No office rate
Both are one-piece LeFort I reconstructions. Use 21145 when bone grafting is included in the reconstruction; use 21141 without grafting.
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CMS RVU26D · Effective 2026-10-01
21145 LeFort I reconstruction Medicare reimbursement rates in Illinois
Reports one-piece LeFort I maxillary reconstruction with bone grafting when the maxilla is repositioned as a single segment. Compare 21145 office and facility rates across CMS payment localities in Illinois.
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 21145 in Illinois?
Illinois has 4 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 4 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1411.02–$1544.96
4 of 4 localities have a supported rate.
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.
Where 21145 pays more and less in Illinois
Craniofacial surgery
About 21145: Single-piece LeFort I reconstruction with graft
Reports one-piece LeFort I maxillary reconstruction with bone grafting when the maxilla is repositioned as a single segment.
This operation repositions the maxilla through a LeFort I osteotomy as one segment and includes bone grafting as part of the reconstruction. Oral and maxillofacial, plastic, or craniofacial surgeons perform it in an operating room for selected maxillary deformities, such as dentofacial disproportion or malocclusion requiring maxillary advancement or repositioning. The one-piece designation reflects the maxilla being mobilized as a single segment.
Select 21145 when the reconstruction is one piece and includes grafting; the related LeFort I codes distinguish reconstructions without grafting and those divided into multiple pieces. The operative report should establish the LeFort I approach, the number of maxillary segments, the repositioning performed, and use of bone graft. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Do not append modifier 50; CMS treats this as a single midface reconstruction. An assistant at surgery may be paid, but co-surgeon and team-surgery payment are not permitted.
CMS billing rules for 21145
- 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 RVU23.34 · 56%
- Practice expense (office) RVU14.92 · 36%
- Malpractice RVU3.38 · 8%
83
Medicare services in 2024 · #5012 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.
21145 compared with similar codes
Office rates for Illinois, from the same CMS release.
No office rate
Both include grafting, but 21146 is for a two-piece LeFort I reconstruction; 21145 is for one piece.
No office rate
Both include grafting, but 21147 is for three or more pieces; 21145 is for a single-piece reconstruction.
No office rate
21150 describes a LeFort II midface procedure with a different osteotomy pattern, rather than the one-piece LeFort I reconstruction reported with 21145.
Compare 21145 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.
4 of 4 payment localities
Chicago →
Office / nonfacility
Unavailable
Facility
$1544.96
East St. Louis →
Office / nonfacility
Unavailable
Facility
$1465.42
Rest Of Illinois →
Office / nonfacility
Unavailable
Facility
$1411.02
Suburban Chicago →
Office / nonfacility
Unavailable
Facility
$1496.88
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21145 billing questions
How is 21145 different from 21141?
Both describe a one-piece LeFort I reconstruction. 21145 includes bone grafting; 21141 is the corresponding one-piece reconstruction without grafting.
When should 21146 or 21147 be used instead?
Choose between these grafted LeFort I codes by the number of maxillary pieces: 21145 is one piece, 21146 is two, and 21147 is three or more.
Is bone grafting separately reported with 21145?
Bone grafting is part of the service represented by 21145. The operative report should document that grafting was performed.
What documentation supports the one-piece level?
Document the LeFort I reconstruction, that the maxilla was mobilized as a single segment, the repositioning performed, and the bone grafting.
Can modifier 50 be reported?
No. CMS treats the service as a single midface reconstruction, so modifier 50 is inappropriate.
How does the 90-day global period affect postoperative billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
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.
1,88621141,,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
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