No office rate
Both cover reconstruction in three or more pieces. Choose 21147 when bone grafting is part of the reconstruction; choose 21143 when it is not.
On this page
CMS RVU26D · Effective 2026-10-01
21147 in Chico
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$1533.61
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Craniofacial surgery
About 21147: Multi-piece LeFort I reconstruction with graft
Reconstructs the maxilla through a LeFort I osteotomy in three or more segments with bone grafting for complex midface deformity correction.
This service reconstructs the midface by mobilizing the maxilla with a LeFort I osteotomy, dividing it into three or more pieces, and using bone grafting as part of the reconstruction. Oral and maxillofacial surgeons, plastic surgeons, or craniofacial surgeons may perform it in an operating room for complex maxillary deformity, such as a developmental midface discrepancy requiring segmental repositioning.
Select this code when the operative report supports both three or more maxillary segments and bone grafting; the number of segments and graft use distinguish it from neighboring LeFort I codes. The record should describe the osteotomy, segment configuration, reconstruction, and grafting. This major surgery has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeons and team surgery are not permitted.
CMS billing rules for 21147
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU25.81 · 57%
- Practice expense (office) RVU16.11 · 35%
- Malpractice RVU3.75 · 8%
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.
21147 compared with similar codes
Office rates for Chico, from the same CMS release.
No office rate
This is the grafted LeFort I option for two pieces. Use 21147 when the maxilla is reconstructed in three or more pieces.
No office rate
This is the grafted LeFort I option for one piece. Use 21147 when the operative report supports three or more pieces.
The same code, a different location
How does Chico compare?
21147 across payment areas
Same release and payment basis · bars start at $0
Chico · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Merced
California · 21147
Office
Unavailable
Facility
$1533.61
No comparable office rate is available.
Modesto
California · 21147
Office
Unavailable
Facility
$1533.61
No comparable office rate is available.
Napa
California · 21147
Office
Unavailable
Facility
$1689.22
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 21147
Office
Unavailable
Facility
$1600.27
No comparable office rate is available.
Redding
California · 21147
Office
Unavailable
Facility
$1533.61
No comparable office rate is available.
Rest Of California
California · 21147
Office
Unavailable
Facility
$1533.61
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 21147
Office
Unavailable
Facility
$1574.18
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 21147
Office
Unavailable
Facility
$1586.04
No comparable office rate is available.
Salinas
California · 21147
Office
Unavailable
Facility
$1579.58
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 21147
Office
Unavailable
Facility
$1599.38
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 21147
Office
Unavailable
Facility
$1760.17
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 21147
Office
Unavailable
Facility
$1755.91
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 21147
Office
Unavailable
Facility
$1799.97
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 21147
Office
Unavailable
Facility
$1782.55
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 21147
Office
Unavailable
Facility
$1556.75
No comparable office rate is available.
Santa Cruz-Watsonville
California · 21147
Office
Unavailable
Facility
$1601.09
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 21147
Office
Unavailable
Facility
$1580.76
No comparable office rate is available.
Santa Rosa-Petaluma
California · 21147
Office
Unavailable
Facility
$1615.85
No comparable office rate is available.
Stockton
California · 21147
Office
Unavailable
Facility
$1533.61
No comparable office rate is available.
Vallejo
California · 21147
Office
Unavailable
Facility
$1683.08
No comparable office rate is available.
Visalia
California · 21147
Office
Unavailable
Facility
$1533.61
No comparable office rate is available.
Yuba City
California · 21147
Office
Unavailable
Facility
$1533.61
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 21147
Office
Unavailable
Facility
$1681.90
No comparable office rate is available.
Miami
Florida · 21147
Office
Unavailable
Facility
$1738.99
No comparable office rate is available.
Chicago
Illinois · 21147
Office
Unavailable
Facility
$1696.35
No comparable office rate is available.
Manhattan
New York · 21147
Office
Unavailable
Facility
$1741.16
No comparable office rate is available.
Alaska*
Alaska · 21147
Office
Unavailable
Facility
$1935.19
No comparable office rate is available.
Alabama
Alabama · 21147
Office
Unavailable
Facility
$1403.80
No comparable office rate is available.
Arkansas
Arkansas · 21147
Office
Unavailable
Facility
$1388.80
No comparable office rate is available.
Arizona
Arizona · 21147
Office
Unavailable
Facility
$1490.70
No comparable office rate is available.
Colorado
Colorado · 21147
Office
Unavailable
Facility
$1542.77
No comparable office rate is available.
Connecticut
Connecticut · 21147
Office
Unavailable
Facility
$1610.40
No comparable office rate is available.
Delaware
Delaware · 21147
Office
Unavailable
Facility
$1510.62
No comparable office rate is available.
Fort Lauderdale
Florida · 21147
Office
Unavailable
Facility
$1633.62
No comparable office rate is available.
Rest Of Florida
Florida · 21147
Office
Unavailable
Facility
$1564.75
No comparable office rate is available.
Atlanta
Georgia · 21147
Office
Unavailable
Facility
$1561.79
No comparable office rate is available.
Rest Of Georgia
Georgia · 21147
Office
Unavailable
Facility
$1491.35
No comparable office rate is available.
Hawaii, Guam
Hawaii · 21147
Office
Unavailable
Facility
$1546.41
No comparable office rate is available.
Iowa
Iowa · 21147
Office
Unavailable
Facility
$1404.15
No comparable office rate is available.
Idaho
Idaho · 21147
Office
Unavailable
Facility
$1416.36
No comparable office rate is available.
East St. Louis
Illinois · 21147
Office
Unavailable
Facility
$1609.38
No comparable office rate is available.
Rest Of Illinois
Illinois · 21147
Office
Unavailable
Facility
$1549.12
No comparable office rate is available.
Suburban Chicago
Illinois · 21147
Office
Unavailable
Facility
$1642.68
No comparable office rate is available.
Indiana
Indiana · 21147
Office
Unavailable
Facility
$1421.76
No comparable office rate is available.
Kansas
Kansas · 21147
Office
Unavailable
Facility
$1411.64
No comparable office rate is available.
Kentucky
Kentucky · 21147
Office
Unavailable
Facility
$1455.04
No comparable office rate is available.
New Orleans
Louisiana · 21147
Office
Unavailable
Facility
$1510.71
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 21147
Office
Unavailable
Facility
$1458.28
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 21147
Office
Unavailable
Facility
$1651.38
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 21147
Office
Unavailable
Facility
$1542.30
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 21147
Office
Unavailable
Facility
$1608.18
No comparable office rate is available.
Rest Of Maryland
Maryland · 21147
Office
Unavailable
Facility
$1530.23
No comparable office rate is available.
Rest Of Maine
Maine · 21147
Office
Unavailable
Facility
$1435.03
No comparable office rate is available.
Southern Maine
Maine · 21147
Office
Unavailable
Facility
$1474.36
No comparable office rate is available.
Detroit
Michigan · 21147
Office
Unavailable
Facility
$1592.51
No comparable office rate is available.
Rest Of Michigan
Michigan · 21147
Office
Unavailable
Facility
$1494.76
No comparable office rate is available.
Minnesota
Minnesota · 21147
Office
Unavailable
Facility
$1452.85
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 21147
Office
Unavailable
Facility
$1489.71
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 21147
Office
Unavailable
Facility
$1499.84
No comparable office rate is available.
Rest Of Missouri
Missouri · 21147
Office
Unavailable
Facility
$1447.91
No comparable office rate is available.
Mississippi
Mississippi · 21147
Office
Unavailable
Facility
$1417.93
No comparable office rate is available.
Montana**
Montana · 21147
Office
Unavailable
Facility
$1525.17
No comparable office rate is available.
North Carolina
North Carolina · 21147
Office
Unavailable
Facility
$1444.15
No comparable office rate is available.
North Dakota**
North Dakota · 21147
Office
Unavailable
Facility
$1451.02
No comparable office rate is available.
Nebraska
Nebraska · 21147
Office
Unavailable
Facility
$1406.08
No comparable office rate is available.
New Hampshire
New Hampshire · 21147
Office
Unavailable
Facility
$1531.82
No comparable office rate is available.
Northern Nj
New Jersey · 21147
Office
Unavailable
Facility
$1674.34
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 21147
Office
Unavailable
Facility
$1621.56
No comparable office rate is available.
New Mexico
New Mexico · 21147
Office
Unavailable
Facility
$1505.93
No comparable office rate is available.
Nevada**
Nevada · 21147
Office
Unavailable
Facility
$1505.04
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 21147
Office
Unavailable
Facility
$1789.63
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 21147
Office
Unavailable
Facility
$1641.63
No comparable office rate is available.
Queens
New York · 21147
Office
Unavailable
Facility
$1733.89
No comparable office rate is available.
Rest Of New York
New York · 21147
Office
Unavailable
Facility
$1461.31
No comparable office rate is available.
Ohio
Ohio · 21147
Office
Unavailable
Facility
$1479.61
No comparable office rate is available.
Oklahoma
Oklahoma · 21147
Office
Unavailable
Facility
$1439.91
No comparable office rate is available.
Portland
Oregon · 21147
Office
Unavailable
Facility
$1566.88
No comparable office rate is available.
Rest Of Oregon
Oregon · 21147
Office
Unavailable
Facility
$1486.07
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 21147
Office
Unavailable
Facility
$1587.17
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 21147
Office
Unavailable
Facility
$1474.41
No comparable office rate is available.
Puerto Rico
Puerto Rico · 21147
Office
Unavailable
Facility
$1529.46
No comparable office rate is available.
Rhode Island
Rhode Island · 21147
Office
Unavailable
Facility
$1546.03
No comparable office rate is available.
South Carolina
South Carolina · 21147
Office
Unavailable
Facility
$1465.74
No comparable office rate is available.
South Dakota**
South Dakota · 21147
Office
Unavailable
Facility
$1442.25
No comparable office rate is available.
Tennessee
Tennessee · 21147
Office
Unavailable
Facility
$1418.46
No comparable office rate is available.
Austin
Texas · 21147
Office
Unavailable
Facility
$1544.07
No comparable office rate is available.
Beaumont
Texas · 21147
Office
Unavailable
Facility
$1468.10
No comparable office rate is available.
Brazoria
Texas · 21147
Office
Unavailable
Facility
$1499.92
No comparable office rate is available.
Dallas
Texas · 21147
Office
Unavailable
Facility
$1513.24
No comparable office rate is available.
Fort Worth
Texas · 21147
Office
Unavailable
Facility
$1509.49
No comparable office rate is available.
Galveston
Texas · 21147
Office
Unavailable
Facility
$1507.01
No comparable office rate is available.
Houston
Texas · 21147
Office
Unavailable
Facility
$1575.64
No comparable office rate is available.
Rest Of Texas
Texas · 21147
Office
Unavailable
Facility
$1485.83
No comparable office rate is available.
Utah
Utah · 21147
Office
Unavailable
Facility
$1480.36
No comparable office rate is available.
Virginia
Virginia · 21147
Office
Unavailable
Facility
$1479.45
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 21147
Office
Unavailable
Facility
$1529.46
No comparable office rate is available.
Vermont
Vermont · 21147
Office
Unavailable
Facility
$1458.16
No comparable office rate is available.
Rest Of Washington
Washington · 21147
Office
Unavailable
Facility
$1535.21
No comparable office rate is available.
Seattle (King Cnty)
Washington · 21147
Office
Unavailable
Facility
$1667.75
No comparable office rate is available.
Wisconsin
Wisconsin · 21147
Office
Unavailable
Facility
$1416.14
No comparable office rate is available.
West Virginia
West Virginia · 21147
Office
Unavailable
Facility
$1508.91
No comparable office rate is available.
Wyoming**
Wyoming · 21147
Office
Unavailable
Facility
$1492.85
No comparable office rate is available.
See how rates vary across the country
21147 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | 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 |
Where does this rate apply?
Chico is a Medicare payment area. Our Census mapping connects it to 30 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 21147 in Chico. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$1686.97
$1533.61 × 110% = $1686.97
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 21147 in Chico.
PPRRVU2026_Oct_nonQPP.csv
1,891
- Code
- 21147
- Physician work
- 25.81
- Practice expense
- 16.11
- Malpractice
- 3.75
GPCI2026.csv
9
- Locality
- Chico
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 25.81 | × 1.017 | 26.2488 |
| Practice expense | 16.11 | × 1.096 | 17.6566 |
| Malpractice | 3.75 | × 0.536 | 2.0100 |
| Total RVUs | 45.9153 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Chico$1533.61
Open 21147 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 25.81 | 1.017 |
| Practice expense | 16.11 | 1.096 |
| Malpractice | 3.75 | 0.536 |
(25.81 × 1.017 + 16.11 × 1.096 + 3.75 × 0.536) × $33.4009 = $1533.61
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
21147 · 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
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $1533.61 | RVU26D |
| 2026-07-01 | Not available in this setting | $1533.61 | RVU26C |
| 2026-04-01 | Not available in this setting | $1533.61 | RVU26B |
| 2026-01-01 | Not available in this setting | $1533.61 | RVU26A |
| 2025-10-01 | Not available in this setting | $1693.13 | RVU25D |
| 2025-07-01 | Not available in this setting | $1693.13 | RVU25C |
| 2025-04-01 | Not available in this setting | $1693.13 | RVU25B |
| 2025-01-01 | Not available in this setting | $1693.13 | RVU25A |
21147 billing questions
How does this differ from 21143?
Both describe a LeFort I reconstruction in three or more pieces. This code is for the reconstruction with bone grafting; 21143 is the corresponding option without grafting.
How many segments support this code?
The maxilla must be divided into three or more pieces. The operative report should document the segment configuration rather than relying only on a general description of a LeFort I procedure.
Can the bone graft be reported separately?
Bone grafting is part of the service represented by this code. Do not separately report the same grafting work; assess any distinct graft-harvesting work under applicable coding instructions.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 or an assistant surgeon be reported?
Modifier 50 is inappropriate for this code. Assistant-at-surgery payment may be made, while co-surgeons and team surgery are not permitted.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard 50% multiple procedure 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
1,88821143,,Rcnstj mdface lefort i 3/>pc,A,,20.52,14.63,NA,14.63,,2.98,38.13,38.13,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,88921145,,Rcnstj mdfc lefort i 1 w/grf,A,,23.34,14.92,NA,14.92,,3.38,41.64,41.64,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,89021146,,Rcnstj mdfc lefort i 2 w/grf,A,,24.25,15.74,NA,15.74,,3.51,43.50,43.50,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,89121147,,Rcnstj mdfc lefort i 3/>grf,A,,25.81,16.11,NA,16.11,,3.75,45.67,45.67,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,89221150,,Rcnstj mdfc lefrtii ant ntru,A,,25.31,13.37,NA,13.37,,3.69,42.37,42.37,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,89321151,,Rcnstj mdfc lefrtii w/b1 grf,A,,28.29,14.10,NA,14.10,,4.13,46.52,46.52,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,89421154,,Rcnstj mdfc lefort iii w/o i,A,,30.51,15.14,NA,15.14,,4.46,50.11,50.11,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609
901112,CA,55,CHICO,1.017,1.096,0.536
1001182,CA,71,EL CENTRO,1.017,1.096,0.541
1101112,CA,56,FRESNO,1.017,1.096,0.536
1201112,CA,57,HANFORD-CORCORAN,1.017,1.096,0.536