,821.46
KentuckyKentucky	—	$1,969.38
New Orleans, LALouisiana	—	$2,095.90
Rest of LouisianaLouisiana	—	$1,982.95
Metropolitan Boston, MAMassachusetts	—	$2,235.91
Rest of MassachusettsMassachusetts	—	$2,066.53
Baltimore area, MDMaryland	—	$2,253.09
Rest of MarylandMaryland	—	$2,075.95
Rest of MaineMaine	—	$1,879.81
Southern Maine, MEMaine	—	$1,938.85
Detroit, MIMichigan	—	$2,328.33
Rest of MichiganMichigan	—	$2,071.28
MinnesotaMinnesota	—	$1,838.44
Metropolitan Kansas City, MOMissouri	—	$2,032.57
Metropolitan St. Louis, MOMissouri	—	$2,052.46
Rest of MissouriMissouri	—	$1,971.18
MississippiMississippi	—	$1,879.11
MontanaMontana	—	$2,088.45
North CarolinaNorth Carolina	—	$1,896.58
North DakotaNorth Dakota	—	$1,858.49
NebraskaNebraska	—	$1,787.38
New HampshireNew Hampshire	—	$2,072.74
Northern New JerseyNew Jersey	—	$2,298.67
Rest of New JerseyNew Jersey	—	$2,235.61
NevadaNevada	—	$2,025.14
NYC suburbs and Long Island, NYNew York	—	$2,628.76
Poughkeepsie and northern NYC suburbs, NYNew York	—	$2,286.45
Queens, NYNew York	—	$2,462.08
Rest of New YorkNew York	—	$1,934.74
OhioOhio	—	$2,024.28
OklahomaOklahoma	—	$1,918.90
Portland, OROregon	—	$2,091.31
Rest of OregonOregon	—	$1,970.73
Metropolitan Philadelphia, PAPennsylvania	—	$2,212.80
Rest of PennsylvaniaPennsylvania	—	$2,003.72
Puerto RicoPuerto Rico	—	$2,092.00
Rhode IslandRhode Island	—	$2,090.54
South CarolinaSouth Carolina	—	$1,971.51
South DakotaSouth Dakota	—	$1,831.29
TennesseeTennessee	—	$1,838.19
Austin, TXTexas	—	$2,092.15
Beaumont, TXTexas	—	$1,991.24
Brazoria, TXTexas	—	$2,004.07
Dallas, TXTexas	—	$2,039.20
Fort Worth, TXTexas	—	$2,036.43
Galveston, TXTexas	—	$2,024.28
Houston, TXTexas	—	$2,237.16
Rest of TexasTexas	—	$2,011.65
UtahUtah	—	$2,002.67
VirginiaVirginia	—	$1,961.72
Virgin Islands, VIUnited States Virgin Islands	—	$2,092.00
VermontVermont	—	$1,889.51
Rest of WashingtonWashington	—	$2,049.79
King County, WAWashington	—	$2,241.64
WisconsinWisconsin	—	$1,787.56
West VirginiaWest Virginia	—	$2,154.17
WyomingWyoming	—	$1,988.23

21172 rates by state

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

ME WI VT NH MT ND MN MI NY MA RI WA ID WY SD IA IL IN OH PA NJ CT OR NV UT CO NE MO KY WV VA MD DE CA AZ NM KS OK AR TN NC SC DC TX LA MS AL GA FL AK HI

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Local rates. Clear comparisons.

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21172 office rate range by state
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

See 21172 in every payment locality

How the 21172 rate is calculated

Each of 21172’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 · 21172

RVUs × geographic indexes × conversion factor

Office or facility?

Your ZIP

Work27.50

27.50 RVUs× 1.000 GPCI

Practice expense23.42

23.42 RVUs× 1.000 GPCI

Malpractice11.63

11.63 RVUs× 1.000 GPCI

Adjusted RVUs

62.5500

Conversion factor

$33.4009

Medicare rate

$2,089.23

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

1,898

Code: 21172
Physician work: 27.50
Practice expense: 23.42
Malpractice: 11.63

GPCI2026.csv

Locality: New Mexico
Physician work: 1.000
Practice expense: 0.917
Malpractice: 1.201

Facility calculation for 21172 in New Mexico
Component	RVU	Locality factor	Adjusted
Physician work	27.50	× 1.000	27.5000
Practice expense	23.42	× 0.917	21.4761
Malpractice	11.63	× 1.201	13.9676
Total RVUs			62.9438
Conversion factor			× 33.4009

Facility rate, New Mexico$2102.38

Facility: (27.5 × 1 + 23.42 × 0.917 + 11.63 × 1.201) × $33.4009 = $2102.38

Open 21172 in the RVU calculator

Payment rules and modifiers for 21172

21172 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21172

Forehead reconstruction, supraorbital rim and lower forehead

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 · 21172

Forehead reconstruction, supraorbital rim and lower forehead

Date of surgery

Date of a later visit

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

21172 without 51 · national facility

$2,089.23

Forehead reconstruction, supraorbital rim and lower forehead

21172-51 · Second procedure: 50%

$1,044.62

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

Codes related to 21172

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

Codes related to 21172
Code	How it relates	Office range, New Mexico
Same family
21175	Forehead reconstruction, bifrontal orbital rim advancementRelated bifrontal reconstruction of the supraorbital rims and lower forehead.	No office rate
21179	Forehead reconstruction, with graftsForehead reconstruction code that specifies grafts.	No office rate
21180	Forehead reconstruction, autograftForehead reconstruction code that specifies an autograft.	No office rate

How 21172 has changed in New Mexico

21172 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

Compare with release effective

A rate is unavailable in one of these releases, so a change cannot be calculated.

Base rate by release · bars start at $0 · select a bar to compare

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

Rates in every CMS release
Effective from	Office	Facility	CMS release
2026-10-01	Not available in this setting	$2,102.38	RVU26D
2026-07-01	Not available in this setting	$2,102.38	RVU26C
2026-04-01	Not available in this setting	$2,102.38	RVU26B
2026-01-01	Not available in this setting	$2,102.38	RVU26A
2025-10-01	Not available in this setting	$2,072.98	RVU25D
2025-07-01	Not available in this setting	$2,072.98	RVU25C
2025-04-01	Not available in this setting	$2,072.98	RVU25B
2025-01-01	Not available in this setting	$2,072.98	RVU25A
2024-10-01	Not available in this setting	$2,134.60	RVU24D
2024-07-01	Not available in this setting	$2,134.60	RVU24C
2024-04-01	Not available in this setting	$2,134.60	RVU24B
2024-03-09	Not available in this setting	$2,134.60	RVU24AR
2024-01-01	Not available in this setting	$2,099.76	RVU24A
2023-10-01	Not available in this setting	$2,150.38	RVU23D
2023-07-01	Not available in this setting	$2,150.38	RVU23C
2023-04-01	Not available in this setting	$2,150.38	RVU23B
2023-01-01	Not available in this setting	$2,150.38	RVU23A
2022-10-01	Not available in this setting	$2,159.45	RVU22D
2022-07-01	Not available in this setting	$2,159.45	RVU22C
2022-04-01	Not available in this setting	$2,159.45	RVU22B
2022-01-01	Not available in this setting	$2,159.45	RVU22A
2021-10-01	Not available in this setting	$2,149.67	RVU21D
2021-07-01	Not available in this setting	$2,149.67	RVU21C
2021-04-01	Not available in this setting	$2,149.67	RVU21B
2021-01-01	Not available in this setting	$2,149.67	RVU21A
2020-10-01	Not available in this setting	$2,180.75	RVU20D
2020-07-01	Not available in this setting	$2,180.75	RVU20C
2020-04-01	Not available in this setting	$2,180.75	RVU20B
2020-01-01	Not available in this setting	$2,180.75	RVU20A
2019-10-01	Not available in this setting	$2,237.95	RVU19D
2019-07-01	Not available in this setting	$2,237.95	RVU19C
2019-04-01	Not available in this setting	$2,226.27	RVU19B
2019-01-01	Not available in this setting	$2,226.27	RVU19A
2018-10-01	Not available in this setting	$2,209.16	RVU18D
2018-07-01	Not available in this setting	$2,209.16	RVU18C
2018-04-01	Not available in this setting	$2,209.16	RVU18B
2018-01-01	Not available in this setting	$2,209.16	RVU18AR1
2017-10-01	Not available in this setting	$2,155.90	RVU17D
2017-07-01	Not available in this setting	$2,155.90	RVU17C
2017-04-01	Not available in this setting	$2,155.90	RVU17B
2017-01-01	Not available in this setting	$2,155.90	RVU17A
2016-10-01	Not available in this setting	$1,818.88	RVU16D
2016-07-01	Not available in this setting	$1,818.88	RVU16C
2016-04-01	Not available in this setting	$1,818.88	RVU16B
2016-01-01	Not available in this setting	$1,818.88	RVU16A
2015-10-01	Not available in this setting	$1,780.77	RVU15D
2015-07-01	Not available in this setting	$1,780.77	RVU15C
2015-04-01	Not available in this setting	$1,771.91	RVU15B
2015-01-01	Not available in this setting	$1,771.91	RVU15A
2014-10-01	Not available in this setting	$1,871.37	RVU14D
2014-07-01	Not available in this setting	$1,871.37	RVU14C
2014-04-01	Not available in this setting	$1,871.37	RVU14B
2014-01-01	Not available in this setting	$1,871.37	RVU14A
2013-10-01	Not available in this setting	$1,822.41	RVU13D
2013-07-01	Not available in this setting	$1,822.41	RVU13C
2013-04-01	Not available in this setting	$1,822.41	RVU13B
2013-01-01	Not available in this setting	$1,822.41	RVU13AR

Price 21172 for an earlier date of service

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

Browse all communities in New Mexico

21172 billing questions

How is this distinguished from 21175?

This code describes reconstruction of the supraorbital rim and lower forehead. Code 21175 identifies a bifrontal reconstruction involving the supraorbital rims and lower forehead; use the code matching the operative work documented.

Should modifier 50 be reported for both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.

What postoperative care is included?

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

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction when performed in the same session.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.

What documentation supports this code?

The operative report should identify the supraorbital rim and lower forehead as the reconstructed anatomy and describe the bony reconstruction 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

Show the CMS file lines behind this rate

RVUs for 21172PPRRVU2026_Oct_nonQPP.csv, line 1,898 (RVU26D)

1,89521155,,[CPT descriptor omitted],A,,34.34,16.08,NA,16.08,,5.01,55.43,55.43,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

1,89621159,,[CPT descriptor omitted],A,,42.06,17.96,NA,17.96,,6.15,66.17,66.17,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00

1,89721160,,[CPT descriptor omitted],A,,46.01,18.92,NA,18.92,,6.71,71.64,71.64,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

1,89821172,,[CPT descriptor omitted],A,,27.50,23.42,NA,23.42,,11.63,62.55,62.55,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00

1,89921175,,[CPT descriptor omitted],A,,32.72,19.04,NA,19.04,,6.08,57.84,57.84,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

1,90021179,,[CPT descriptor omitted],A,,22.08,14.03,NA,14.03,,4.10,40.21,40.21,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00

1,90121180,,[CPT descriptor omitted],A,,24.94,15.21,NA,15.21,,4.63,44.78,44.78,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00

Geographic factors for New MexicoGPCI2026.csv, line 77 (RVU26D)

7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875

7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068

7612402,NJ,99,REST OF NEW JERSEY,1.040,1.092,1.097

7704212,NM,05,NEW MEXICO,1.000,0.917,1.201

7813202,NY,01,MANHATTAN,1.064,1.162,1.586

7913202,NY,02,NYC SUBURBS/LONG ISLAND,1.064,1.189,1.857

8013202,NY,03,POUGHKPSIE/N NYC SUBURBS,1.045,1.095,1.210

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What 21172 covers

How New Mexico compares for 21172

Every other payment area

21172 rates by state

How the 21172 rate is calculated

Payment rules and modifiers for 21172

What modifiers do to the payment

Codes related to 21172

How 21172 has changed in New Mexico

Where the New Mexico rate applies

21172 billing questions

How is this distinguished from 21175?

Should modifier 50 be reported for both sides?

What postoperative care is included?

How are other procedures in the same session paid?

Can an assistant or co-surgeon be reported?

What documentation supports this code?

Where these rates come from

Did this answer your question about what 21172 pays in New Mexico?

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