No office rate
21183 represents the next defect-area tier in the cranial cranioplasty series. Select between the codes using the total area documented for reconstruction.
On this page
CMS RVU26D · Effective 2026-10-01
21182 Cranial cranioplasty Medicare reimbursement rates in Wisconsin
Reports cranioplasty using multiple autografts to rebuild a small cranial bone defect, with code selection based on the total defect area. Compare 21182 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 21182 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
$1687.89
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.
Cranial reconstruction
About 21182: Cranial defect cranioplasty with autografts
Reports cranioplasty using multiple autografts to rebuild a small cranial bone defect, with code selection based on the total defect area.
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.
CMS billing rules for 21182
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU31.77 · 57%
- Practice expense (office) RVU17.69 · 32%
- Malpractice RVU5.90 · 11%
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.
21182 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
No office rate
21184 is the larger defect-area tier in this series. 21182 represents the smallest tier.
No office rate
21181 describes cranial contouring associated with benign tumor excision. 21182 is for cranioplasty of a cranial bone defect using multiple autografts.
Compare 21182 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
$1687.89
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 21182 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
1,903
- Code
- 21182
- Physician work
- 31.77
- Practice expense
- 17.69
- Malpractice
- 5.90
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 31.77 | × 1.000 | 31.7700 |
| Practice expense | 17.69 | × 0.958 | 16.9470 |
| Malpractice | 5.90 | × 0.308 | 1.8172 |
| Total RVUs | 50.5342 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wisconsin$1687.89
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 31.77 | 1 |
| Practice expense | 17.69 | 0.958 |
| Malpractice | 5.9 | 0.308 |
(31.77 × 1 + 17.69 × 0.958 + 5.9 × 0.308) × $33.4009 = $1687.89
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.
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 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.
1,90021179,,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
1,90421183,,Reconstruct cranial bone,A,,34.81,18.81,NA,18.81,,6.46,60.08,60.08,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,90521184,,Reconstruct cranial bone,A,,37.65,19.84,NA,19.84,,7.01,64.50,64.50,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,90621188,,Reconstruction of midface,A,,22.57,16.94,NA,16.94,,3.27,42.78,42.78,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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,,,,,,