FeeBase
Log inGet started
Menu

CPT code 21184: Cranial reconstruction, cranial bone2026 Medicare rate & RVUs

Reports operative reconstruction of cranial bone for a defect or deformity, such as after trauma, tumor removal, or congenital cranial conditions.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $2,154.36 for 21184 nationally in a facility.

Medicare rate · 21184

Cranial reconstruction, cranial bone

Office or facility?

Work RVUs
37.65
Total RVUs
64.50
Global days
090

National rate · 2026

$2,154.36

Facility setting, before claim adjustments.

See every locality for 21184 →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 21184 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 21184 covers

Code 21184 reports surgery to reconstruct cranial bone and restore the contour or continuity of the skull. Typical clinical contexts include a cranial defect after trauma or tumor removal and selected congenital cranial deformities. Neurosurgeons and craniofacial or plastic surgeons may perform the operation, generally in a hospital operating room. The operative report should identify the defect, the bones treated, and the reconstructive work performed.

Select this code by matching the documented operation to the full descriptor and distinguishing it from other cranial reconstruction levels, including 21182 and 21183. CMS assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. 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 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment may be made; co-surgeons and team surgery are 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 21184 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

21184 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,969.91
AlaskaUnavailable$2,721.07
ArizonaUnavailable$2,100.10
ArkansasUnavailable$1,947.36
Atlanta, GAUnavailable$2,215.80
Austin, TXUnavailable$2,168.62
Bakersfield, CAUnavailable$2,150.32
Baltimore area, MDUnavailable$2,278.35
Beaumont, TXUnavailable$2,078.09
Brazoria, TXUnavailable$2,106.94

21184 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
21184 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 21184 rate is calculated

Each of 21184’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 · 21184

RVUs × geographic indexes × conversion factor

Office or facility?

Work37.65

37.65 RVUs× 1.000 GPCI

Practice expense19.84

19.84 RVUs× 1.000 GPCI

Malpractice7.01

7.01 RVUs× 1.000 GPCI

Adjusted RVUs

64.5000

Conversion factor

$33.4009

Medicare rate

$2,154.36

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

Payment rules and modifiers for 21184

21184 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21184

Cranial reconstruction, cranial bone

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)0Not permitted.
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 · 21184

Cranial reconstruction, cranial bone

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

21184 without 51 · national facility

$2,154.36

Cranial reconstruction, cranial bone

21184-51 · Second procedure: 50%

$1,077.18

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

21184 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 21184

    Cranial reconstruction, cranial bone37.65 wRVU

    Not priced

  • 21182

    Cranial cranioplasty, multiple autografts, small defect31.77 wRVU

    Not priced

  • 21183

    Cranial reconstruction, multiple-suture craniosynostosis34.81 wRVU

    Not priced

  • 21175

    Forehead reconstruction, bifrontal orbital rim advancement32.72 wRVU

    Not priced

  • 21188

    Midface reconstruction22.57 wRVU

    Not priced

How to choose

21182Cranial cranioplastyMultiple autografts, small defect
Both are in the cranial bone reconstruction family. Use the full descriptors and operative documentation to identify the specific level and scope.
21183Cranial reconstructionMultiple-suture craniosynostosis
This is a related cranial bone reconstruction code; distinguish it from 21184 by the exact operative service described in the full descriptor.
21175Forehead reconstructionBifrontal orbital rim advancement
21175 addresses forehead and brow reconstruction. Choose 21184 when the documented service is cranial bone reconstruction rather than that forehead-and-brow service.
21188Midface reconstruction
21188 addresses midface reconstruction, while 21184 concerns cranial bone reconstruction. The operative site separates the codes.

Codes related to 21184

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

Codes related to 21184
CodeHow it relatesNational office range
Same family
21182Cranial cranioplasty, multiple autografts, small defectRelated cranial bone reconstruction level; compare the full descriptors and documented operative scope.No office rate
21183Cranial reconstruction, multiple-suture craniosynostosisRelated cranial bone reconstruction level; distinguish by the specific operation documented.No office rate
Used instead
21175Forehead reconstruction, bifrontal orbital rim advancementForehead and brow reconstruction rather than cranial bone reconstruction.No office rate
21179Forehead reconstruction, with graftsForehead reconstruction; compare the treated anatomy and operative service.No office rate
21188Midface reconstructionReconstruction of the midface rather than cranial bone.No office rate

21184 billing questions

How do I choose 21184 instead of 21182 or 21183?

Compare the full descriptors and documented operative scope for the cranial reconstruction levels. The abbreviated CMS labels are similar, so the operative report should make clear what reconstruction was performed.

Can routine postoperative visits be billed separately?

Related postoperative care during the 90-day global period is included in the surgical payment.

Should modifier 50 be appended for reconstruction on both sides?

No. CMS identifies bilateral adjustment as inappropriate for this code.

Can an assistant surgeon be paid for this operation?

Assistant-at-surgery payment may be made. Co-surgeons and team surgery are not permitted.

What happens when another procedure is performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.

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 21184PPRRVU2026_Oct_nonQPP.csv, line 1,905 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 21184 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 21184 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Build my fee sheet