CPT code 21180: Forehead reconstruction, autograft2026 Medicare rate & RVUs in Illinois
Reports reconstructive surgery of the forehead using the patient's own graft tissue when the operative work specifically includes autograft reconstruction.
CMS doesn’t publish an office rate for 21180 in Illinois.
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
On this page 9 sections
What 21180 covers
A craniofacial surgeon, plastic surgeon, or neurosurgeon may use this service to rebuild forehead contour or structure with tissue taken from the patient. The operative plan and report should identify the forehead reconstruction performed and the autograft used. Cases may arise in craniofacial reconstruction after congenital deformity, trauma, or removal of abnormal tissue, when the surgeon determines autologous grafting is part of the repair.
Select this code when the documented reconstruction includes an autograft; distinguish it from nearby forehead codes by the anatomy treated and the graft technique described in the operative report. CMS classifies the procedure as major surgery with a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. If 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. 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.
Where 21180 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | Unavailable | $1,704.33 |
| East St. Louis, IL | Unavailable | $1,611.86 |
| Rest of Illinois | Unavailable | $1,538.56 |
| Suburban Chicago, IL | Unavailable | $1,634.63 |
How the 21180 rate is calculated
Each of 21180’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 · 21180
RVUs × geographic indexes × conversion factor
Work24.94
24.94 RVUs× 1.000 GPCI
Practice expense15.21
15.21 RVUs× 1.000 GPCI
Malpractice4.63
4.63 RVUs× 1.000 GPCI
Adjusted RVUs
44.7800
Conversion factor
$33.4009
Medicare rate
$1,495.69
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 21180
21180 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21180
Forehead reconstruction, autograft
| 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 · 21180
Forehead reconstruction, autograft
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
21180 without 51 · national facility
$1,495.69
Forehead reconstruction, autograft
21180-51 · Second procedure: 50%
$747.85
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%).
21180 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 21179Forehead reconstructionWith grafts
- Both address forehead reconstruction. Use the code whose full descriptor and graft method match the documented operation; this code specifies autograft reconstruction.
- 21172Forehead reconstructionSupraorbital rim and lower forehead
- This code concerns forehead reconstruction with autograft. Code 21172 is directed to reconstruction involving the superior-lateral orbital rim and lower forehead.
- 21175Forehead reconstructionBifrontal orbital rim advancement
- Choose 21175 when the operation involves the bifrontal region, superior orbital rims, and lower forehead rather than the autograft forehead reconstruction described here.
21180 billing questions
How does this differ from 21179?
Both concern forehead reconstruction. This code identifies autograft reconstruction; compare the complete code descriptions and operative technique when deciding between them.
Should modifier 50 be appended for both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What documentation supports reporting this code?
The operative report should describe the forehead reconstruction, the structural work performed, and the use of the patient's own graft tissue.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What happens when another procedure is performed in the same session?
CMS pays the highest-valued procedure in full and applies the standard multiple-procedure reduction to the other procedures.
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
Put 21180 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Build my fee sheet