CPT code 21184: Cranial reconstruction, cranial bone2026 Medicare rate & RVUs in Texas
Reports operative reconstruction of cranial bone for a defect or deformity, such as after trauma, tumor removal, or congenital cranial conditions.
CMS doesn’t publish an office rate for 21184 in Texas.
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
On this page 9 sections
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 in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $2,168.62 |
| Beaumont, TX | Unavailable | $2,078.09 |
| Brazoria, TX | Unavailable | $2,106.94 |
| Dallas, TX | Unavailable | $2,129.78 |
| Fort Worth, TX | Unavailable | $2,126.19 |
| Galveston, TX | Unavailable | $2,119.51 |
| Houston, TX | Unavailable | $2,247.82 |
| Rest of Texas | Unavailable | $2,097.85 |
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
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
| 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) | 0 | Not permitted. |
| 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 · 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.
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%).
21184 compared with similar codes
Compare codes · National
5 codes, side by side
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.
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
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