CPT 21182
Global 090 ActiveReconstruct cranial bone
CPT 21182 Billing & Documentation Guide
CPT code 21182 (Reconstruct cranial bone) is classified under Surgery (Musculoskeletal) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 31.77, a non-facility practice expense RVU of 17.69, and a malpractice RVU of 5.9, a total non-facility RVU of 55.36 and facility RVU of 55.36. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $1868.16, though rates vary from $1670.19 to $2329.57 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 21182, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 21182 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
90-day global period (major surgery: 1 day pre-op + procedure + 90 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 21182 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 21182
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 31.77 | 31.77 |
| Practice Expense RVU | 17.69 | 17.69 |
| Malpractice RVU | 5.9 | 5.9 |
| Total RVU | 55.36 | 55.36 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 21182
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $1905.2 | $1905.2 | $1832.4 - $2135.52 | 29 |
| Florida | $2037.6 | $2037.6 | $1922.2 - $2174.61 | 3 |
| Georgia | $1862.21 | $1862.21 | $1823.1 - $1901.32 | 2 |
| Illinois | $2012.38 | $2012.38 | $1908.62 - $2114.66 | 4 |
| Michigan | $1893.34 | $1893.34 | $1823.09 - $1963.58 | 2 |
| North Carolina | $1738.35 | $1738.35 | $1738.35 - $1738.35 | 1 |
| New York | $2038.54 | $2038.54 | $1761 - $2197.55 | 5 |
| Ohio | $1799.25 | $1799.25 | $1799.25 - $1799.25 | 1 |
| Pennsylvania | $1860.11 | $1860.11 | $1789.78 - $1930.43 | 2 |
| Texas | $1831.73 | $1831.73 | $1781.9 - $1927.52 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 21182
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 21182 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0904T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 21182
What does CPT code 21182 mean? +
CPT code 21182 represents: Reconstruct cranial bone. It's in the Surgery (Musculoskeletal) category with a global period of 090.
What is the Medicare reimbursement for CPT 21182? +
The 2026 Medicare national average non-facility payment for CPT 21182 is $1868.16. Rates range from $1670.19 to $2329.57 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 21182? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 21182? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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