Billing code 21182: Cranial cranioplastyMedicare rate & RVUs in Texas
Reports cranioplasty using multiple autografts to rebuild a small cranial bone defect, with code selection based on the total defect area.
CMS doesn’t publish an office rate for 21182 in Texas.
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 21182 covers
This service rebuilds a cranial bone defect with multiple autografts, including harvesting the grafts. It is typically performed by a neurosurgeon or craniofacial plastic surgeon in an operating room for a patient who needs structural reconstruction after a defect or prior cranial surgery. The code represents the smallest defect-area tier in the 21182–21184 series; the operative record should support the defect’s total area and the use of multiple autografts.
Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction. An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this anatomy and descriptor.
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 21182 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $1,863.00 |
| Beaumont | Unavailable | $1,781.90 |
| Brazoria | Unavailable | $1,808.89 |
| Dallas | Unavailable | $1,828.28 |
| Fort Worth | Unavailable | $1,824.93 |
| Galveston | Unavailable | $1,819.53 |
| Houston | Unavailable | $1,927.52 |
| Rest Of Texas | Unavailable | $1,799.82 |
How the 21182 rate is calculated
Each of 21182’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 · 21182
RVUs × geographic indexes × conversion factor
Work31.77
31.77 RVUs× 1.000 GPCI
Practice expense17.69
17.69 RVUs× 1.000 GPCI
Malpractice5.90
5.90 RVUs× 1.000 GPCI
Adjusted RVUs
55.3600
Conversion factor
$33.4009
Medicare rate
$1,849.07
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 21182
21182 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21182
Cranial cranioplasty
| 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 · 21182
Cranial cranioplasty
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
21182 without 51 · national facility
$1,849.07
Cranial cranioplasty
21182-51 · Second procedure: 50%
$924.54
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%).
21182 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 21183Cranial reconstruction
- 21183 represents the next defect-area tier in the cranial cranioplasty series. Select between the codes using the total area documented for reconstruction.
- 21184Cranial reconstruction
- 21184 is the larger defect-area tier in this series. 21182 represents the smallest tier.
- 21181Cranial reconstruction
- 21181 describes cranial contouring associated with benign tumor excision. 21182 is for cranioplasty of a cranial bone defect using multiple autografts.
21182 billing questions
How do I choose 21182 rather than 21183 or 21184?
These codes distinguish cranial reconstruction by total defect area. Use 21182 for the smallest tier and check the operative measurements against the applicable code-family thresholds.
Does 21182 include harvesting the bone grafts?
Yes. The multiple autografts are included, including obtaining the grafts; do not report graft harvesting separately as part of this service.
What documentation supports reporting 21182?
Document the cranial defect and its total area, the reconstruction performed, and that multiple autografts were used and obtained.
Can 21182 be reported with another procedure performed in the same session?
It may be reported with other separately supported procedures when appropriate. Medicare applies its standard multiple-procedure reduction when multiple procedures are performed in the same session.
Can an assistant or co-surgeon be reported for this operation?
Medicare may pay for an assistant at surgery. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
Does modifier 50 apply to 21182?
No. The anatomy and service represented by 21182 make modifier 50 inappropriate.
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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