CPT code 21188: Midface reconstruction2026 Medicare rate & RVUs in Mississippi
Midface reconstruction covers major surgical reconstruction of the central facial skeleton, reported when the operative plan and documented work support this specific procedure.
In Mississippi, Medicare pays $1,321.74 for 21188 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 21188 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 21188 covers
This major reconstructive operation addresses the bony framework of the midface, such as the maxillary and cheek-region structures. It may be performed for a congenital craniofacial deformity, significant facial trauma, or a defect after removal of diseased tissue. Craniofacial, oral and maxillofacial, and plastic surgeons commonly perform this work in an operating room. The operative report should identify the reconstructed anatomy and describe the surgical approach and any grafting or other reconstruction performed.
Report 21188 when the documented midface reconstruction matches this procedure rather than a separately defined LeFort reconstruction or a lower-jaw procedure. The 90-day global period 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. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment may be allowed; 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.
How Mississippi compares for 21188
Across 109 of 109 payment localities, the facility rate for 21188 runs from $1,296.14 in Arkansas to $1,793.56 in Alaska. Mississippi pays $1,321.74. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Mississippi · this page$1,321.74
- Los Angeles, CA · California$1,526.64+$204.90
- Washington, DC area · District of Columbia$1,582.66+$260.92
- Miami, FL · Florida$1,619.09+$297.35
- Chicago, IL · Illinois$1,578.44+$256.70
- Manhattan, NY · New York$1,632.80+$311.06
- Alaska · Alaska$1,793.56+$471.82
Other areas in Mississippi first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $1,310.76 |
| ArkansasArkansas | — | $1,296.14 |
| ArizonaArizona | — | $1,395.62 |
| Bakersfield, CACalifornia | — | $1,454.83 |
| Chico, CACalifornia | — | $1,445.35 |
| El Centro, CACalifornia | — | $1,445.89 |
| Fresno, CACalifornia | — | $1,445.35 |
| Hanford, CACalifornia | — | $1,445.35 |
| Madera, CACalifornia | — | $1,445.35 |
| Merced, CACalifornia | — | $1,445.35 |
| Modesto, CACalifornia | — | $1,445.35 |
| Napa, CACalifornia | — | $1,602.57 |
| Oxnard, CACalifornia | — | $1,511.80 |
| Redding, CACalifornia | — | $1,445.35 |
| Rest of CaliforniaCalifornia | — | $1,445.35 |
| Riverside, CACalifornia | — | $1,480.72 |
| Sacramento, CACalifornia | — | $1,497.58 |
| Salinas, CACalifornia | — | $1,491.55 |
| San Diego, CACalifornia | — | $1,512.38 |
| Marin County, CACalifornia | — | $1,673.40 |
| San Francisco, CACalifornia | — | $1,669.69 |
| San Benito County, CACalifornia | — | $1,711.22 |
| Santa Clara County, CACalifornia | — | $1,696.04 |
| San Luis Obispo, CACalifornia | — | $1,469.68 |
| Santa Cruz, CACalifornia | — | $1,515.69 |
| Santa Maria, CACalifornia | — | $1,493.24 |
| Santa Rosa, CACalifornia | — | $1,529.83 |
| Stockton, CACalifornia | — | $1,445.35 |
| Vallejo, CACalifornia | — | $1,597.22 |
| Visalia, CACalifornia | — | $1,445.35 |
| Yuba City, CACalifornia | — | $1,445.35 |
| ColoradoColorado | — | $1,450.23 |
| ConnecticutConnecticut | — | $1,510.47 |
| DelawareDelaware | — | $1,414.84 |
| Fort Lauderdale, FLFlorida | — | $1,524.50 |
| Rest of FloridaFlorida | — | $1,458.93 |
| Atlanta, GAGeorgia | — | $1,462.16 |
| Rest of GeorgiaGeorgia | — | $1,388.75 |
| Hawaii, Guam, HIHawaii | — | $1,460.42 |
| IowaIowa | — | $1,314.94 |
| IdahoIdaho | — | $1,326.07 |
| East St. Louis, ILIllinois | — | $1,494.38 |
| Rest of IllinoisIllinois | — | $1,441.16 |
| Suburban Chicago, ILIllinois | — | $1,533.76 |
| IndianaIndiana | — | $1,331.45 |
| KansasKansas | — | $1,320.40 |
| KentuckyKentucky | — | $1,356.80 |
| New Orleans, LALouisiana | — | $1,410.36 |
| Rest of LouisianaLouisiana | — | $1,359.23 |
| Metropolitan Boston, MAMassachusetts | — | $1,557.55 |
| Rest of MassachusettsMassachusetts | — | $1,448.77 |
| Baltimore area, MDMaryland | — | $1,508.14 |
| Rest of MarylandMaryland | — | $1,434.26 |
| Rest of MaineMaine | — | $1,342.34 |
| Southern Maine, MEMaine | — | $1,383.50 |
| Detroit, MIMichigan | — | $1,484.01 |
| Rest of MichiganMichigan | — | $1,393.75 |
| MinnesotaMinnesota | — | $1,368.41 |
| Metropolitan Kansas City, MOMissouri | — | $1,391.86 |
| Metropolitan St. Louis, MOMissouri | — | $1,401.95 |
| Rest of MissouriMissouri | — | $1,347.97 |
| MontanaMontana | — | $1,428.67 |
| North CarolinaNorth Carolina | — | $1,351.55 |
| North DakotaNorth Dakota | — | $1,364.01 |
| NebraskaNebraska | — | $1,317.39 |
| New HampshireNew Hampshire | — | $1,438.44 |
| Northern New JerseyNew Jersey | — | $1,574.34 |
| Rest of New JerseyNew Jersey | — | $1,521.69 |
| New MexicoNew Mexico | — | $1,403.88 |
| NevadaNevada | — | $1,411.22 |
| NYC suburbs and Long Island, NYNew York | — | $1,677.68 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $1,539.50 |
| Queens, NYNew York | — | $1,628.39 |
| Rest of New YorkNew York | — | $1,368.16 |
| OhioOhio | — | $1,380.54 |
| OklahomaOklahoma | — | $1,343.99 |
| Portland, OROregon | — | $1,475.80 |
| Rest of OregonOregon | — | $1,394.19 |
| Metropolitan Philadelphia, PAPennsylvania | — | $1,486.74 |
| Rest of PennsylvaniaPennsylvania | — | $1,376.49 |
| Puerto RicoPuerto Rico | — | $1,433.48 |
| Rhode IslandRhode Island | — | $1,450.09 |
| South CarolinaSouth Carolina | — | $1,369.51 |
| South DakotaSouth Dakota | — | $1,356.37 |
| TennesseeTennessee | — | $1,326.83 |
| Austin, TXTexas | — | $1,450.76 |
| Beaumont, TXTexas | — | $1,370.21 |
| Brazoria, TXTexas | — | $1,405.80 |
| Dallas, TXTexas | — | $1,417.90 |
| Fort Worth, TXTexas | — | $1,413.66 |
| Galveston, TXTexas | — | $1,412.17 |
| Houston, TXTexas | — | $1,472.03 |
| Rest of TexasTexas | — | $1,389.44 |
| UtahUtah | — | $1,383.80 |
| VirginiaVirginia | — | $1,387.16 |
| Virgin Islands, VIUnited States Virgin Islands | — | $1,433.48 |
| VermontVermont | — | $1,369.28 |
| Rest of WashingtonWashington | — | $1,442.57 |
| King County, WAWashington | — | $1,575.04 |
| WisconsinWisconsin | — | $1,329.55 |
| West VirginiaWest Virginia | — | $1,401.84 |
| WyomingWyoming | — | $1,400.49 |
21188 rates by state
Office rate range in each state. Select a state to see its payment localities.
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 21188 rate is calculated
Each of 21188’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 · 21188
RVUs × geographic indexes × conversion factor
Work22.57
22.57 RVUs× 1.000 GPCI
Practice expense16.94
16.94 RVUs× 1.000 GPCI
Malpractice3.27
3.27 RVUs× 1.000 GPCI
Adjusted RVUs
42.7800
Conversion factor
$33.4009
Medicare rate
$1,428.89
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Mississippi inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
1,906
- Code
- 21188
- Physician work
- 22.57
- Practice expense
- 16.94
- Malpractice
- 3.27
GPCI2026.csv
67
- Locality
- Mississippi
- Physician work
- 1.000
- Practice expense
- 0.861
- Malpractice
- 0.739
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 22.57 | × 1.000 | 22.5700 |
| Practice expense | 16.94 | × 0.861 | 14.5853 |
| Malpractice | 3.27 | × 0.739 | 2.4165 |
| Total RVUs | 39.5719 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Mississippi$1321.74
Facility: (22.57 × 1 + 16.94 × 0.861 + 3.27 × 0.739) × $33.4009 = $1321.74
Payment rules and modifiers for 21188
21188 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21188
Midface reconstruction
| 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 · 21188
Midface reconstruction
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
21188 without 51 · national facility
$1,428.89
Midface reconstruction
21188-51 · Second procedure: 50%
$714.45
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%).
How 21188 has changed in Mississippi
21188 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $1,321.74 | RVU26D |
| 2026-07-01 | Not available in this setting | $1,321.74 | RVU26C |
| 2026-04-01 | Not available in this setting | $1,321.74 | RVU26B |
| 2026-01-01 | Not available in this setting | $1,321.74 | RVU26A |
| 2025-10-01 | Not available in this setting | $1,409.07 | RVU25D |
| 2025-07-01 | Not available in this setting | $1,409.07 | RVU25C |
| 2025-04-01 | Not available in this setting | $1,409.07 | RVU25B |
| 2025-01-01 | Not available in this setting | $1,409.07 | RVU25A |
| 2024-10-01 | Not available in this setting | $1,441.81 | RVU24D |
| 2024-07-01 | Not available in this setting | $1,441.81 | RVU24C |
| 2024-04-01 | Not available in this setting | $1,441.81 | RVU24B |
| 2024-03-09 | Not available in this setting | $1,441.81 | RVU24AR |
| 2024-01-01 | Not available in this setting | $1,418.27 | RVU24A |
| 2023-10-01 | Not available in this setting | $1,464.47 | RVU23D |
| 2023-07-01 | Not available in this setting | $1,464.47 | RVU23C |
| 2023-04-01 | Not available in this setting | $1,464.47 | RVU23B |
| 2023-01-01 | Not available in this setting | $1,464.47 | RVU23A |
| 2022-10-01 | Not available in this setting | $1,475.95 | RVU22D |
| 2022-07-01 | Not available in this setting | $1,475.95 | RVU22C |
| 2022-04-01 | Not available in this setting | $1,475.95 | RVU22B |
| 2022-01-01 | Not available in this setting | $1,475.95 | RVU22A |
| 2021-10-01 | Not available in this setting | $1,500.65 | RVU21D |
| 2021-07-01 | Not available in this setting | $1,500.65 | RVU21C |
| 2021-04-01 | Not available in this setting | $1,500.65 | RVU21B |
| 2021-01-01 | Not available in this setting | $1,500.65 | RVU21A |
| 2020-10-01 | Not available in this setting | $1,532.99 | RVU20D |
| 2020-07-01 | Not available in this setting | $1,532.99 | RVU20C |
| 2020-04-01 | Not available in this setting | $1,532.99 | RVU20B |
| 2020-01-01 | Not available in this setting | $1,532.99 | RVU20A |
| 2019-10-01 | Not available in this setting | $1,550.92 | RVU19D |
| 2019-07-01 | Not available in this setting | $1,550.92 | RVU19C |
| 2019-04-01 | Not available in this setting | $1,548.12 | RVU19B |
| 2019-01-01 | Not available in this setting | $1,548.12 | RVU19A |
| 2018-10-01 | Not available in this setting | $1,559.96 | RVU18D |
| 2018-07-01 | Not available in this setting | $1,559.96 | RVU18C |
| 2018-04-01 | Not available in this setting | $1,559.96 | RVU18B |
| 2018-01-01 | Not available in this setting | $1,559.96 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $1,525.71 | RVU17D |
| 2017-07-01 | Not available in this setting | $1,525.71 | RVU17C |
| 2017-04-01 | Not available in this setting | $1,525.71 | RVU17B |
| 2017-01-01 | Not available in this setting | $1,525.71 | RVU17A |
| 2016-10-01 | Not available in this setting | $1,522.61 | RVU16D |
| 2016-07-01 | Not available in this setting | $1,522.61 | RVU16C |
| 2016-04-01 | Not available in this setting | $1,522.61 | RVU16B |
| 2016-01-01 | Not available in this setting | $1,522.61 | RVU16A |
| 2015-10-01 | Not available in this setting | $1,482.36 | RVU15D |
| 2015-07-01 | Not available in this setting | $1,482.36 | RVU15C |
| 2015-04-01 | Not available in this setting | $1,474.98 | RVU15B |
| 2015-01-01 | Not available in this setting | $1,474.98 | RVU15A |
| 2014-10-01 | Not available in this setting | $1,491.90 | RVU14D |
| 2014-07-01 | Not available in this setting | $1,491.90 | RVU14C |
| 2014-04-01 | Not available in this setting | $1,491.90 | RVU14B |
| 2014-01-01 | Not available in this setting | $1,491.90 | RVU14A |
| 2013-10-01 | Not available in this setting | $1,480.88 | RVU13D |
| 2013-07-01 | Not available in this setting | $1,480.88 | RVU13C |
| 2013-04-01 | Not available in this setting | $1,480.88 | RVU13B |
| 2013-01-01 | Not available in this setting | $1,480.88 | RVU13AR |
Where the Mississippi rate applies
Mississippi is a Medicare payment area, not a city. Our Census mapping connects it to 427 cities and communities in Mississippi. Some span more than one payment area; confirm with the service ZIP.
- Abbeville
- Aberdeen
- Ackerman
- Agricola
- Alcorn State University
- Algoma
- Alligator
- Amory
21188 billing questions
How should 21188 be distinguished from the LeFort reconstruction codes?
Use the code whose defined procedure matches the operative work. The LeFort codes identify specific LeFort levels and, in some cases, grafting or advancement details; the operative report must support the selected procedure.
Can modifier 50 be appended for reconstruction on both sides?
No. CMS identifies bilateral adjustment as inappropriate for 21188, so modifier 50 is not the right way to report bilateral work.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon be reported?
Assistant-at-surgery payment may be allowed for 21188. Co-surgeons and team surgery are not permitted.
How is 21188 paid when another procedure is performed in the same session?
Under the standard multiple-procedure rule, the highest-valued procedure is paid in full and other procedures are subject to a 50% 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
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