CPT code 21181: Cranial reconstruction, benign tumor contouring2026 Medicare rate & RVUs in Washington, DC area

In Washington, DC area, Medicare pays $746.90 for 21181 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 21181 nationwide

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

What 21181 covers

This service addresses contour deformity of the external cranial bones associated with a benign tumor, such as an irregular skull contour after tumor treatment. A craniofacial or plastic surgeon, or a neurosurgeon with reconstructive expertise, reshapes or reconstructs the affected cranial area in an operative setting. The work is directed at the bony contour rather than simply removing the tumor.

Report 21181 when the operation performs the specific cranial contour reconstruction for a benign tumor; documentation should identify the tumor-related deformity, the cranial site, and the reconstructive work performed. Tumor excision is a distinct service and should be evaluated separately when performed. Medicare assigns a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care. 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. Assistant-at-surgery payment requires documented medical necessity.

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 Washington, DC area compares for 21181

Across 109 of 109 payment localities, the facility rate for 21181 runs from $603.66 in Arkansas to $830.07 in Alaska. Washington, DC area pays $746.90. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

21181 rates by state

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

See 21181 in every payment locality

How the 21181 rate is calculated

Each of 21181’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.

Payment rules and modifiers for 21181

21181 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

Codes related to 21181

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

How 21181 has changed in Washington, DC area

Price 21181 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

• Washington

Browse all communities in District of Columbia

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

Open CMS sourceHow we calculate rates