Billing code 21137: Forehead reductionMedicare rate & RVUs

Medicare pays $685.05 for 21137 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 21137 covers

This operation reduces and reshapes the frontal bone to address forehead prominence or brow bossing. A craniofacial, plastic, or facial plastic surgeon typically performs it in an operating room, often as part of facial skeletal surgery. The defining scope is contouring alone: the procedure does not include augmentation or setback of the anterior frontal sinus wall.

Select the code from the operative report’s documented work, not from the patient’s stated goal or the general label of facial feminization surgery. Documentation should identify the forehead and brow work and distinguish bone contouring from an implant or graft and from frontal sinus wall osteotomy and setback. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one 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; an assistant at surgery may be paid, while 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 21137 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

21137 rates by state

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

How the 21137 rate is calculated

Each of 21137’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.

Payment rules and modifiers for 21137

21137 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

21137 compared with similar codes

How to choose

21138Forehead reduction

Choose 21137 for contouring alone. Choose 21138 when the documented forehead procedure also includes augmentation.

21139Forehead reconstruction

Choose 21139 when frontal sinus wall setback accompanies contouring. Without that setback, forehead contouring alone is the scope of 21137.

21172Forehead reconstruction

21172 describes reconstruction of the supra-lateral orbital rim and lateral forehead. It is not the code for standalone reduction and contouring of forehead prominence.

Codes related to 21137

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

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

Open CMS sourceHow we calculate rates