No office rate
Use 21151 for LeFort II reconstruction that includes bone grafting. Code 21150 describes the corresponding reconstruction without grafting.
On this page
CMS RVU26D · Effective 2026-10-01
21150 Midface reconstruction Medicare reimbursement rates in Hawaii
Reports reconstruction of the midface using a LeFort II osteotomy pattern without bone grafting, typically for significant skeletal deformity or reconstruction. Compare 21150 office and facility rates across CMS payment localities in Hawaii.
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 21150 in Hawaii?
Hawaii 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
$1424.49
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 21150: LeFort II midface reconstruction
Reports reconstruction of the midface using a LeFort II osteotomy pattern without bone grafting, typically for significant skeletal deformity or reconstruction.
This service reconstructs the central midface by mobilizing and repositioning facial bones in a LeFort II pattern. It is performed by craniofacial, oral and maxillofacial, or plastic surgeons, generally in a hospital operating room. Clinical indications may include congenital midface deficiency or reconstruction after facial trauma. The code identifies the LeFort II level of reconstruction, rather than a LeFort I or LeFort III pattern.
Report 21150 when the documented reconstruction follows the LeFort II pattern and does not include bone grafting; use 21151 when a bone graft is part of the reconstruction. The operative report should establish the osteotomy pattern, reconstruction performed, and whether grafting was used. Medicare assigns a 90-day global period, including 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 multiple-procedure reduction. Assistant-at-surgery services may be paid; co-surgeons and team surgery are not permitted. Modifier 50 is inappropriate for this code.
CMS billing rules for 21150
- 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 RVU25.31 · 60%
- Practice expense (office) RVU13.37 · 32%
- Malpractice RVU3.69 · 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.
21150 compared with similar codes
Office rates for Hawaii, from the same CMS release.
No office rate
This is a LeFort I reconstruction in one piece. Select by the documented osteotomy pattern, not by a general description of midface surgery.
No office rate
This is a LeFort I reconstruction in three or more pieces; 21150 identifies a LeFort II pattern instead.
No office rate
This describes LeFort III reconstruction without LeFort I involvement, a different and more extensive osteotomy pattern than LeFort II.
Compare 21150 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
$1424.49
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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 21150 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
1,892
- Code
- 21150
- Physician work
- 25.31
- Practice expense
- 13.37
- Malpractice
- 3.69
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 25.31 | × 1.000 | 25.3100 |
| Practice expense | 13.37 | × 1.137 | 15.2017 |
| Malpractice | 3.69 | × 0.579 | 2.1365 |
| Total RVUs | 42.6482 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$1424.49
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 25.31 | 1 |
| Practice expense | 13.37 | 1.137 |
| Malpractice | 3.69 | 0.579 |
(25.31 × 1 + 13.37 × 1.137 + 3.69 × 0.579) × $33.4009 = $1424.49
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.
21150 billing questions
How is 21150 distinguished from 21151?
Both describe LeFort II midface reconstruction. Report 21150 without bone grafting; report 21151 when the reconstruction includes a bone graft.
How does this differ from the LeFort I reconstruction codes?
The osteotomy pattern determines the code: 21150 is for LeFort II reconstruction, while 21141–21147 describe LeFort I reconstruction with distinctions based on segmentation and grafting.
What operative details support reporting 21150?
Document the LeFort II osteotomy pattern, the bones mobilized and repositioned, the reconstructive work, and whether bone grafting was performed.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.
What postoperative care is included in the Medicare 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 services may be paid. Co-surgeons and team surgery are not permitted for this code under the stated CMS rules.
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.
1,88921145,,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
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
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