Billing code 21150: Midface reconstructionMedicare rate & RVUs

Medicare pays $1,415.20 for 21150 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 21150 covers

This service reconstructs the central midface by mobilizing and repositioning facial bones in a LeFort II pattern. It is performed by craniofacial, oral and maxillofacial, or plastic surgeons, generally in a hospital operating room. Clinical indications may include congenital midface deficiency or reconstruction after facial trauma. The code identifies the LeFort II level of reconstruction, rather than a LeFort I or LeFort III pattern.

Report 21150 when the documented reconstruction follows the LeFort II pattern and does not include bone grafting; use 21151 when a bone graft is part of the reconstruction. The operative report should establish the osteotomy pattern, reconstruction performed, and whether grafting was used. Medicare assigns a 90-day global period, including 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. Assistant-at-surgery services may be paid; co-surgeons and team surgery are not permitted. Modifier 50 is inappropriate for this code.

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 21150 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

21150 rates by state

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

How the 21150 rate is calculated

Each of 21150’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 21150

21150 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

21150 compared with similar codes

How to choose

21151Midface reconstruction

Use 21151 for LeFort II reconstruction that includes bone grafting. Code 21150 describes the corresponding reconstruction without grafting.

21141Le Fort I reconstruction

This is a LeFort I reconstruction in one piece. Select by the documented osteotomy pattern, not by a general description of midface surgery.

21143LeFort I reconstruction

This is a LeFort I reconstruction in three or more pieces; 21150 identifies a LeFort II pattern instead.

21154Midface reconstruction

This describes LeFort III reconstruction without LeFort I involvement, a different and more extensive osteotomy pattern than LeFort II.

Codes related to 21150

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