No office rate
21137 is the contouring-only option. Report 21139 when frontal bone setback is also performed.
On this page
CMS RVU26D · Effective 2026-10-01
21139 Forehead reconstruction Medicare reimbursement rates in Nebraska
Reports forehead reconstruction that combines brow contouring with setback of the frontal bone, commonly performed for craniofacial or gender-affirming facial surgery. Compare 21139 office and facility rates across CMS payment localities in Nebraska.
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 21139 in Nebraska?
Nebraska 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
$896.67
1 of 1 localities have a supported rate.
Payment area: Nebraska
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 21139: Forehead contouring with bone setback
Reports forehead reconstruction that combines brow contouring with setback of the frontal bone, commonly performed for craniofacial or gender-affirming facial surgery.
This operation reshapes the forehead and brow and sets back the frontal bone to change the forehead’s projection. It is performed by craniofacial or plastic surgeons, often as part of facial feminization surgery or reconstruction for a craniofacial deformity. The operative work may involve exposing and reshaping the bone, repositioning it, and securing it in the planned contour. The setting is typically a hospital operating room.
Select this code when the documented procedure includes both contouring and bone setback; contouring alone or a prosthetic approach has a different code in this family. The operative report should describe the bone work, setback, and brow contouring performed. This major surgery has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. 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 reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 21139
- 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 RVU14.64 · 50%
- Practice expense (office) RVU12.11 · 41%
- Malpractice RVU2.72 · 9%
17
Medicare services in 2024 · #5989 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.
21139 compared with similar codes
Office rates for Nebraska, from the same CMS release.
No office rate
21138 describes forehead contouring with a prosthetic approach; 21139 describes contouring with bone setback.
No office rate
21172 is a related supraorbital and lower-forehead reconstruction option. Distinguish it from 21139 by the operative anatomy and work documented.
No office rate
21175 addresses reconstruction involving the supraorbital rim and lower forehead. Use 21139 for the documented forehead contouring and setback procedure.
Compare 21139 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
Nebraska →
Office / nonfacility
Unavailable
Facility
$896.67
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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 21139 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
1,885
- Code
- 21139
- Physician work
- 14.64
- Practice expense
- 12.11
- Malpractice
- 2.72
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 14.64 | × 1.000 | 14.6400 |
| Practice expense | 12.11 | × 0.923 | 11.1775 |
| Malpractice | 2.72 | × 0.378 | 1.0282 |
| Total RVUs | 26.8457 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nebraska$896.67
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 14.64 | 1 |
| Practice expense | 12.11 | 0.923 |
| Malpractice | 2.72 | 0.378 |
(14.64 × 1 + 12.11 × 0.923 + 2.72 × 0.378) × $33.4009 = $896.67
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.
21139 billing questions
How does 21139 differ from 21137?
21139 is for forehead contouring that also includes setback of the frontal bone. Use 21137 when the documented work is forehead contouring without setback.
How does 21139 differ from 21138?
21138 describes forehead contouring with a prosthetic approach. 21139 describes contouring with bone setback; select based on the work documented in the operative report.
Can modifier 50 be reported?
No. Bilateral adjustment does not apply to this code, and modifier 50 is inappropriate for its descriptor and anatomy.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.
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.
What documentation supports reporting 21139?
The operative report should identify the forehead and brow work and document frontal bone setback, distinguishing it from contouring alone or a prosthetic approach.
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.
1,88221127,,Augmentation mndblr b1 grf,A,,12.13,105.28,,7.31,,1.39,118.80,20.83,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,88321137,,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
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068