Billing code 21270: Cheek augmentationMedicare rate & RVUs

Medicare pays $1,104.23 for 21270 nationally in the office and $675.37 in a hospital or facility. Local office rates run $975.27–$1,419.32.

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

What 21270 covers

This service increases projection or restores contour over the malar, or cheekbone, region using prosthetic material. Plastic surgeons, facial plastic surgeons, and oral and maxillofacial surgeons may perform it in an operating room, commonly for malar hypoplasia or a persistent contour deficit after facial trauma. The operative note should identify the treated side, the malar site, the prosthetic material, and the reason for augmentation.

Report the procedure for the cheekbone augmentation itself, not for a broader reconstruction of the orbit or jaw. The code has a 90-day major-surgery global period, including the day-before preoperative visit and related postoperative care during that period. When other 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. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is 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 21270 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

21270 rates by state

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

How the 21270 rate is calculated

Each of 21270’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 21270

21270 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 50

21270 compared with similar codes

How to choose

21210Facial bone graft

Code 21210 is for bone grafting to the malar, nasal, or maxillary area and includes obtaining the graft. This code describes augmentation with prosthetic material.

21230Rib cartilage graft

Code 21230 describes use of autogenous rib cartilage graft to the face, chin, nose, or ear. This code is for prosthetic malar augmentation.

21256Orbital reconstruction

Code 21256 addresses orbital reconstruction. Choose this code when the operative target is cheekbone projection, not reconstruction of the orbit.

21275Orbitofacial revision

Code 21275 is for revision of orbitofacial bones. This code is limited to augmentation of the malar region with prosthetic material.

Codes related to 21270

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