No office rate
Choose 21137 for contouring alone. Choose 21138 when the documented forehead procedure also includes augmentation.
On this page
CMS RVU26D · Effective 2026-10-01
21137 Forehead reduction Medicare reimbursement rates in Wisconsin
Reports surgical reduction and contouring of prominent forehead bone, including brow shaping, when the work does not include augmentation or frontal sinus setback. Compare 21137 office and facility rates across CMS payment localities in Wisconsin.
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 21137 in Wisconsin?
Wisconsin 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
$630.12
1 of 1 localities have a supported rate.
Payment area: Wisconsin
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 21137: Forehead reduction with contouring only
Reports surgical reduction and contouring of prominent forehead bone, including brow shaping, when the work does not include augmentation or frontal sinus setback.
This operation reduces and reshapes the frontal bone to address forehead prominence or brow bossing. A craniofacial, plastic, or facial plastic surgeon typically performs it in an operating room, often as part of facial skeletal surgery. The defining scope is contouring alone: the procedure does not include augmentation or setback of the anterior frontal sinus wall.
Select the code from the operative report’s documented work, not from the patient’s stated goal or the general label of facial feminization surgery. Documentation should identify the forehead and brow work and distinguish bone contouring from an implant or graft and from frontal sinus wall osteotomy and setback. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate; an assistant at surgery may be paid, while co-surgeons and team surgery are not permitted.
CMS billing rules for 21137
- 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 RVU9.98 · 49%
- Practice expense (office) RVU8.68 · 42%
- Malpractice RVU1.85 · 9%
16
Medicare services in 2024 · #6025 by national volume
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.
21137 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
No office rate
Choose 21139 when frontal sinus wall setback accompanies contouring. Without that setback, forehead contouring alone is the scope of 21137.
No office rate
21172 describes reconstruction of the supra-lateral orbital rim and lateral forehead. It is not the code for standalone reduction and contouring of forehead prominence.
Compare 21137 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
Wisconsin →
Office / nonfacility
Unavailable
Facility
$630.12
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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 21137 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
1,883
- Code
- 21137
- Physician work
- 9.98
- Practice expense
- 8.68
- Malpractice
- 1.85
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.98 | × 1.000 | 9.9800 |
| Practice expense | 8.68 | × 0.958 | 8.3154 |
| Malpractice | 1.85 | × 0.308 | 0.5698 |
| Total RVUs | 18.8652 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wisconsin$630.12
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.98 | 1 |
| Practice expense | 8.68 | 0.958 |
| Malpractice | 1.85 | 0.308 |
(9.98 × 1 + 8.68 × 0.958 + 1.85 × 0.308) × $33.4009 = $630.12
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.
21137 billing questions
How is 21137 distinguished from 21138?
Use 21137 for forehead bone reduction and contouring alone. 21138 describes contouring that also includes augmentation.
When is 21139 more appropriate?
Use 21139 when the operation includes contouring and setback of the anterior frontal sinus wall. Contouring without that setback is the distinguishing work for 21137.
Can modifier 50 be reported?
No. Modifier 50 is inappropriate for this forehead procedure; the code is not reported as a paired right-and-left service.
Are related postoperative visits included?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How does Medicare handle another procedure performed in the same session?
The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard 50% multiple-procedure reduction.
May 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 listed CMS rules.
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.
1,88021123,,Geniop sldg augmentation,A,,11.06,10.62,NA,10.62,,1.61,23.29,23.29,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,88121125,,Augmentation mndblr prostc,A,,10.53,65.97,,6.39,,1.21,77.71,18.13,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,88221127,,Augmentation mndblr b1 grf,A,,12.13,105.28,,7.31,,1.39,118.80,20.83,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,88321137,,Rdctj forehead cntrg only,A,,9.98,8.68,NA,8.68,,1.85,20.51,20.51,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,88421138,,Rdctj forehead cntrg&prostc,A,,12.55,9.86,NA,9.86,,2.34,24.75,24.75,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,88521139,,Rdctj forehead cntrg&setback,A,,14.64,12.11,NA,12.11,,2.72,29.47,29.47,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,88621141,,Rcnstj midface lefort i 1pc,A,,19.08,14.34,NA,14.34,,2.76,36.18,36.18,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,