No office rate
Choose 21159 for LeFort III advancement without a bone graft. Code 21154 describes LeFort III reconstruction without the advancement distinction and without grafting.
On this page
CMS RVU26D · Effective 2026-10-01
21159 Midface reconstruction Medicare reimbursement rates in Delaware
Reports LeFort III midface reconstruction with advancement and no bone graft, commonly performed to correct severe midface retrusion in craniofacial conditions. Compare 21159 office and facility rates across CMS payment localities in Delaware.
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 21159 in Delaware?
Delaware 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
$2189.22
1 of 1 localities have a supported rate.
Payment area: Delaware
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 21159: LeFort III midface advancement without bone graft
Reports LeFort III midface reconstruction with advancement and no bone graft, commonly performed to correct severe midface retrusion in craniofacial conditions.
This operation mobilizes and advances the midface at the LeFort III level without a bone graft. Craniofacial, oral and maxillofacial, or plastic surgeons may perform it for substantial midface retrusion, including deformity associated with syndromic craniosynostosis. It is a major reconstructive procedure generally performed in a hospital operating room.
Select this code when the operative report supports LeFort III reconstruction with advancement and documents that no bone graft was used. Distinguish it from the non-advancement LeFort III codes and from the advancement code that includes grafting. The 90-day global period includes the day-before preoperative visit and related postoperative care during the following 90 days. When multiple procedures are performed in one 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 service. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 21159
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU42.06 · 64%
- Practice expense (office) RVU17.96 · 27%
- Malpractice RVU6.15 · 9%
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.
21159 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
Code 21155 describes LeFort III reconstruction with a bone graft but without the advancement distinction. For advancement with a graft, use 21160 instead.
No office rate
Both codes describe LeFort III advancement; 21159 is the no-graft version, while 21160 includes bone grafting.
Compare 21159 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
Delaware →
Office / nonfacility
Unavailable
Facility
$2189.22
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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 21159 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
1,896
- Code
- 21159
- Physician work
- 42.06
- Practice expense
- 17.96
- Malpractice
- 6.15
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 42.06 | × 1.005 | 42.2703 |
| Practice expense | 17.96 | × 0.988 | 17.7445 |
| Malpractice | 6.15 | × 0.899 | 5.5289 |
| Total RVUs | 65.5436 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$2189.22
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 42.06 | 1.005 |
| Practice expense | 17.96 | 0.988 |
| Malpractice | 6.15 | 0.899 |
(42.06 × 1.005 + 17.96 × 0.988 + 6.15 × 0.899) × $33.4009 = $2189.22
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.
21159 billing questions
How does 21159 differ from 21154?
21159 describes LeFort III reconstruction with advancement and no bone graft. 21154 is the LeFort III reconstruction code without the advancement distinction.
When should 21160 be reported instead?
Use 21160 when the LeFort III advancement includes a bone graft. The operative report should establish whether a graft was used.
Can modifier 50 be used for bilateral work?
No. Modifier 50 is inappropriate for this code; the descriptor and anatomy do not support bilateral adjustment.
Is an assistant at surgery payable?
CMS permits assistant-at-surgery payment for this procedure. Co-surgeon payment requires supporting documentation, while team surgery is not permitted.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days after surgery.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures in the same session 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.
1,89321151,,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
1,89521155,,Rcnstj mdfc lefort iii w/i,A,,34.34,16.08,NA,16.08,,5.01,55.43,55.43,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,89621159,,Rcnst mdfc lfrtiii advm wo i,A,,42.06,17.96,NA,17.96,,6.15,66.17,66.17,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,89721160,,Rcnst mdfc lfrtiii advm w/i,A,,46.01,18.92,NA,18.92,,6.71,71.64,71.64,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,89821172,,Rcnst supr-lat orb rm&lw fhd,A,,27.50,23.42,NA,23.42,,11.63,62.55,62.55,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,89921175,,Rcnst bfrnt sp orb rm&lw fhd,A,,32.72,19.04,NA,19.04,,6.08,57.84,57.84,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503