CPT code 21179: Forehead reconstruction, with grafts2026 Medicare rate & RVUs in Maryland
Reports reconstructive surgery of the forehead using graft material to restore contour or structure after congenital deformity, trauma, or surgical resection.
CMS doesn’t publish an office rate for 21179 in Maryland.
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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What 21179 covers
This code represents operative reconstruction of the forehead using graft material to restore or reshape the affected area. Craniofacial and plastic surgeons may perform the procedure for a congenital craniofacial deformity, a traumatic defect, or a defect remaining after tumor or other surgical resection. The operative report should describe the forehead reconstruction, the defect addressed, and the graft material used; the diagnosis alone does not establish this service.
Report the code when the documented operation matches forehead reconstruction with grafts, rather than a procedure focused on the orbit or broader cranial bone. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When other 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. 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 21179 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | Unavailable | $1,421.51 |
| Rest of Maryland | Unavailable | $1,344.82 |
| Washington, DC area | Unavailable | $1,481.76 |
How the 21179 rate is calculated
Each of 21179’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 · 21179
RVUs × geographic indexes × conversion factor
Work22.08
22.08 RVUs× 1.000 GPCI
Practice expense14.03
14.03 RVUs× 1.000 GPCI
Malpractice4.10
4.10 RVUs× 1.000 GPCI
Adjusted RVUs
40.2100
Conversion factor
$33.4009
Medicare rate
$1,343.05
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 21179
21179 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21179
Forehead reconstruction, with grafts
| 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 · 21179
Forehead reconstruction, with grafts
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
21179 without 51 · national facility
$1,343.05
Forehead reconstruction, with grafts
21179-51 · Second procedure: 50%
$671.53
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%).
21179 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 21180Forehead reconstructionAutograft
- This code describes forehead reconstruction with grafts; 21180 specifically identifies an autogenous bone graft. Follow the documented graft and operative service when selecting between them.
- 21175Forehead reconstructionBifrontal orbital rim advancement
- Use 21175 when the operation matches its bifrontal, supraorbital rim, and lower-forehead reconstruction pattern, rather than the forehead graft reconstruction represented here.
- 21182Cranial cranioplastyMultiple autografts, small defect
- Code 21182 concerns reconstruction of cranial bone. This code is directed to reconstruction of the forehead using graft material.
21179 billing questions
How is this code distinguished from 21180?
Both describe forehead reconstruction involving grafting. Code 21180 specifically identifies an autogenous bone graft, so use the operative details and the applicable descriptor to distinguish the services.
What documentation supports reporting this code?
Document the forehead defect or deformity, the reconstructive work performed, and the graft material used. The diagnosis by itself does not show that graft-based forehead reconstruction was performed.
Can modifier 50 be appended for both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.
How are other procedures in the same session paid?
Under the standard multiple-procedure rule, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons and team surgery are not permitted 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.
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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