CPT code 21432: Craniofacial repair2026 Medicare rate & RVUs in Alaska
Reports open reduction of a craniofacial separation fracture with wire fixation, when the operative approach and fixation match this treatment level.
CMS doesn’t publish an office rate for 21432 in Alaska.
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 9 sections
What 21432 covers
This code describes open surgical treatment of a craniofacial separation fracture, commonly associated with a Le Fort III injury that separates the midface from the cranial base. The surgeon exposes and repositions the separated facial bones and uses wiring for fixation. Oral and maxillofacial, plastic, otolaryngology, or craniofacial surgeons may perform the repair in a hospital or other surgical facility, often as part of care for significant facial trauma.
Select this code when the operative report supports open treatment with wiring, rather than closed treatment or a more complicated open approach. Documentation should identify the fracture pattern, surgical exposure, reduction, and fixation method. Medicare assigns a 90-day global period, which includes 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 50% reduction. Modifier 50 is inappropriate for this code. An assistant at surgery may be paid; co-surgeons and team surgery are 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.
21432 in Alaska*
| Payment locality | Office | Facility |
|---|---|---|
| Alaska* | Unavailable | $813.36 |
How the 21432 rate is calculated
Each of 21432’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 · 21432
RVUs × geographic indexes × conversion factor
Work8.60
8.60 RVUs× 1.000 GPCI
Practice expense9.93
9.93 RVUs× 1.000 GPCI
Malpractice1.59
1.59 RVUs× 1.000 GPCI
Adjusted RVUs
20.1200
Conversion factor
$33.4009
Medicare rate
$672.03
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 21432
21432 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21432
Craniofacial repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 21432
Craniofacial repair
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
21432 without 51 · national facility
$672.03
Craniofacial repair
21432-51 · Second procedure: 50%
$336.02
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%).
21432 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 21431Fracture treatment
- 21431 is for closed treatment. This code is for open treatment with wiring.
- 21433Craniofacial repair
- 21433 describes complicated open treatment using multiple approaches. Choose this code when the documented repair is open treatment with wiring without that multiple-approach complexity.
- 21435Craniofacial fracture repair
- 21435 applies to complicated treatment involving an intracranial approach and/or external fixation. This code describes open repair with wiring.
- 21423Fracture repair
- 21423 concerns open treatment of a complicated palatal or maxillary fracture. This code concerns craniofacial separation, a different fracture pattern involving separation of the midface from the cranial base.
21432 billing questions
How does this differ from 21431?
21431 describes closed treatment of a craniofacial separation. Use 21432 when the fracture is treated through an open approach with wiring.
When would 21433 be a better fit?
21433 is for a complicated open treatment involving multiple approaches. The operative report should support that added complexity rather than open treatment with wiring alone.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 is not suitable.
Is an assistant surgeon payable?
CMS allows payment for an assistant at surgery. Co-surgeons and team surgery are not permitted for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session handled?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction when performed in the same session.
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
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