No office rate
Both involve LeFort II reconstruction, but 21150 identifies an anterior-intrusion configuration; 21151 is the bone-graft configuration. Follow the operative details.
On this page
CMS RVU26D · Effective 2026-10-01
21151 Midface reconstruction Medicare reimbursement rates in Wyoming
Reconstructs the midface using a LeFort II osteotomy and bone graft, typically for significant midface deficiency requiring skeletal advancement or rebuilding. Compare 21151 office and facility rates across CMS payment localities in Wyoming.
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 21151 in Wyoming?
Wyoming 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
$1517.94
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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 21151: LeFort II midface reconstruction with bone graft
Reconstructs the midface using a LeFort II osteotomy and bone graft, typically for significant midface deficiency requiring skeletal advancement or rebuilding.
This operation reconstructs the central midface by repositioning the LeFort II segment and using bone graft to support the skeletal repair. Craniofacial and oral and maxillofacial surgeons may perform it for substantial midface hypoplasia, including deficiency associated with craniofacial syndromes. It is generally performed in an operating room, with the operative report identifying the osteotomy, graft use, and reconstructed anatomy.
Report 21151 when the documented reconstruction is a LeFort II procedure with bone graft; the surgical approach and grafting must support that selection rather than a different LeFort level or configuration. The code includes obtaining an autograft, so do not separately report the harvest as an independent service. The day-before preoperative visit and 90 days of related postoperative care are included. For multiple procedures in the same session, the highest-valued procedure is paid in full and other procedures are paid at 50%. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeons and team surgery are not permitted.
CMS billing rules for 21151
- 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 RVU28.29 · 61%
- Practice expense (office) RVU14.10 · 30%
- Malpractice RVU4.13 · 9%
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.
21151 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
This is a one-piece LeFort I reconstruction with graft. Use 21151 when the documented osteotomy and reconstruction are LeFort II.
No office rate
This describes LeFort III reconstruction without LeFort I involvement. The operative level and extent, not the general goal of midface advancement, determine the choice.
Compare 21151 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
Wyoming** →
Office / nonfacility
Unavailable
Facility
$1517.94
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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 21151 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
1,893
- Code
- 21151
- Physician work
- 28.29
- Practice expense
- 14.10
- Malpractice
- 4.13
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 28.29 | × 1.000 | 28.2900 |
| Practice expense | 14.10 | × 1.000 | 14.1000 |
| Malpractice | 4.13 | × 0.740 | 3.0562 |
| Total RVUs | 45.4462 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$1517.94
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 28.29 | 1 |
| Practice expense | 14.1 | 1 |
| Malpractice | 4.13 | 0.74 |
(28.29 × 1 + 14.1 × 1 + 4.13 × 0.74) × $33.4009 = $1517.94
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.
21151 billing questions
How do I distinguish 21151 from 21150?
21151 describes LeFort II reconstruction with bone graft. Code 21150 identifies the LeFort II anterior-intrusion configuration; select based on the documented operation, not simply whether both procedures involve the midface.
Can the autograft harvest be reported separately?
No. The code includes obtaining an autograft, so the harvest is part of the reported reconstruction.
Does the code include postoperative care?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be used for bilateral work?
No. The descriptor and anatomy make a bilateral adjustment with modifier 50 inappropriate.
How are other same-session procedures paid?
The highest-valued procedure is paid in full, and other procedures are paid at 50% under the standard multiple procedure reduction.
Can an assistant or another surgeon be reported?
An assistant at surgery may be paid. Co-surgeons and team surgery are not permitted for this code.
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.
1,89021146,,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
1,89521155,,Rcnstj mdfc lefort iii w/i,A,,34.34,16.08,NA,16.08,,5.01,55.43,55.43,0,090,0.10,0.69,0.21,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1,89621159,,Rcnst mdfc lfrtiii advm wo i,A,,42.06,17.96,NA,17.96,,6.15,66.17,66.17,0,090,0.10,0.69,0.21,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,