No office rate
Choose 21175 for bifrontal forehead and supraorbital rim reconstruction with advancement. Code 21172 describes reconstruction focused on the superolateral orbital rim and lower forehead.
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CMS RVU26D · Effective 2026-10-01
21175 Forehead reconstruction Medicare reimbursement rates in Illinois
Reports bifrontal reconstruction advancing and reshaping the forehead and supraorbital rims, commonly performed to correct craniosynostosis-related craniofacial deformity. Compare 21175 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 21175 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
$1990.91–$2205.72
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 21175 pays more and less in Illinois
Craniofacial reconstruction
About 21175: Bifrontal forehead and orbital rim reconstruction
Reports bifrontal reconstruction advancing and reshaping the forehead and supraorbital rims, commonly performed to correct craniosynostosis-related craniofacial deformity.
This major craniofacial operation reshapes and advances the frontal bone and supraorbital rims to reconstruct the lower forehead and brow region. It is commonly performed for craniosynostosis-related deformity by a craniofacial or plastic surgeon, often working with a neurosurgeon, in a hospital operating room. Bone grafting, when performed as part of the reconstruction, is included in the service.
Report the code when the operative work includes the bifrontal forehead and supraorbital rim reconstruction, rather than a more limited superolateral orbital rim procedure or forehead reconstruction alone. The operative report should identify the anatomy reconstructed, advancement performed, and any grafting. The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 21175
- 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 RVU32.72 · 57%
- Practice expense (office) RVU19.04 · 33%
- Malpractice RVU6.08 · 11%
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.
21175 compared with similar codes
Office rates for Illinois, from the same CMS release.
No office rate
Code 21179 addresses forehead reconstruction with grafts; use 21175 when the operative work includes bifrontal advancement and reconstruction of the supraorbital rims.
21188
No office rateMidface reconstruction
Code 21188 addresses reconstruction centered on the midface. Code 21175 is for reconstruction of the forehead and supraorbital rims.
Compare 21175 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
$2205.72
East St. Louis →
Office / nonfacility
Unavailable
Facility
$2086.95
Rest Of Illinois →
Office / nonfacility
Unavailable
Facility
$1990.91
Suburban Chicago →
Office / nonfacility
Unavailable
Facility
$2113.50
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21175 billing questions
How does this differ from 21172?
This code describes bifrontal reconstruction of the forehead and supraorbital rims. Code 21172 is the related, more limited reconstruction of the superolateral orbital rim and lower forehead.
Can bone grafting be reported separately?
Bone grafting performed as part of this reconstruction is included in the service. The operative report should document the reconstruction and any grafting performed.
Should modifier 50 be added for both sides?
No. The anatomy and descriptor make modifier 50 inappropriate 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.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons and team surgery are not permitted for this code under the CMS facts provided.
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.
1,89621159,,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
1,90021179,,Rcnstj forehead with grafts,A,,22.08,14.03,NA,14.03,,4.10,40.21,40.21,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,90121180,,Rcnstj forehead w/autograft,A,,24.94,15.21,NA,15.21,,4.63,44.78,44.78,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,90221181,,Rcnst cntrg b9 tum crnl xtrc,A,,10.02,8.26,NA,8.26,,1.86,20.14,20.14,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00