Billing code 21175: Forehead reconstructionMedicare rate & RVUs in Oregon
Reports bifrontal reconstruction advancing and reshaping the forehead and supraorbital rims, commonly performed to correct craniosynostosis-related craniofacial deformity.
CMS doesn’t publish an office rate for 21175 in Oregon.
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 21175 covers
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.
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.
Where 21175 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $1,968.00 |
| Rest Of Oregon | Unavailable | $1,869.05 |
How the 21175 rate is calculated
Each of 21175’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 · 21175
RVUs × geographic indexes × conversion factor
Work32.72
32.72 RVUs× 1.000 GPCI
Practice expense19.04
19.04 RVUs× 1.000 GPCI
Malpractice6.08
6.08 RVUs× 1.000 GPCI
Adjusted RVUs
57.8400
Conversion factor
$33.4009
Medicare rate
$1,931.91
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 21175
21175 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21175
Forehead 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) | 0 | Not permitted. |
| 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 · 21175
Forehead 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
21175 without 51 · national facility
$1,931.91
Forehead reconstruction
21175-51 · Second procedure: 50%
$965.96
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%).
21175 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 21172Forehead reconstruction
- Choose 21175 for bifrontal forehead and supraorbital rim reconstruction with advancement. Code 21172 describes reconstruction focused on the superolateral orbital rim and lower forehead.
- 21179Forehead reconstruction
- Code 21179 addresses forehead reconstruction with grafts; use 21175 when the operative work includes bifrontal advancement and reconstruction of the supraorbital rims.
- 21188Midface reconstruction
- Code 21188 addresses reconstruction centered on the midface. Code 21175 is for reconstruction of the forehead and supraorbital rims.
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 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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