CPT code 21180: Forehead reconstruction, autograft2026 Medicare rate & RVUs in North Dakota

Reports reconstructive surgery of the forehead using the patient's own graft tissue when the operative work specifically includes autograft reconstruction.

CMS RVU26DEffective Oct 1, 2026One payment locality

In North Dakota, Medicare pays $1,403.83 for 21180 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$1,403.83Hospital or facility

Check a contract rate as a % of Medicare · 21180 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 21180 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Dakota
  2. What 21180 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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.

How North Dakota compares for 21180

Across 109 of 109 payment localities, the facility rate for 21180 runs from $1,349.06 in Arkansas to $1,875.79 in Alaska. North Dakota pays $1,403.83. The RVUs are the same everywhere; the geographic indexes change the dollars.

21180 in North Dakota vs other payment areas
  1. North Dakota · this page$1,403.83
  2. Los Angeles, CA · California$1,570.85+$167.02
  3. Washington, DC area · District of Columbia$1,648.58+$244.75
  4. Miami, FL · Florida$1,752.98+$349.15
  5. Chicago, IL · Illinois$1,704.33+$300.50
  6. Manhattan, NY · New York$1,721.93+$318.10
  7. Alaska · Alaska$1,875.79+$471.96

Other areas in North Dakota first, then benchmark localities. Bars start at $0.

Every other payment area

21180 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$1,365.07
ArkansasArkansas—$1,349.06
ArizonaArizona—$1,457.67
Bakersfield, CACalifornia—$1,499.82
Chico, CACalifornia—$1,486.87
El Centro, CACalifornia—$1,487.64
Fresno, CACalifornia—$1,486.87
Hanford, CACalifornia—$1,486.87

21180 rates by state

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

Explore a state

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
21180 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

See 21180 in every payment locality

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

Office or facility?

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.

The exact North Dakota inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,901

Code
21180
Physician work
24.94
Practice expense
15.21
Malpractice
4.63

GPCI2026.csv

84

Locality
North Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.406
Facility calculation for 21180 in North Dakota
ComponentRVULocality factorAdjusted
Physician work24.94× 1.00024.9400
Practice expense15.21× 1.00015.2100
Malpractice4.63× 0.4061.8798
Total RVUs42.0298
Conversion factor× 33.4009

Facility rate, North Dakota$1403.83

Facility: (24.94 × 1 + 15.21 × 1 + 4.63 × 0.406) × $33.4009 = $1403.83

Open 21180 in the RVU calculator

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

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)1Permitted with supporting documentation.
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 · 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.

  • 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

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%).

When to use modifier 51

How 21180 has changed in North Dakota

21180 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

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 fromOfficeFacilityCMS release
2026-10-01Not available in this setting$1,403.83RVU26D
2026-07-01Not available in this setting$1,403.83RVU26C
2026-04-01Not available in this setting$1,403.83RVU26B
2026-01-01Not available in this setting$1,403.83RVU26A
2025-10-01Not available in this setting$1,582.21RVU25D
2025-07-01Not available in this setting$1,582.21RVU25C
2025-04-01Not available in this setting$1,582.21RVU25B
2025-01-01Not available in this setting$1,582.21RVU25A
2024-10-01Not available in this setting$1,614.28RVU24D
2024-07-01Not available in this setting$1,614.28RVU24C
2024-04-01Not available in this setting$1,614.28RVU24B
2024-03-09Not available in this setting$1,614.28RVU24AR
2024-01-01Not available in this setting$1,587.93RVU24A
2023-10-01Not available in this setting$1,636.77RVU23D
2023-07-01Not available in this setting$1,636.77RVU23C
2023-04-01Not available in this setting$1,636.77RVU23B
2023-01-01Not available in this setting$1,636.77RVU23A
2022-10-01Not available in this setting$1,648.39RVU22D
2022-07-01Not available in this setting$1,648.39RVU22C
2022-04-01Not available in this setting$1,648.39RVU22B
2022-01-01Not available in this setting$1,648.39RVU22A
2021-10-01Not available in this setting$1,654.37RVU21D
2021-07-01Not available in this setting$1,654.37RVU21C
2021-04-01Not available in this setting$1,654.37RVU21B
2021-01-01Not available in this setting$1,654.37RVU21A
2020-10-01Not available in this setting$1,700.63RVU20D
2020-07-01Not available in this setting$1,700.63RVU20C
2020-04-01Not available in this setting$1,700.63RVU20B
2020-01-01Not available in this setting$1,700.63RVU20A
2019-10-01Not available in this setting$1,695.80RVU19D
2019-07-01Not available in this setting$1,695.80RVU19C
2019-04-01Not available in this setting$1,695.80RVU19B
2019-01-01Not available in this setting$1,695.80RVU19A
2018-10-01Not available in this setting$1,693.36RVU18D
2018-07-01Not available in this setting$1,693.36RVU18C
2018-04-01Not available in this setting$1,693.36RVU18B
2018-01-01Not available in this setting$1,693.36RVU18AR1
2017-10-01Not available in this setting$1,555.63RVU17D
2017-07-01Not available in this setting$1,555.63RVU17C
2017-04-01Not available in this setting$1,555.63RVU17B
2017-01-01Not available in this setting$1,555.63RVU17A
2016-10-01Not available in this setting$1,541.50RVU16D
2016-07-01Not available in this setting$1,541.50RVU16C
2016-04-01Not available in this setting$1,541.50RVU16B
2016-01-01Not available in this setting$1,541.50RVU16A
2015-10-01Not available in this setting$1,524.57RVU15D
2015-07-01Not available in this setting$1,524.57RVU15C
2015-04-01Not available in this setting$1,516.98RVU15B
2015-01-01Not available in this setting$1,516.98RVU15A
2014-10-01Not available in this setting$1,526.71RVU14D
2014-07-01Not available in this setting$1,526.71RVU14C
2014-04-01Not available in this setting$1,526.71RVU14B
2014-01-01Not available in this setting$1,526.71RVU14A
2013-10-01Not available in this setting$1,493.30RVU13D
2013-07-01Not available in this setting$1,493.30RVU13C
2013-04-01Not available in this setting$1,493.30RVU13B
2013-01-01Not available in this setting$1,493.30RVU13AR

Price 21180 for an earlier date of service

Where the North Dakota rate applies

North Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 406 cities and communities in North Dakota. Some span more than one payment area; confirm with the service ZIP.

  • Abercrombie
  • Adams
  • Alamo
  • Alexander
  • Alice
  • Almont
  • Alsen
  • Ambrose

Browse all communities in North Dakota

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
RVUs for 21180PPRRVU2026_Oct_nonQPP.csv, line 1,901 (RVU26D)
Geographic factors for North DakotaGPCI2026.csv, line 84 (RVU26D)

Open CMS sourceHow we calculate rates

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