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CPT code 21183: Cranial reconstruction, multiple-suture craniosynostosis2026 Medicare rate & RVUs

Cranial vault reconstruction with grafting for multiple-suture craniosynostosis, reported when surgery remodels the skull to address the fused-suture pattern.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $2,006.73 for 21183 nationally in a facility.

Medicare rate · 21183

Cranial reconstruction, multiple-suture craniosynostosis

Office or facility?

Work RVUs
34.81
Total RVUs
60.08
Global days
090

National rate · 2026

$2,006.73

Facility setting, before claim adjustments.

See every locality for 21183 →Billed by an NP, PA or therapist? →

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

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 21183 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 21183 covers

21183 represents operative cranial-vault remodeling for craniosynostosis affecting multiple sutures, with bone grafting as part of the reconstruction. The surgeon reshapes and repositions cranial bone to correct the vault deformity and create room for brain growth. Craniofacial surgeons and pediatric neurosurgeons commonly perform this major operation in a hospital operating room, often as part of a multidisciplinary craniofacial plan.

Select this code when the operative record supports multiple-suture synostosis and the reconstruction matches this extent; a single-suture repair or a secondary extensive reconstruction falls under a different family level. Documentation should identify the fused sutures, deformity, bone remodeling and osteotomies, graft use, and reconstructive work. CMS assigns a 90-day major-surgery global, including the day-before preoperative visit and related postoperative care through day 90. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is not appropriate for this cranial anatomy. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team-surgery billing 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 21183 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

21183 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,834.55
AlaskaUnavailable$2,532.03
ArizonaUnavailable$1,956.18
ArkansasUnavailable$1,813.49
Atlanta, GAUnavailable$2,063.64
Austin, TXUnavailable$2,020.89
Bakersfield, CAUnavailable$2,004.77
Baltimore area, MDUnavailable$2,122.33
Beaumont, TXUnavailable$1,934.86
Brazoria, TXUnavailable$1,962.90

21183 rates by state

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

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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
21183 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

How the 21183 rate is calculated

Each of 21183’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 · 21183

RVUs × geographic indexes × conversion factor

Office or facility?

Work34.81

34.81 RVUs× 1.000 GPCI

Practice expense18.81

18.81 RVUs× 1.000 GPCI

Malpractice6.46

6.46 RVUs× 1.000 GPCI

Adjusted RVUs

60.0800

Conversion factor

$33.4009

Medicare rate

$2,006.73

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 21183

21183 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21183

Cranial reconstruction, multiple-suture craniosynostosis

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 · 21183

Cranial reconstruction, multiple-suture craniosynostosis

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

21183 without 51 · national facility

$2,006.73

Cranial reconstruction, multiple-suture craniosynostosis

21183-51 · Second procedure: 50%

$1,003.37

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

21183 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 21183

    Cranial reconstruction, multiple-suture craniosynostosis34.81 wRVU

    Not priced

  • 21182

    Cranial cranioplasty, multiple autografts, small defect31.77 wRVU

    Not priced

  • 21184

    Cranial reconstruction, cranial bone37.65 wRVU

    Not priced

  • 21188

    Midface reconstruction22.57 wRVU

    Not priced

How to choose

21182Cranial cranioplastyMultiple autografts, small defect
21182 is the related level for craniosynostosis involving a single suture; 21183 is for multiple-suture disease.
21184Cranial reconstructionCranial bone
21184 describes secondary, extensive cranial reconstruction. Distinguish it from 21183 by the documented secondary status and extent of the reconstruction.
21188Midface reconstruction
21188 addresses midface reconstruction with Le Fort III advancement. 21183 is cranial-vault reconstruction for multiple-suture craniosynostosis.

Codes related to 21183

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

Codes related to 21183
CodeHow it relatesNational office range
Same family
21182Cranial cranioplasty, multiple autografts, small defectRelated cranial reconstruction level for craniosynostosis involving a single suture.No office rate
21184Cranial reconstruction, cranial boneRelated level for secondary, extensive cranial reconstruction.No office rate
Used instead
21175Forehead reconstruction, bifrontal orbital rim advancementUsed for reconstruction centered on the bifrontal, supraorbital, and lower forehead region.No office rate

21183 billing questions

How does 21183 differ from 21182?

21183 is for craniosynostosis involving multiple sutures; 21182 is the related single-suture level. The operative documentation should establish the suture pattern.

When would 21184 be considered instead?

21184 describes a secondary, extensive cranial reconstruction. Use the documented procedure and extent to distinguish that work from a multiple-suture reconstruction reported with 21183.

Should modifier 50 be appended?

No. Modifier 50 is inappropriate for this cranial reconstruction.

What documentation supports 21183?

Document the fused sutures, cranial-vault deformity, bone remodeling and osteotomies, graft use, and the reconstructive work performed.

How are assistant and co-surgeon services handled?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team-surgery billing is not permitted.

What happens when other procedures are performed in the same session?

CMS applies the standard multiple procedure reduction: the highest-valued procedure is paid in full and other procedures are paid at 50%.

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 21183PPRRVU2026_Oct_nonQPP.csv, line 1,904 (RVU26D)

Open CMS sourceHow we calculate rates

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