No office rate
Both cover reconstruction in three or more pieces. Choose 21147 when bone grafting is part of the reconstruction; choose 21143 when it is not.
On this page
CMS RVU26D · Effective 2026-10-01
21147 Midface reconstruction Medicare reimbursement rates in Tennessee
Reconstructs the maxilla through a LeFort I osteotomy in three or more segments with bone grafting for complex midface deformity correction. Compare 21147 office and facility rates across CMS payment localities in Tennessee.
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 21147 in Tennessee?
Tennessee 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
$1418.46
1 of 1 localities have a supported rate.
Payment area: Tennessee
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 21147: Multi-piece LeFort I reconstruction with graft
Reconstructs the maxilla through a LeFort I osteotomy in three or more segments with bone grafting for complex midface deformity correction.
This service reconstructs the midface by mobilizing the maxilla with a LeFort I osteotomy, dividing it into three or more pieces, and using bone grafting as part of the reconstruction. Oral and maxillofacial surgeons, plastic surgeons, or craniofacial surgeons may perform it in an operating room for complex maxillary deformity, such as a developmental midface discrepancy requiring segmental repositioning.
Select this code when the operative report supports both three or more maxillary segments and bone grafting; the number of segments and graft use distinguish it from neighboring LeFort I codes. The record should describe the osteotomy, segment configuration, reconstruction, and grafting. This major surgery has a 90-day global period that includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeons and team surgery are not permitted.
CMS billing rules for 21147
- 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 RVU25.81 · 57%
- Practice expense (office) RVU16.11 · 35%
- Malpractice RVU3.75 · 8%
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.
21147 compared with similar codes
Office rates for Tennessee, from the same CMS release.
No office rate
This is the grafted LeFort I option for two pieces. Use 21147 when the maxilla is reconstructed in three or more pieces.
No office rate
This is the grafted LeFort I option for one piece. Use 21147 when the operative report supports three or more pieces.
Compare 21147 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
Tennessee →
Office / nonfacility
Unavailable
Facility
$1418.46
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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 21147 in Tennessee.
PPRRVU2026_Oct_nonQPP.csv
1,891
- Code
- 21147
- Physician work
- 25.81
- Practice expense
- 16.11
- Malpractice
- 3.75
GPCI2026.csv
95
- Locality
- Tennessee
- Physician work
- 1.000
- Practice expense
- 0.909
- Malpractice
- 0.537
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 25.81 | × 1.000 | 25.8100 |
| Practice expense | 16.11 | × 0.909 | 14.6440 |
| Malpractice | 3.75 | × 0.537 | 2.0137 |
| Total RVUs | 42.4677 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Tennessee$1418.46
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 25.81 | 1 |
| Practice expense | 16.11 | 0.909 |
| Malpractice | 3.75 | 0.537 |
(25.81 × 1 + 16.11 × 0.909 + 3.75 × 0.537) × $33.4009 = $1418.46
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.
21147 billing questions
How does this differ from 21143?
Both describe a LeFort I reconstruction in three or more pieces. This code is for the reconstruction with bone grafting; 21143 is the corresponding option without grafting.
How many segments support this code?
The maxilla must be divided into three or more pieces. The operative report should document the segment configuration rather than relying only on a general description of a LeFort I procedure.
Can the bone graft be reported separately?
Bone grafting is part of the service represented by this code. Do not separately report the same grafting work; assess any distinct graft-harvesting work under applicable coding instructions.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 or an assistant surgeon be reported?
Modifier 50 is inappropriate for this code. Assistant-at-surgery payment may be made, while co-surgeons and team surgery are not permitted.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard 50% multiple procedure reduction.
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.
1,88821143,,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
1,88921145,,Rcnstj mdfc lefort i 1 w/grf,A,,23.34,14.92,NA,14.92,,3.38,41.64,41.64,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,89021146,,Rcnstj mdfc lefort i 2 w/grf,A,,24.25,15.74,NA,15.74,,3.51,43.50,43.50,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,89121147,,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
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780