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

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, 2026One payment locality

In Iowa, Medicare pays $1,823.21 for 21183 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$1,823.21Hospital or facility

Check a contract rate as a % of Medicare · 21183 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 21183 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Iowa
  2. What 21183 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 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.

How Iowa compares for 21183

Across 109 of 109 payment localities, the facility rate for 21183 runs from $1,813.49 in Arkansas to $2,532.03 in Alaska. Iowa pays $1,823.21. The RVUs are the same everywhere; the geographic indexes change the dollars.

21183 in Iowa vs other payment areas
  1. Iowa · this page$1,823.21
  2. Los Angeles, CA · California$2,096.87+$273.66
  3. Washington, DC area · District of Columbia$2,205.73+$382.52
  4. Miami, FL · Florida$2,362.40+$539.19
  5. Chicago, IL · Illinois$2,297.43+$474.22
  6. Manhattan, NY · New York$2,309.36+$486.15
  7. Alaska · Alaska$2,532.03+$708.82

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

Every other payment area

21183 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$1,834.55
ArkansasArkansas—$1,813.49
ArizonaArizona—$1,956.18
Bakersfield, CACalifornia—$2,004.77
Chico, CACalifornia—$1,986.69
El Centro, CACalifornia—$1,987.77
Fresno, CACalifornia—$1,986.69
Hanford, CACalifornia—$1,986.69

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

See 21183 in every payment locality

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.

The exact Iowa inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,904

Code
21183
Physician work
34.81
Practice expense
18.81
Malpractice
6.46

GPCI2026.csv

53

Locality
Iowa
Physician work
1.000
Practice expense
0.915
Malpractice
0.397
Facility calculation for 21183 in Iowa
ComponentRVULocality factorAdjusted
Physician work34.81× 1.00034.8100
Practice expense18.81× 0.91517.2111
Malpractice6.46× 0.3972.5646
Total RVUs54.5858
Conversion factor× 33.4009

Facility rate, Iowa$1823.21

Facility: (34.81 × 1 + 18.81 × 0.915 + 6.46 × 0.397) × $33.4009 = $1823.21

Open 21183 in the RVU calculator

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

How 21183 has changed in Iowa

21183 · 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$1,823.21RVU26D
2026-07-01Not available in this setting$1,823.21RVU26C
2026-04-01Not available in this setting$1,823.21RVU26B
2026-01-01Not available in this setting$1,823.21RVU26A
2025-10-01Not available in this setting$2,049.85RVU25D
2025-07-01Not available in this setting$2,049.85RVU25C
2025-04-01Not available in this setting$2,049.85RVU25B
2025-01-01Not available in this setting$2,049.85RVU25A
2024-10-01Not available in this setting$2,091.56RVU24D
2024-07-01Not available in this setting$2,091.56RVU24C
2024-04-01Not available in this setting$2,091.56RVU24B
2024-03-09Not available in this setting$2,091.56RVU24AR
2024-01-01Not available in this setting$2,057.42RVU24A
2023-10-01Not available in this setting$2,123.51RVU23D
2023-07-01Not available in this setting$2,123.51RVU23C
2023-04-01Not available in this setting$2,123.51RVU23B
2023-01-01Not available in this setting$2,123.51RVU23A
2022-10-01Not available in this setting$2,142.06RVU22D
2022-07-01Not available in this setting$2,142.06RVU22C
2022-04-01Not available in this setting$2,142.06RVU22B
2022-01-01Not available in this setting$2,142.06RVU22A
2021-10-01Not available in this setting$2,152.91RVU21D
2021-07-01Not available in this setting$2,152.91RVU21C
2021-04-01Not available in this setting$2,152.91RVU21B
2021-01-01Not available in this setting$2,152.91RVU21A
2020-10-01Not available in this setting$2,209.35RVU20D
2020-07-01Not available in this setting$2,209.35RVU20C
2020-04-01Not available in this setting$2,209.35RVU20B
2020-01-01Not available in this setting$2,209.35RVU20A
2019-10-01Not available in this setting$2,195.49RVU19D
2019-07-01Not available in this setting$2,195.49RVU19C
2019-04-01Not available in this setting$2,195.49RVU19B
2019-01-01Not available in this setting$2,195.49RVU19A
2018-10-01Not available in this setting$2,195.43RVU18D
2018-07-01Not available in this setting$2,195.43RVU18C
2018-04-01Not available in this setting$2,195.43RVU18B
2018-01-01Not available in this setting$2,195.43RVU18AR1
2017-10-01Not available in this setting$2,166.27RVU17D
2017-07-01Not available in this setting$2,166.27RVU17C
2017-04-01Not available in this setting$2,166.27RVU17B
2017-01-01Not available in this setting$2,166.27RVU17A
2016-10-01Not available in this setting$2,185.34RVU16D
2016-07-01Not available in this setting$2,185.34RVU16C
2016-04-01Not available in this setting$2,185.34RVU16B
2016-01-01Not available in this setting$2,185.34RVU16A
2015-10-01Not available in this setting$2,160.66RVU15D
2015-07-01Not available in this setting$2,160.66RVU15C
2015-04-01Not available in this setting$2,149.91RVU15B
2015-01-01Not available in this setting$2,149.91RVU15A
2014-10-01Not available in this setting$2,227.69RVU14D
2014-07-01Not available in this setting$2,227.69RVU14C
2014-04-01Not available in this setting$2,227.69RVU14B
2014-01-01Not available in this setting$2,227.69RVU14A
2013-10-01Not available in this setting$2,167.62RVU13D
2013-07-01Not available in this setting$2,167.62RVU13C
2013-04-01Not available in this setting$2,167.62RVU13B
2013-01-01Not available in this setting$2,167.62RVU13AR

Price 21183 for an earlier date of service

Where the Iowa rate applies

Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.

  • Ackley
  • Ackworth
  • Adair
  • Adel
  • Afton
  • Agency
  • Ainsworth
  • Akron

Browse all communities in Iowa

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)
Geographic factors for IowaGPCI2026.csv, line 53 (RVU26D)

Open CMS sourceHow we calculate rates

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