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.
In North Dakota, Medicare pays $1,403.83 for 21180 in a facility. There’s no office rate.
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.
On this page 11 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.
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.
- North Dakota · this page$1,403.83
- Los Angeles, CA · California$1,570.85+$167.02
- Washington, DC area · District of Columbia$1,648.58+$244.75
- Miami, FL · Florida$1,752.98+$349.15
- Chicago, IL · Illinois$1,704.33+$300.50
- Manhattan, NY · New York$1,721.93+$318.10
- Alaska · Alaska$1,875.79+$471.96
Other areas in North Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| Madera, CACalifornia | — | $1,486.87 |
| Merced, CACalifornia | — | $1,486.87 |
| Modesto, CACalifornia | — | $1,486.87 |
| Napa, CACalifornia | — | $1,633.64 |
| Oxnard, CACalifornia | — | $1,553.18 |
| Redding, CACalifornia | — | $1,486.87 |
| Rest of CaliforniaCalifornia | — | $1,486.87 |
| Riverside, CACalifornia | — | $1,536.72 |
| Sacramento, CACalifornia | — | $1,536.73 |
| Salinas, CACalifornia | — | $1,530.54 |
| San Diego, CACalifornia | — | $1,549.43 |
| Marin County, CACalifornia | — | $1,699.46 |
| San Francisco, CACalifornia | — | $1,694.20 |
| San Benito County, CACalifornia | — | $1,740.12 |
| Santa Clara County, CACalifornia | — | $1,718.62 |
| San Luis Obispo, CACalifornia | — | $1,508.71 |
| Santa Cruz, CACalifornia | — | $1,550.66 |
| Santa Maria, CACalifornia | — | $1,531.59 |
| Santa Rosa, CACalifornia | — | $1,564.76 |
| Stockton, CACalifornia | — | $1,486.87 |
| Vallejo, CACalifornia | — | $1,626.06 |
| Visalia, CACalifornia | — | $1,486.87 |
| Yuba City, CACalifornia | — | $1,486.87 |
| ColoradoColorado | — | $1,504.33 |
| ConnecticutConnecticut | — | $1,583.95 |
| DelawareDelaware | — | $1,478.14 |
| Fort Lauderdale, FLFlorida | — | $1,627.25 |
| Rest of FloridaFlorida | — | $1,551.13 |
| Atlanta, GAGeorgia | — | $1,537.40 |
| Rest of GeorgiaGeorgia | — | $1,470.52 |
| Hawaii, Guam, HIHawaii | — | $1,500.19 |
| IowaIowa | — | $1,359.26 |
| IdahoIdaho | — | $1,373.55 |
| East St. Louis, ILIllinois | — | $1,611.86 |
| Rest of IllinoisIllinois | — | $1,538.56 |
| Suburban Chicago, ILIllinois | — | $1,634.63 |
| IndianaIndiana | — | $1,379.12 |
| KansasKansas | — | $1,370.22 |
| KentuckyKentucky | — | $1,426.16 |
| New Orleans, LALouisiana | — | $1,486.75 |
| Rest of LouisianaLouisiana | — | $1,430.77 |
| Metropolitan Boston, MAMassachusetts | — | $1,611.39 |
| Rest of MassachusettsMassachusetts | — | $1,504.55 |
| Baltimore area, MDMaryland | — | $1,582.76 |
| Rest of MarylandMaryland | — | $1,497.44 |
| Rest of MaineMaine | — | $1,396.59 |
| Southern Maine, MEMaine | — | $1,434.06 |
| Detroit, MIMichigan | — | $1,584.00 |
| Rest of MichiganMichigan | — | $1,471.44 |
| MinnesotaMinnesota | — | $1,401.55 |
| Metropolitan Kansas City, MOMissouri | — | $1,461.15 |
| Metropolitan St. Louis, MOMissouri | — | $1,471.62 |
| Rest of MissouriMissouri | — | $1,421.56 |
| MississippiMississippi | — | $1,384.71 |
| MontanaMontana | — | $1,495.38 |
| North CarolinaNorth Carolina | — | $1,405.83 |
| NebraskaNebraska | — | $1,360.38 |
| New HampshireNew Hampshire | — | $1,497.19 |
| Northern New JerseyNew Jersey | — | $1,639.97 |
| Rest of New JerseyNew Jersey | — | $1,590.75 |
| New MexicoNew Mexico | — | $1,484.61 |
| NevadaNevada | — | $1,470.37 |
| NYC suburbs and Long Island, NYNew York | — | $1,777.55 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $1,613.92 |
| Queens, NYNew York | — | $1,709.82 |
| Rest of New YorkNew York | — | $1,424.36 |
| OhioOhio | — | $1,452.73 |
| OklahomaOklahoma | — | $1,406.85 |
| Portland, OROregon | — | $1,525.82 |
| Rest of OregonOregon | — | $1,447.73 |
| Metropolitan Philadelphia, PAPennsylvania | — | $1,561.36 |
| Rest of PennsylvaniaPennsylvania | — | $1,445.53 |
| Puerto RicoPuerto Rico | — | $1,498.96 |
| Rhode IslandRhode Island | — | $1,511.58 |
| South CarolinaSouth Carolina | — | $1,433.89 |
| South DakotaSouth Dakota | — | $1,393.01 |
| TennesseeTennessee | — | $1,377.86 |
| Austin, TXTexas | — | $1,509.19 |
| Beaumont, TXTexas | — | $1,438.99 |
| Brazoria, TXTexas | — | $1,463.76 |
| Dallas, TXTexas | — | $1,479.20 |
| Fort Worth, TXTexas | — | $1,476.13 |
| Galveston, TXTexas | — | $1,472.20 |
| Houston, TXTexas | — | $1,556.95 |
| Rest of TexasTexas | — | $1,454.78 |
| UtahUtah | — | $1,449.44 |
| VirginiaVirginia | — | $1,441.59 |
| Virgin Islands, VIUnited States Virgin Islands | — | $1,498.96 |
| VermontVermont | — | $1,414.22 |
| Rest of WashingtonWashington | — | $1,496.49 |
| King County, WAWashington | — | $1,624.37 |
| WisconsinWisconsin | — | $1,367.34 |
| West VirginiaWest Virginia | — | $1,495.79 |
| WyomingWyoming | — | $1,455.48 |
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
| 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 |
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.
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
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 24.94 | × 1.000 | 24.9400 |
| Practice expense | 15.21 | × 1.000 | 15.2100 |
| Malpractice | 4.63 | × 0.406 | 1.8798 |
| Total RVUs | 42.0298 | ||
| 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
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%).
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.
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
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $1,403.83 | RVU26D |
| 2026-07-01 | Not available in this setting | $1,403.83 | RVU26C |
| 2026-04-01 | Not available in this setting | $1,403.83 | RVU26B |
| 2026-01-01 | Not available in this setting | $1,403.83 | RVU26A |
| 2025-10-01 | Not available in this setting | $1,582.21 | RVU25D |
| 2025-07-01 | Not available in this setting | $1,582.21 | RVU25C |
| 2025-04-01 | Not available in this setting | $1,582.21 | RVU25B |
| 2025-01-01 | Not available in this setting | $1,582.21 | RVU25A |
| 2024-10-01 | Not available in this setting | $1,614.28 | RVU24D |
| 2024-07-01 | Not available in this setting | $1,614.28 | RVU24C |
| 2024-04-01 | Not available in this setting | $1,614.28 | RVU24B |
| 2024-03-09 | Not available in this setting | $1,614.28 | RVU24AR |
| 2024-01-01 | Not available in this setting | $1,587.93 | RVU24A |
| 2023-10-01 | Not available in this setting | $1,636.77 | RVU23D |
| 2023-07-01 | Not available in this setting | $1,636.77 | RVU23C |
| 2023-04-01 | Not available in this setting | $1,636.77 | RVU23B |
| 2023-01-01 | Not available in this setting | $1,636.77 | RVU23A |
| 2022-10-01 | Not available in this setting | $1,648.39 | RVU22D |
| 2022-07-01 | Not available in this setting | $1,648.39 | RVU22C |
| 2022-04-01 | Not available in this setting | $1,648.39 | RVU22B |
| 2022-01-01 | Not available in this setting | $1,648.39 | RVU22A |
| 2021-10-01 | Not available in this setting | $1,654.37 | RVU21D |
| 2021-07-01 | Not available in this setting | $1,654.37 | RVU21C |
| 2021-04-01 | Not available in this setting | $1,654.37 | RVU21B |
| 2021-01-01 | Not available in this setting | $1,654.37 | RVU21A |
| 2020-10-01 | Not available in this setting | $1,700.63 | RVU20D |
| 2020-07-01 | Not available in this setting | $1,700.63 | RVU20C |
| 2020-04-01 | Not available in this setting | $1,700.63 | RVU20B |
| 2020-01-01 | Not available in this setting | $1,700.63 | RVU20A |
| 2019-10-01 | Not available in this setting | $1,695.80 | RVU19D |
| 2019-07-01 | Not available in this setting | $1,695.80 | RVU19C |
| 2019-04-01 | Not available in this setting | $1,695.80 | RVU19B |
| 2019-01-01 | Not available in this setting | $1,695.80 | RVU19A |
| 2018-10-01 | Not available in this setting | $1,693.36 | RVU18D |
| 2018-07-01 | Not available in this setting | $1,693.36 | RVU18C |
| 2018-04-01 | Not available in this setting | $1,693.36 | RVU18B |
| 2018-01-01 | Not available in this setting | $1,693.36 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $1,555.63 | RVU17D |
| 2017-07-01 | Not available in this setting | $1,555.63 | RVU17C |
| 2017-04-01 | Not available in this setting | $1,555.63 | RVU17B |
| 2017-01-01 | Not available in this setting | $1,555.63 | RVU17A |
| 2016-10-01 | Not available in this setting | $1,541.50 | RVU16D |
| 2016-07-01 | Not available in this setting | $1,541.50 | RVU16C |
| 2016-04-01 | Not available in this setting | $1,541.50 | RVU16B |
| 2016-01-01 | Not available in this setting | $1,541.50 | RVU16A |
| 2015-10-01 | Not available in this setting | $1,524.57 | RVU15D |
| 2015-07-01 | Not available in this setting | $1,524.57 | RVU15C |
| 2015-04-01 | Not available in this setting | $1,516.98 | RVU15B |
| 2015-01-01 | Not available in this setting | $1,516.98 | RVU15A |
| 2014-10-01 | Not available in this setting | $1,526.71 | RVU14D |
| 2014-07-01 | Not available in this setting | $1,526.71 | RVU14C |
| 2014-04-01 | Not available in this setting | $1,526.71 | RVU14B |
| 2014-01-01 | Not available in this setting | $1,526.71 | RVU14A |
| 2013-10-01 | Not available in this setting | $1,493.30 | RVU13D |
| 2013-07-01 | Not available in this setting | $1,493.30 | RVU13C |
| 2013-04-01 | Not available in this setting | $1,493.30 | RVU13B |
| 2013-01-01 | Not available in this setting | $1,493.30 | RVU13AR |
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
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
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