No office rate
This code describes forehead reconstruction with grafts; 21180 specifically identifies an autogenous bone graft. Follow the documented graft and operative service when selecting between them.
On this page
CMS RVU26D · Effective 2026-10-01
21179 Forehead reconstruction Medicare reimbursement rates in Tennessee
Reports reconstructive surgery of the forehead using graft material to restore contour or structure after congenital deformity, trauma, or surgical resection. Compare 21179 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 21179 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
$1237.00
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 21179: Forehead reconstruction with grafts
Reports reconstructive surgery of the forehead using graft material to restore contour or structure after congenital deformity, trauma, or surgical resection.
This code represents operative reconstruction of the forehead using graft material to restore or reshape the affected area. Craniofacial and plastic surgeons may perform the procedure for a congenital craniofacial deformity, a traumatic defect, or a defect remaining after tumor or other surgical resection. The operative report should describe the forehead reconstruction, the defect addressed, and the graft material used; the diagnosis alone does not establish this service.
Report the code when the documented operation matches forehead reconstruction with grafts, rather than a procedure focused on the orbit or broader cranial bone. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this code. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 21179
- 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 RVU22.08 · 55%
- Practice expense (office) RVU14.03 · 35%
- Malpractice RVU4.10 · 10%
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.
21179 compared with similar codes
Office rates for Tennessee, from the same CMS release.
No office rate
Use 21175 when the operation matches its bifrontal, supraorbital rim, and lower-forehead reconstruction pattern, rather than the forehead graft reconstruction represented here.
No office rate
Code 21182 concerns reconstruction of cranial bone. This code is directed to reconstruction of the forehead using graft material.
Compare 21179 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
$1237.00
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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 21179 in Tennessee.
PPRRVU2026_Oct_nonQPP.csv
1,900
- Code
- 21179
- Physician work
- 22.08
- Practice expense
- 14.03
- Malpractice
- 4.10
GPCI2026.csv
95
- Locality
- Tennessee
- Physician work
- 1.000
- Practice expense
- 0.909
- Malpractice
- 0.537
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 22.08 | × 1.000 | 22.0800 |
| Practice expense | 14.03 | × 0.909 | 12.7533 |
| Malpractice | 4.10 | × 0.537 | 2.2017 |
| Total RVUs | 37.0350 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Tennessee$1237.00
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 22.08 | 1 |
| Practice expense | 14.03 | 0.909 |
| Malpractice | 4.1 | 0.537 |
(22.08 × 1 + 14.03 × 0.909 + 4.1 × 0.537) × $33.4009 = $1237.00
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.
21179 billing questions
How is this code distinguished from 21180?
Both describe forehead reconstruction involving grafting. Code 21180 specifically identifies an autogenous bone graft, so use the operative details and the applicable descriptor to distinguish the services.
What documentation supports reporting this code?
Document the forehead defect or deformity, the reconstructive work performed, and the graft material used. The diagnosis by itself does not show that graft-based forehead reconstruction was performed.
Can modifier 50 be appended for both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.
How are other procedures in the same session paid?
Under the standard multiple-procedure rule, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction.
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 rules provided.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
1,89721160,,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
1,89821172,,Rcnst supr-lat orb rm&lw fhd,A,,27.50,23.42,NA,23.42,,11.63,62.55,62.55,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,89921175,,Rcnst bfrnt sp orb rm&lw fhd,A,,32.72,19.04,NA,19.04,,6.08,57.84,57.84,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,90021179,,Rcnstj forehead with grafts,A,,22.08,14.03,NA,14.03,,4.10,40.21,40.21,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,90121180,,Rcnstj forehead w/autograft,A,,24.94,15.21,NA,15.21,,4.63,44.78,44.78,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,90221181,,Rcnst cntrg b9 tum crnl xtrc,A,,10.02,8.26,NA,8.26,,1.86,20.14,20.14,0,090,0.10,0.69,0.21,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,90321182,,Reconstruct cranial bone,A,,31.77,17.69,NA,17.69,,5.90,55.36,55.36,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,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