Billing code 21143: LeFort I reconstructionMedicare rate & RVUs in Oklahoma
Reconstructs the midface with a LeFort I osteotomy divided into three or more segments, without bone grafting, to reposition the maxilla.
CMS doesn’t publish an office rate for 21143 in Oklahoma.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 21143 covers
This operation repositions the maxilla after a LeFort I osteotomy that divides it into at least three pieces. Oral and maxillofacial surgeons, plastic surgeons, or craniofacial surgeons may perform it for skeletal maxillary deformity, such as a significant jaw discrepancy affecting facial balance or bite. It is generally performed in an operating room under general anesthesia. The distinguishing features are the LeFort I level, the number of segments, and the absence of bone grafting.
Report 21143 when the operative record supports three or more maxillary pieces and the reconstruction does not include bone grafting; the one-piece and two-piece versions are separate family codes. The operative note should identify the osteotomy, segment count, repositioning, and whether grafting was performed. The 90-day global includes the day-before preoperative visit and related postoperative care for 90 days. In a same-session multiple-procedure situation, the highest-valued procedure is paid in full and other procedures at 50%. Modifier 50 is inappropriate for this service. An assistant may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
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.
21143 in Oklahoma
| Payment locality | Office | Facility |
|---|---|---|
| Oklahoma | Unavailable | $1,199.09 |
How the 21143 rate is calculated
Each of 21143’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 21143
RVUs × geographic indexes × conversion factor
Work20.52
20.52 RVUs× 1.000 GPCI
Practice expense14.63
14.63 RVUs× 1.000 GPCI
Malpractice2.98
2.98 RVUs× 1.000 GPCI
Adjusted RVUs
38.1300
Conversion factor
$33.4009
Medicare rate
$1,273.58
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 21143
21143 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21143
LeFort I reconstruction
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 21143
LeFort I reconstruction
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
21143 without 51 · national facility
$1,273.58
LeFort I reconstruction
21143-51 · Second procedure: 50%
$636.79
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
21143 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 21142Le Fort I reconstruction
- Use 21142 when the LeFort I reconstruction divides the maxilla into two pieces; 21143 requires three or more.
- 21147Midface reconstruction
- Both describe three-or-more-piece LeFort I reconstruction. 21147 is the grafting version; 21143 is without bone grafting.
- 21150Midface reconstruction
- 21150 describes a LeFort II-level midface reconstruction, not the LeFort I osteotomy represented by 21143.
21143 billing questions
How does 21143 differ from 21142?
21143 is for a LeFort I reconstruction in which the maxilla is divided into three or more pieces. 21142 describes the two-piece version.
When is 21147 reported instead?
Use 21147 for the three-or-more-piece LeFort I reconstruction when bone grafting is part of the reconstruction. This code, 21143, is the corresponding version without bone grafting.
What operative documentation supports 21143?
Document the LeFort I osteotomy, the number of maxillary segments, their repositioning, and whether bone grafting was performed.
Can modifier 50 be appended?
No. The CMS bilateral adjustment does not apply to this midface reconstruction, and modifier 50 is inappropriate.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery 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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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