No office rate
Both are Le Fort I reconstructions without grafting; 21141 is for a one-piece maxilla, while 21142 is for two pieces.
On this page
CMS RVU26D · Effective 2026-10-01
21141 Le Fort I reconstruction Medicare reimbursement rates in Guam
Reports reconstruction of the midface using a one-piece Le Fort I maxillary osteotomy, without bone graft, to reposition the maxilla for correction of a skeletal discrepancy. Compare 21141 office and facility rates across CMS payment localities in Guam.
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 21141 in Guam?
Guam 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
$1235.25
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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 21141: One-piece Le Fort I maxillary reconstruction
Reports reconstruction of the midface using a one-piece Le Fort I maxillary osteotomy, without bone graft, to reposition the maxilla for correction of a skeletal discrepancy.
A surgeon mobilizes the maxilla with a Le Fort I osteotomy and repositions it as one segment. This approach may address maxillary hypoplasia, malocclusion, or vertical or positional jaw discrepancies as part of orthognathic treatment. Oral and maxillofacial, plastic, or craniofacial surgeons typically perform the operation in a hospital operating room. The one-piece designation describes the number of maxillary segments; it is not a count of teeth or sides.
Report 21141 when the reconstruction uses one maxillary segment and does not include bone grafting. Use the operative report to support the Le Fort I approach, segment configuration, repositioning, and whether grafting was performed. The service has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care. For same-session procedures, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 21141
- 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 RVU19.08 · 53%
- Practice expense (office) RVU14.34 · 40%
- Malpractice RVU2.76 · 8%
23
Medicare services in 2024 · #5829 by national volume
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.
21141 compared with similar codes
Office rates for Guam, from the same CMS release.
No office rate
Use 21143 when the Le Fort I reconstruction divides the maxilla into three or more pieces; 21141 is limited to one piece.
No office rate
Both describe one-piece Le Fort I reconstruction. The distinguishing feature is bone grafting: 21145 includes it, while 21141 does not.
No office rate
21150 describes a Le Fort II midface reconstruction rather than the Le Fort I approach reported with 21141.
Compare 21141 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
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$1235.25
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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 21141 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
1,886
- Code
- 21141
- Physician work
- 19.08
- Practice expense
- 14.34
- Malpractice
- 2.76
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 19.08 | × 1.000 | 19.0800 |
| Practice expense | 14.34 | × 1.137 | 16.3046 |
| Malpractice | 2.76 | × 0.579 | 1.5980 |
| Total RVUs | 36.9826 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$1235.25
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 19.08 | 1 |
| Practice expense | 14.34 | 1.137 |
| Malpractice | 2.76 | 0.579 |
(19.08 × 1 + 14.34 × 1.137 + 2.76 × 0.579) × $33.4009 = $1235.25
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.
21141 billing questions
How does 21141 differ from 21142 or 21143?
Choose 21141 when the maxilla is reconstructed as one segment. Codes 21142 and 21143 describe two segments and three or more segments, respectively.
When is 21145 used instead?
Use 21145 for a one-piece Le Fort I reconstruction that includes bone grafting. Code 21141 is for the one-piece reconstruction without grafting.
Does the one-piece service use modifier 50?
No. The CMS bilateral adjustment does not apply to 21141; its descriptor and anatomy make modifier 50 inappropriate.
What postoperative care is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How does payment change when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures performed in that 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.
1,88321137,,Rdctj forehead cntrg only,A,,9.98,8.68,NA,8.68,,1.85,20.51,20.51,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,88421138,,Rdctj forehead cntrg&prostc,A,,12.55,9.86,NA,9.86,,2.34,24.75,24.75,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,88521139,,Rdctj forehead cntrg&setback,A,,14.64,12.11,NA,12.11,,2.72,29.47,29.47,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,88621141,,Rcnstj midface lefort i 1pc,A,,19.08,14.34,NA,14.34,,2.76,36.18,36.18,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,88721142,,Rcnstj midface lefort i 2pcs,A,,19.77,14.43,NA,14.43,,2.87,37.07,37.07,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,88821143,,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
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014