No office rate
The Le Fort III reconstruction level is shared, but 21155 includes an interpositional bone graft; 21154 is selected when one is not used.
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CMS RVU26D · Effective 2026-10-01
21154 Midface reconstruction Medicare reimbursement rates in Nebraska
Reports Le Fort III midface reconstruction without an interpositional bone graft, commonly performed to correct substantial midface deficiency or craniofacial skeletal deformity. Compare 21154 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 21154 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
$1542.12
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 21154: Le Fort III midface reconstruction without graft
Reports Le Fort III midface reconstruction without an interpositional bone graft, commonly performed to correct substantial midface deficiency or craniofacial skeletal deformity.
This operation reconstructs the midface at the Le Fort III level, separating and repositioning the midfacial skeleton relative to the cranial base, then stabilizing it. Craniofacial, plastic, or oral and maxillofacial surgeons commonly perform it in a hospital setting for significant midface hypoplasia, including deformities associated with craniosynostosis. The code distinguishes this reconstruction from the advancement-specific codes and from the version that includes an interpositional bone graft.
Select the code from the documented operative technique: the record should identify the Le Fort III reconstruction and whether an interpositional bone graft was used. The procedure has a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate because the reconstruction treats the midface as a unit. An assistant at surgery may be paid; co-surgeon payment requires supporting documentation, and team-surgery billing is not permitted.
CMS billing rules for 21154
- 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 RVU30.51 · 61%
- Practice expense (office) RVU15.14 · 30%
- Malpractice RVU4.46 · 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.
21154 compared with similar codes
Office rates for Nebraska, from the same CMS release.
No office rate
21159 describes Le Fort III advancement without an interpositional graft. Use 21154 for the Le Fort III reconstruction when the documented procedure is not the advancement variant.
No office rate
21160 describes Le Fort III advancement with an interpositional bone graft; 21154 is the non-advancement reconstruction without that graft.
No office rate
21150 is a Le Fort II reconstruction involving anterior intrusion. 21154 is for reconstruction at the Le Fort III level.
Compare 21154 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
$1542.12
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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 21154 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
1,894
- Code
- 21154
- Physician work
- 30.51
- Practice expense
- 15.14
- Malpractice
- 4.46
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 30.51 | × 1.000 | 30.5100 |
| Practice expense | 15.14 | × 0.923 | 13.9742 |
| Malpractice | 4.46 | × 0.378 | 1.6859 |
| Total RVUs | 46.1701 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nebraska$1542.12
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 30.51 | 1 |
| Practice expense | 15.14 | 0.923 |
| Malpractice | 4.46 | 0.378 |
(30.51 × 1 + 15.14 × 0.923 + 4.46 × 0.378) × $33.4009 = $1542.12
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.
21154 billing questions
How is 21154 distinguished from 21155?
Use 21154 for the Le Fort III reconstruction without an interpositional bone graft. The corresponding graft version is 21155.
When would 21159 or 21160 be considered instead?
Those codes describe Le Fort III advancement. Choose between them based on whether the documented advancement includes an interpositional bone graft.
Can modifier 50 be reported?
No. This is a reconstruction of the midface as a unit, not a separately reportable procedure on each side.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care through the 90-day period.
How are assistant and co-surgeon claims handled?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team-surgery billing is not permitted.
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.
1,89121147,,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
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
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