No office rate
Both are in the cranial bone reconstruction family. Use the full descriptors and operative documentation to identify the specific level and scope.
On this page
CMS RVU26D · Effective 2026-10-01
21184 Cranial reconstruction Medicare reimbursement rates in Alabama
Reports operative reconstruction of cranial bone for a defect or deformity, such as after trauma, tumor removal, or congenital cranial conditions. Compare 21184 office and facility rates across CMS payment localities in Alabama.
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.
What does Medicare pay for 21184 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1969.91
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Craniofacial surgery
About 21184: Cranial bone reconstruction
Reports operative reconstruction of cranial bone for a defect or deformity, such as after trauma, tumor removal, or congenital cranial conditions.
Code 21184 reports surgery to reconstruct cranial bone and restore the contour or continuity of the skull. Typical clinical contexts include a cranial defect after trauma or tumor removal and selected congenital cranial deformities. Neurosurgeons and craniofacial or plastic surgeons may perform the operation, generally in a hospital operating room. The operative report should identify the defect, the bones treated, and the reconstructive work performed.
Select this code by matching the documented operation to the full descriptor and distinguishing it from other cranial reconstruction levels, including 21182 and 21183. CMS assigns a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. 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 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment may be made; co-surgeons and team surgery are not permitted.
CMS billing rules for 21184
- 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 RVU37.65 · 58%
- Practice expense (office) RVU19.84 · 31%
- Malpractice RVU7.01 · 11%
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.
21184 compared with similar codes
Office rates for Alabama, from the same CMS release.
No office rate
This is a related cranial bone reconstruction code; distinguish it from 21184 by the exact operative service described in the full descriptor.
No office rate
21175 addresses forehead and brow reconstruction. Choose 21184 when the documented service is cranial bone reconstruction rather than that forehead-and-brow service.
21188
No office rateMidface reconstruction
21188 addresses midface reconstruction, while 21184 concerns cranial bone reconstruction. The operative site separates the codes.
Compare 21184 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
Unavailable
Facility
$1969.91
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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 21184 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
1,905
- Code
- 21184
- Physician work
- 37.65
- Practice expense
- 19.84
- Malpractice
- 7.01
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 37.65 | × 1.000 | 37.6500 |
| Practice expense | 19.84 | × 0.875 | 17.3600 |
| Malpractice | 7.01 | × 0.566 | 3.9677 |
| Total RVUs | 58.9777 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Alabama$1969.91
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 37.65 | 1 |
| Practice expense | 19.84 | 0.875 |
| Malpractice | 7.01 | 0.566 |
(37.65 × 1 + 19.84 × 0.875 + 7.01 × 0.566) × $33.4009 = $1969.91
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.
21184 billing questions
How do I choose 21184 instead of 21182 or 21183?
Compare the full descriptors and documented operative scope for the cranial reconstruction levels. The abbreviated CMS labels are similar, so the operative report should make clear what reconstruction was performed.
Can routine postoperative visits be billed separately?
Related postoperative care during the 90-day global period is included in the surgical payment.
Should modifier 50 be appended for reconstruction on both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code.
Can an assistant surgeon be paid for this operation?
Assistant-at-surgery payment may be made. Co-surgeons and team surgery are not permitted under the CMS rules supplied for this code.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard 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.
1,90221181,,Rcnst cntrg b9 tum crnl xtrc,A,,10.02,8.26,NA,8.26,,1.86,20.14,20.14,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,90321182,,Reconstruct cranial bone,A,,31.77,17.69,NA,17.69,,5.90,55.36,55.36,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,90421183,,Reconstruct cranial bone,A,,34.81,18.81,NA,18.81,,6.46,60.08,60.08,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,90521184,,Reconstruct cranial bone,A,,37.65,19.84,NA,19.84,,7.01,64.50,64.50,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,90621188,,Reconstruction of midface,A,,22.57,16.94,NA,16.94,,3.27,42.78,42.78,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,90721193,,Reconst lwr jaw w/o graft,A,,18.43,12.08,NA,12.08,,2.68,33.19,33.19,0,090,0.10,0.69,0.21,2,2,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,90821194,,Reconst lwr jaw w/graft,A,,21.27,13.97,NA,13.97,,3.07,38.31,38.31,0,090,0.10,0.69,0.21,2,2,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515