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Billing code 21182: Cranial cranioplastyMedicare rate & RVUs

Reports cranioplasty using multiple autografts to rebuild a small cranial bone defect, with code selection based on the total defect area.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $1,849.07 for 21182 nationally in a facility.

Medicare rate · 21182

Cranial cranioplasty

Work RVUs
31.77
Total RVUs
55.36
Global days
090

National rate · 2026

$1,849.07

Facility setting, before claim adjustments.

See every locality for 21182 →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.

On this page 10 sections
  1. Medicare rate
  2. What 21182 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 21182 covers

This service rebuilds a cranial bone defect with multiple autografts, including harvesting the grafts. It is typically performed by a neurosurgeon or craniofacial plastic surgeon in an operating room for a patient who needs structural reconstruction after a defect or prior cranial surgery. The code represents the smallest defect-area tier in the 21182–21184 series; the operative record should support the defect’s total area and the use of multiple autografts.

Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction. An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this anatomy and descriptor.

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 21182 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

21182 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,689.69
Alaska*Unavailable$2,329.57
ArizonaUnavailable$1,802.38
ArkansasUnavailable$1,670.19
AtlantaUnavailable$1,901.32
AustinUnavailable$1,863.00
BakersfieldUnavailable$1,848.91
Baltimore/Surr. CntysUnavailable$1,955.89
BeaumontUnavailable$1,781.90
BrazoriaUnavailable$1,808.89

21182 rates by state

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

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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
21182 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 21182 rate is calculated

Each of 21182’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 · 21182

RVUs × geographic indexes × conversion factor

Work31.77

31.77 RVUs× 1.000 GPCI

Practice expense17.69

17.69 RVUs× 1.000 GPCI

Malpractice5.90

5.90 RVUs× 1.000 GPCI

Adjusted RVUs

55.3600

Conversion factor

$33.4009

Medicare rate

$1,849.07

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

Payment rules and modifiers for 21182

21182 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21182

Cranial cranioplasty

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)1Permitted with supporting documentation.
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 · 21182

Cranial cranioplasty

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

21182 without 51 · national facility

$1,849.07

Cranial cranioplasty

21182-51 · Second procedure: 50%

$924.54

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

21182 compared with similar codes

Compare codes · National

4 codes, side by side

  • 21182

    Cranial cranioplasty31.77 wRVU

    Not priced

  • 21183

    Cranial reconstruction34.81 wRVU

    Not priced

  • 21184

    Cranial reconstruction37.65 wRVU

    Not priced

  • 21181

    Cranial reconstruction10.02 wRVU

    Not priced

How to choose

21183Cranial reconstruction
21183 represents the next defect-area tier in the cranial cranioplasty series. Select between the codes using the total area documented for reconstruction.
21184Cranial reconstruction
21184 is the larger defect-area tier in this series. 21182 represents the smallest tier.
21181Cranial reconstruction
21181 describes cranial contouring associated with benign tumor excision. 21182 is for cranioplasty of a cranial bone defect using multiple autografts.

Codes related to 21182

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

Codes related to 21182
CodeHow it relatesNational office range
Same family
21183Cranial reconstructionCranial cranioplasty with multiple autografts for the next defect-area tier.No office rate
21184Cranial reconstructionCranial cranioplasty with multiple autografts for a larger defect-area tier.No office rate
Used instead
21181Cranial reconstructionAddresses cranial contouring associated with benign tumor excision rather than this defect-area cranioplasty tier.No office rate

21182 billing questions

How do I choose 21182 rather than 21183 or 21184?

These codes distinguish cranial reconstruction by total defect area. Use 21182 for the smallest tier and check the operative measurements against the applicable code-family thresholds.

Does 21182 include harvesting the bone grafts?

Yes. The multiple autografts are included, including obtaining the grafts; do not report graft harvesting separately as part of this service.

What documentation supports reporting 21182?

Document the cranial defect and its total area, the reconstruction performed, and that multiple autografts were used and obtained.

Can 21182 be reported with another procedure performed in the same session?

It may be reported with other separately supported procedures when appropriate. Medicare applies its standard multiple-procedure reduction when multiple procedures are performed in the same session.

Can an assistant or co-surgeon be reported for this operation?

Medicare may pay for an assistant at surgery. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

Does modifier 50 apply to 21182?

No. The anatomy and service represented by 21182 make modifier 50 inappropriate.

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 21182PPRRVU2026_Oct_nonQPP.csv, line 1,903 (RVU26D)

Open CMS sourceHow we calculate rates

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