{"id":177162,"date":"2026-08-13T11:05:46","date_gmt":"2026-08-13T11:05:46","guid":{"rendered":"https:\/\/pabau.com\/?p=177162"},"modified":"2026-08-13T11:05:48","modified_gmt":"2026-08-13T11:05:48","slug":"cpt-code-21267","status":"publish","type":"post","link":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-21267\/","title":{"rendered":"CPT code 21267: Orbital repositioning with bone grafts"},"content":{"rendered":"\n<script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@type\":\"MedicalWebPage\",\"headline\":\"CPT code 21267: Orbital repositioning with bone grafts, extracranial approach\",\"description\":\"CPT code 21267 covers unilateral orbital repositioning with periorbital osteotomies and bone grafts through an extracranial approach. Review the descriptor, 2026 RVUs, Medicare rates, modifiers, ICD-10 pairings, and documentation requirements.\",\"url\":\"https:\/\/pabau.com\/procedure-codes\/cpt-code-21267\/\",\"audience\":{\"@type\":\"MedicalAudience\",\"audienceType\":\"Clinician\"},\"reviewedBy\":{\"@type\":\"Person\",\"name\":\"Dr Vanja Kitanova\",\"jobTitle\":\"Medical Reviewer\",\"affiliation\":{\"@type\":\"Organization\",\"name\":\"Pabau\"},\"knowsAbout\":[\"Medical Coding\",\"Clinical Documentation\",\"Healthcare Billing\",\"Clinical Safety\"],\"sameAs\":\"https:\/\/pabau.com\/blog\/author\/vanja\/\"},\"datePublished\":\"2026-08-07\",\"dateModified\":\"2026-08-13\"}<\/script>\n\n\n        <div id=\"key_takeaways\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/12\/Key-Takeaways-Icon.svg\" alt=\"Key takeaways\" height=\"42\" width=\"42\">\n                                <h3>Key takeaways<\/h3>\n            <\/div>\n            <div class=\"list\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>CPT code 21267 covers unilateral orbital repositioning with periorbital osteotomies and bone grafts, through an extracranial approach.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Both 21267 and 21268 require bone grafts, so graft use never decides between the two codes. The surgical approach does.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Report 21267 when the cranial cavity is not entered. Report CPT 21268 when the case adds craniotomy and intracranial work.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>CPT 21267 carries 43.91 total RVUs, or roughly $1,467 nationally at the 2026 conversion factor. Facility and non-facility rates match.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Practice management software like Pabau helps craniofacial practices keep operative notes, diagnosis codes, and claim status in one place.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<p class=\"wp-block-paragraph\">CPT code 21267 covers unilateral orbital repositioning through periorbital osteotomies, performed with bone grafts and an extracranial approach. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bone grafting is part of the code rather than the detail that separates it from its neighbor, CPT 21268. Coders who read the descriptor for graft language, instead of the approach, send these claims to the wrong code.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Below you will find the official descriptor, 2026 RVUs and Medicare rates, modifiers, supporting ICD-10-CM codes, and the documentation that keeps these claims paid. It also answers a question the descriptor leaves open. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Can the graft harvest be billed separately? <a href=\"https:\/\/pabau.com\/features\/claims-management-software\/\">Claims management software<\/a> helps practices catch approach and laterality errors before submission, but the coder needs the distinction first.<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe title=\"CPT Coding Pitfalls Every Medical Practice Faces\" width=\"800\" height=\"450\" src=\"https:\/\/www.youtube.com\/embed\/vbvV5okdXKg?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<h2 id=\"h-cpt-code-21267-definition-and-clinical-description\" class=\"wp-block-heading\">CPT code 21267: Definition and clinical description<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">CPT code 21267, as maintained by the American Medical Association (AMA), describes: <strong>Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; extracranial approach.<\/strong> It sits in the Repair, Revision, and\/or Reconstruction Procedures on Skull, Face and Temporomandibular Joint section of the CPT code set, codes 21120-21299.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The semicolon in that descriptor is the part coders need. Everything before it is shared word for word with CPT 21268. Everything after it is what makes the code 21267.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Field<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Detail<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">CPT code<\/td>\n<td style=\"padding:12px 16px;color:#374151\">21267<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Official descriptor<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; extracranial approach<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">CPT section<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Repair, Revision, and\/or Reconstruction &#8211; Skull, Face and TMJ (21120-21299)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Bone grafts<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Required, since grafting is written into the descriptor<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Surgical approach<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Extracranial, so the cranial cavity is not entered<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Laterality<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Unilateral, since the code describes one orbit<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Adjacent code<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CPT 21268 for the combined intra- and extracranial approach<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Global period<\/td>\n<td style=\"padding:12px 16px;color:#374151\">090 days (major surgery)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Typical specialists<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Plastic surgeons, craniofacial surgeons, oculoplastic surgeons<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-21267\/automate-claims-through-healthcode.webp\" alt=\"Automate claims and billing with Pabau\"\/><figcaption class=\"wp-element-caption\"><em>Pabau&#8217;s claims management dashboard submits 21267 claims and tracks denials, so approach and laterality errors surface early.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 id=\"h-procedure-description-orbital-repositioning-through-an-extracranial-approach\" class=\"wp-block-heading\">Procedure description: Orbital repositioning through an extracranial approach<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Periorbital osteotomies are surgical bone cuts made around the orbit, the socket that holds the eye. The surgeon frees the orbital segment, moves it into corrected position, and fixes it there. Bone grafts fill the defects the osteotomies leave behind and support the repositioned bone.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In 21267 all of that work happens from outside the cranial cavity. The surgeon operates through facial and periorbital exposure without performing a craniotomy. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Once the plan requires intracranial access, the correct code becomes <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-21268\/\">CPT 21268<\/a>, which covers the combined intra- and extracranial approach. Common indications for the extracranial version include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Post-traumatic orbital malposition<\/strong> \u2014 displaced orbital segments repositioned and grafted after facial fracture<\/li>\n\n\n\n<li><strong>Congenital orbital malposition<\/strong> \u2014 one orbit repositioned as part of broader craniofacial reconstruction<\/li>\n\n\n\n<li><strong>Post-resection reconstruction<\/strong> \u2014 orbital walls repositioned and grafted after removal of a benign bone lesion<\/li>\n\n\n\n<li><strong>Secondary orbital revision<\/strong> \u2014 earlier repositioning revised while the cranial cavity stays closed<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Neither 21267 nor 21268 carries the phrase &#8222;includes obtaining grafts&#8220; in its descriptor. That wording matters for revenue. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">When the surgeon harvests autogenous bone through a separate incision, a harvest code such as <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-20900\/\">CPT 20900<\/a> or <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-20902\/\">CPT 20902<\/a> may be separately reportable. Check current NCCI edits and your payer&#8217;s policy first, because bundling rules differ.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Code selection therefore rests on the approach described in the operative report, not on the presence of a graft. Confirm whether the cranial cavity was entered before choosing between 21267 and 21268. Graft material changes the harvest code, and cartilage harvest is reported with <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-21235\/\">21235<\/a>.<\/p>\n\n\n\n<h2 id=\"h-cpt-code-21267-vs-cpt-code-21268-key-differences\" class=\"wp-block-heading\">CPT code 21267 vs. CPT code 21268: Key differences<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Both codes describe unilateral orbital repositioning with periorbital osteotomies and bone grafts. Graft use does not separate them, because both descriptors require grafting. The difference is the surgical approach, and 21268 is the one that opens the skull.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Feature<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">CPT 21267<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">CPT 21268<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Official descriptor<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; extracranial approach<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; combined intra- and extracranial approach<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Bone grafts<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Required<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Required<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Surgical approach<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Extracranial only<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Combined intra- and extracranial<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Cranial cavity<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Not entered, and no craniotomy is performed<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Entered, with craniotomy commonly at two or more sites<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Typical scenario<\/td>\n<td style=\"padding:12px 16px;color:#374151\">One orbit repositioned through facial and periorbital exposure<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Repositioning that needs cranial access for exposure or dural protection<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Work RVU<\/td>\n<td style=\"padding:12px 16px;color:#374151\">20.17<\/td>\n<td style=\"padding:12px 16px;color:#374151\">26.39<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Total RVU<\/td>\n<td style=\"padding:12px 16px;color:#374151\">43.91<\/td>\n<td style=\"padding:12px 16px;color:#374151\">54.53<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">2026 Medicare national estimate<\/td>\n<td style=\"padding:12px 16px;color:#374151\">~$1,467<\/td>\n<td style=\"padding:12px 16px;color:#374151\">~$1,821<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Code selection trigger<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Operative report shows no entry into the cranial cavity<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Operative report documents craniotomy and intracranial work<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Documentation rule:<\/strong> the operative report must state the approach in those terms. A report that mentions &#8222;craniofacial exposure&#8220; without naming craniotomy sites leaves the coder guessing. Query the surgeon rather than inferring the approach from the graft description.<\/p>\n\n\n\n<h2 id=\"h-rvu-breakdown-for-cpt-code-21267\" class=\"wp-block-heading\">RVU breakdown for CPT code 21267<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Relative Value Units (RVUs) for CPT 21267 are set each year by <a href=\"https:\/\/www.cms.gov\/medicare\/physician-fee-schedule\/search\/overview\" target=\"_blank\" rel=\"nofollow noopener\">CMS through the Physician Fee Schedule (MPFS)<\/a>. The 2026 values are below. One detail is worth flagging, because several reference pages get it wrong.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">RVU component<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:center;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Non-facility<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:center;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Facility<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Work RVU (wRVU)<\/td>\n<td style=\"padding:12px 16px;text-align:center;color:#374151\">20.17<\/td>\n<td style=\"padding:12px 16px;text-align:center;color:#374151\">20.17<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Practice expense RVU (PE)<\/td>\n<td style=\"padding:12px 16px;text-align:center;color:#374151\">19.99<\/td>\n<td style=\"padding:12px 16px;text-align:center;color:#374151\">19.99<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Malpractice RVU (MP)<\/td>\n<td style=\"padding:12px 16px;text-align:center;color:#374151\">3.75<\/td>\n<td style=\"padding:12px 16px;text-align:center;color:#374151\">3.75<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Total RVU<\/td>\n<td style=\"padding:12px 16px;text-align:center;color:#374151\">43.91<\/td>\n<td style=\"padding:12px 16px;text-align:center;color:#374151\">43.91<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">CMS assigns 21267 the same practice expense RVU in both settings, so the facility and non-facility totals are identical. Reference pages that show a reduced facility total for this code are quoting the general pattern rather than the current file.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Confirm the values with the CMS MPFS lookup or <a href=\"https:\/\/fastrvu.com\/tools\/rvu-lookup\" target=\"_blank\" rel=\"nofollow noopener\">FastRVU&#8217;s RVU lookup<\/a>, then apply your locality&#8217;s geographic practice cost index (GPCI). Both the RVUs and the conversion factor change every January.<\/p>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>Multiply the total RVU by the current conversion factor before quoting any patient. For 2026 that is 43.91 total RVUs at a conversion factor of $33.4009, or roughly $1,467 nationally for 21267. Geographic locality can move the allowable by 10-20% in either direction, so check your MAC&#8217;s locality before putting a number in writing.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-medicare-reimbursement-for-cpt-code-21267\" class=\"wp-block-heading\">Medicare reimbursement for CPT code 21267<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Medicare pays CPT 21267 by multiplying total adjusted RVUs by the annual conversion factor. At the 2026 factor of $33.4009, the national estimate is about $1,467. Because the RVUs do not vary by setting, that figure holds in a hospital, an ASC, and an office.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Setting<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Estimated Medicare allowable (national)<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Notes<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Facility (hospital\/ASC)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">~$1,467<\/td>\n<td style=\"padding:12px 16px;color:#374151\">The usual setting for craniofacial cases under general anesthesia<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Non-facility (office\/outpatient)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">~$1,467<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Same total RVUs as facility, though a rare setting for this procedure<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">CPT 21268, for comparison<\/td>\n<td style=\"padding:12px 16px;color:#374151\">~$1,821<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Higher total RVUs for the combined intra- and extracranial approach<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">The surgeon&#8217;s fee is only one line on the case. Facility fees, anesthesia, and any separately reportable graft harvest are billed apart from 21267. Locality adjustments still apply, so practices in high-cost areas such as San Francisco, New York, and Boston collect above the national estimate.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Medicare participation status matters.<\/strong> Participating providers accept the approved amount as payment in full. Non-participating providers may bill up to 115% of the approved amount but collect less from Medicare directly. Opt-out providers negotiate outside the fee schedule entirely.<\/p>\n\n\n\n<h2 id=\"h-modifiers-for-cpt-code-21267\" class=\"wp-block-heading\">Modifiers for CPT code 21267<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Modifier selection for CPT 21267 follows standard surgical modifier rules, with two wrinkles worth noting. The code is unilateral, and it carries a 90-day global period. Confirm applicability against current National Correct Coding Initiative (NCCI) edits before appending anything, because payer policies vary.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Modifier<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">When to use with 21267<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-51<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Multiple procedures<\/td>\n<td style=\"padding:12px 16px;color:#374151\">When 21267 is performed alongside other procedures in the same session; append to the secondary codes<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-62<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Two surgeons (co-surgery)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">When a second surgeon of a different specialty performs a distinct part of the reconstruction<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-80<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Assistant surgeon<\/td>\n<td style=\"padding:12px 16px;color:#374151\">When a qualified assistant surgeon participates; the assistant reports 21267 with -80<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-81<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Minimum assistant surgeon<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Minimal assistance provided; paid at a reduced percentage of the surgeon&#8217;s fee set by the payer<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-22<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Increased procedural services<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Case substantially more complex than usual; attach documentation of the increased work<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-LT \/ -RT<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Left side \/ right side<\/td>\n<td style=\"padding:12px 16px;color:#374151\">21267 is a unilateral code, so most payers expect a laterality modifier on every claim<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">-58<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Staged or related procedure<\/td>\n<td style=\"padding:12px 16px;color:#374151\">A planned second-stage orbital procedure performed inside the 90-day global period<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Because the descriptor is unilateral, a bilateral case needs a decision before submission. Check the MPFS bilateral surgery indicator and your payer&#8217;s policy to see whether a second unit or modifier -50 is expected. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Also verify whether 21267 carries a modifier -51 exemption in the current AMA CPT manual before reducing a secondary procedure fee.<\/p>\n\n\n\n<h2 id=\"h-icd-10-cm-codes-that-support-medical-necessity-for-cpt-21267\" class=\"wp-block-heading\">ICD-10-CM codes that support medical necessity for CPT 21267<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Every CPT 21267 claim needs a supporting ICD-10-CM diagnosis that establishes medical necessity. A cosmetic request with no structural or functional diagnosis will not clear Medicare or most commercial payers. Because the code is unilateral, the diagnosis should also support the side that was operated on.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">ICD-10-CM code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Clinical context<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S02.31XA<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Fracture of orbital floor, right side, initial encounter for closed fracture<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Traumatic orbital displacement, with the side matching the reported laterality<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">S02.32XA<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Fracture of orbital floor, left side, initial encounter for closed fracture<\/td>\n<td style=\"padding:12px 16px;color:#374151\">The left-side counterpart, using the subsequent-encounter character for secondary repair<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Q75.00<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Craniosynostosis, unspecified<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Premature fusion of cranial sutures that distorts orbital position, coded to a Q75.0x subtype<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Q75.4<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Mandibulofacial dysostosis<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Treacher Collins syndrome with orbital involvement<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Q75.8<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Other specified congenital malformations of skull and face bones<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Congenital orbital malposition not classified elsewhere<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Q87.0<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Congenital malformation syndromes predominantly affecting facial appearance<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Syndromic craniofacial conditions with an orbital component<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">M85.88<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Other specified disorders of bone density and structure, other site<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Osseous orbital deformity that no more specific code describes<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Q75.2<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Hypertelorism<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Usually supports the hypertelorism code family (21260, 21261, 21263) rather than 21267<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">That last row deserves attention. Hypertelorism has its own CPT family, so a Q75.2 diagnosis paired with 21267 invites a reviewer&#8217;s question. Reach for 21267 when the record documents repositioning of a single orbit. Code the diagnosis to the highest specificity the chart supports, including laterality and encounter type.<\/p>\n\n\n\n<h2 id=\"h-cpt-21267-billing-guidelines-and-documentation-requirements\" class=\"wp-block-heading\">CPT 21267 billing guidelines and documentation requirements<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Clean claim submission for CPT 21267 depends on the operative report. Reviewers at Medicare Administrative Contractors (MACs) and commercial insurers look for a defined set of elements before releasing payment. Applying the same standard to every craniofacial case reduces denial rates without adding work at the back end.<\/p>\n\n\n\n<h3 id=\"h-required-documentation-elements\" class=\"wp-block-heading\">Required documentation elements<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Pre-operative diagnosis<\/strong> \u2014 an ICD-10-CM code tied to imaging, functional impairment, or a syndromic diagnosis<\/li>\n\n\n\n<li><strong>Surgical approach<\/strong> \u2014 an explicit statement that the procedure was extracranial and the cranial cavity was not entered<\/li>\n\n\n\n<li><strong>Operative technique<\/strong> \u2014 the periorbital osteotomies performed, the anatomical extent, and the fixation used<\/li>\n\n\n\n<li><strong>Bone graft detail<\/strong> \u2014 the graft material, the donor site, and whether harvest required a separate incision<\/li>\n\n\n\n<li><strong>Laterality<\/strong> \u2014 the side operated on, stated in the report and matched by the diagnosis and modifier<\/li>\n\n\n\n<li><strong>Surgeon attestation<\/strong> \u2014 for co-surgery (-62) or assistant surgeon (-80) claims, each surgeon documents their distinct role<\/li>\n\n\n\n<li><strong>Medical necessity narrative<\/strong> \u2014 physician documentation connecting the diagnosis to functional or structural impairment<\/li>\n\n\n\n<li><strong>Anesthesia coordination<\/strong> \u2014 21267 involves general anesthesia, so the anesthesia record must match the surgical date and the operative report<\/li>\n<\/ul>\n\n\n\n<h3 id=\"h-common-denial-reasons\" class=\"wp-block-heading\">Common denial reasons<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">A handful of patterns account for most rejected 21267 claims. <a href=\"https:\/\/pabau.com\/features\/medical-records-management\/\">Patient record management<\/a> that keeps operative reports, imaging, and diagnosis documentation linked reduces exposure across all of them.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-21267\/comprehensive-emr-patient-record-management.webp\" alt=\"Comprehensive EMR and patient record management\"\/><figcaption class=\"wp-element-caption\"><em>Pabau&#8217;s patient records hold the operative note, imaging, and diagnosis codes together, so a 21267 audit request takes minutes.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Wrong code for the approach<\/strong> \u2014 21267 billed when the report documents craniotomy and intracranial work, which is 21268<\/li>\n\n\n\n<li><strong>Cosmetic-only diagnosis<\/strong> \u2014 no covered ICD-10-CM code linked to structural or functional impairment<\/li>\n\n\n\n<li><strong>Missing or mismatched laterality<\/strong> \u2014 no -LT or -RT on a unilateral code, or a diagnosis coded to the other side<\/li>\n\n\n\n<li><strong>Insufficient operative detail<\/strong> \u2014 the report does not describe the osteotomy technique, the extent, or the approach<\/li>\n\n\n\n<li><strong>Unsupported graft harvest<\/strong> \u2014 a separate harvest code billed without documentation of a separate incision<\/li>\n\n\n\n<li><strong>Missing modifier documentation<\/strong> \u2014 -62 or -80 appended without documentation from both surgeons<\/li>\n<\/ul>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>Attach imaging reports, such as a CT of the facial bones, to 21267 claims wherever payer portals allow it. A pre-operative CT showing orbital malposition is the strongest medical necessity support available. It also reduces the likelihood of a post-payment audit request landing months later.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-prior-authorization-requirements-for-cpt-21267\" class=\"wp-block-heading\">Prior authorization requirements for CPT 21267<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Prior authorization (PA) requirements for CPT 21267 vary by payer, and most reference pages for this code skip the topic. That omission causes scheduling delays for practices that assume no authorization is needed on a reconstructive procedure.<\/p>\n\n\n\n<h3 id=\"h-medicare\" class=\"wp-block-heading\">Medicare<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Traditional Medicare does not currently require prior authorization for CPT 21267. Local coverage determinations (LCDs) issued by individual MACs can still impose coverage criteria and documentation requirements that function much the same way. Check the relevant MAC&#8217;s LCD for craniofacial procedures before scheduling.<\/p>\n\n\n\n<h3 id=\"h-commercial-insurers\" class=\"wp-block-heading\">Commercial insurers<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Most commercial payers treat 21267 as a major reconstructive procedure and require prior authorization. Typical requirements include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>A documented diagnosis with an ICD-10-CM code, such as a Q75.x congenital malformation or an S02.3 orbital fracture code<\/li>\n\n\n\n<li>Supporting imaging, usually a CT scan taken within 6-12 months of the planned surgery<\/li>\n\n\n\n<li>A physician letter of medical necessity stating the functional or structural impairment<\/li>\n\n\n\n<li>Evidence that conservative management failed, where that applies<\/li>\n\n\n\n<li>The planned surgical approach, since some payers authorize 21267 and 21268 separately<\/li>\n<\/ul>\n\n\n\n<h3 id=\"h-medicaid\" class=\"wp-block-heading\">Medicaid<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Medicaid PA requirements vary by state, and so do the rates. Craniofacial reconstruction for congenital conditions is generally covered when the patient is a minor and a qualified craniofacial team documents medical necessity. Adult coverage is more restrictive and usually turns on documented functional impairment.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Use <a href=\"https:\/\/pabau.com\/features\/patient-intake-software\/\">digital clinical documentation<\/a> workflows to standardize how PA packets are assembled. A consistent template for 21267 submissions cuts preparation time and makes it obvious when an element is still missing.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-21267\/digital-forms.webp\" alt=\"Digital forms\"\/><figcaption class=\"wp-element-caption\"><em>Pabau&#8217;s digital forms collect the consent and medical necessity detail a 21267 prior authorization packet needs.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 id=\"h-related-cpt-codes-in-the-craniofacial-section\" class=\"wp-block-heading\">Related CPT codes in the craniofacial section<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">CPT 21267 sits in a small family of orbital and craniofacial reconstruction codes. Every descriptor in the 21256 to 21268 range includes bone grafts. What separates them is the approach, the anatomy treated, and whether the forehead is advanced. The <a href=\"https:\/\/www.aapc.com\/codes\/cpt-codes-range\/\" target=\"_blank\" rel=\"nofollow noopener\">AAPC&#8217;s CPT code lookup<\/a> carries the full descriptor set for cross-reference.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">CPT code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Descriptor<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Key distinction from 21267<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">21256<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Reconstruction of orbit with osteotomies (extracranial) and with bone grafts, includes obtaining autografts<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Orbital reconstruction rather than repositioning; graft harvest is bundled into this code<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">21260<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Periorbital osteotomies for orbital hypertelorism, with bone grafts; extracranial approach<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Hypertelorism-specific, with the same extracranial approach as 21267<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">21261<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Periorbital osteotomies for orbital hypertelorism, with bone grafts; combined intra- and extracranial approach<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Hypertelorism-specific, with intracranial access added<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">21263<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Periorbital osteotomies for orbital hypertelorism, with bone grafts; with forehead advancement<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Hypertelorism repair that also advances the forehead<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">21267<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; extracranial approach<\/td>\n<td style=\"padding:12px 16px;color:#374151\">This code<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">21268<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; combined intra- and extracranial approach<\/td>\n<td style=\"padding:12px 16px;color:#374151\">The same procedure through an approach that enters the cranial cavity<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">21270<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Malar augmentation, prosthetic material<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Cheekbone augmentation with an implant; no osteotomy and no graft<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Read after the semicolon.<\/strong> There is no odd-and-even pattern to lean on in this range, and graft use is not a differentiator anywhere in it. The descriptors move from an extracranial approach to a combined intra- and extracranial approach, and 21263 adds forehead advancement.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Work outside the orbit needs its own code. Partial mandible or maxilla reconstruction is reported with <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-21248\/\">21248<\/a>, and a free osteocutaneous flap with a code such as <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-20972\/\">20972<\/a>. Check NCCI edits before reporting two codes from this family in one session, because unbundling questions are common here.<\/p>\n\n\n\n<h2 id=\"h-how-pabau-keeps-craniofacial-claims-audit-ready\" class=\"wp-block-heading\">How Pabau keeps craniofacial claims audit-ready<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">In most surgical practices the detail that decides 21267 versus 21268 lives in a dictated operative note, and the claim is built somewhere else. A coder reads the note, types a code into billing software, and hopes the two still agree at audit. When the payer asks for the record 18 months later, someone goes looking through two systems.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Pabau, our practice management platform, keeps the operative note, the diagnosis codes, the consent forms, and the claim on the same patient record. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Coders can see the documented approach and laterality next to the code they are about to submit. Claim status, denials, and resubmissions sit in the same place, so nothing is tracked in a side spreadsheet.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For craniofacial teams, <a href=\"https:\/\/pabau.com\/industry\/plastic-surgery-emr\/\">plastic surgery practices<\/a>, and <a href=\"https:\/\/pabau.com\/industry\/dermatology-emr-software\/\">dermatology groups<\/a> handling facial reconstruction, the outcome is fewer avoidable denials and shorter audit responses. You can pull the operative note, the pre-operative CT report, and the submitted claim for any 21267 case in one place. A records request stops being a half-day job.<\/p>\n\n\n        <div id=\"book_a_demo\">\n            <div class=\"left-side\">\n                <div class=\"logo\">\n                    <img decoding=\"async\"\n                        src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Logo.svg\"\n                        alt=\"Logo\"\n                        loading=\"lazy\"\n                    \/>\n                <\/div>\n\n                <h3 class=\"heading\">\n                    Manage craniofacial surgery claims without the paperwork burden                <\/h3>\n\n                <p class=\"description\">\n                    Pabau&#8217;s claims management tools help plastic and craniofacial surgery practices submit accurate 21267 claims, attach supporting diagnosis codes, and track denials from one dashboard.                <\/p>\n\n                <div class=\"button-group\">\n                    <a href=\"\/book-demo\/\" class=\"btn btn-scale-effect btn-cta-color btn-md\">\n                        <span class=\"btn-text\">Book a demo<\/span>\n                        <div class=\"btn-icon btn-icon-right\" aria-hidden=\"true\">\n                            <svg\n                                width=\"14\"\n                                height=\"12\"\n                                viewBox=\"0 0 14 12\"\n                                fill=\"none\"\n                                xmlns=\"http:\/\/www.w3.org\/2000\/svg\"\n                            >\n                                <path\n                                    d=\"M0.75 4.77295C0.335786 4.77295 0 5.10874 0 5.52295C0 5.93716 0.335786 6.27295 0.75 6.27295V5.52295V4.77295ZM13.2803 6.05328C13.5732 5.76039 13.5732 5.28551 13.2803 4.99262L8.50736 0.219648C8.21447 -0.073245 7.73959 -0.073245 7.4467 0.219648C7.15381 0.512542 7.15381 0.987415 7.4467 1.28031L11.6893 5.52295L7.4467 9.76559C7.15381 10.0585 7.15381 10.5334 7.4467 10.8263C7.73959 11.1191 8.21447 11.1191 8.50736 10.8263L13.2803 6.05328ZM0.75 5.52295V6.27295L12.75 6.27295V5.52295V4.77295L0.75 4.77295V5.52295Z\"\n                                    fill=\"currentColor\"\n                                ><\/path>\n                            <\/svg>\n                        <\/div>\n                    <\/a>\n                <\/div>\n            <\/div>\n\n            <div class=\"right-side\">\n                <img decoding=\"async\"\n                    src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Home-Page-Concept-4.webp\"\n                    alt=\"Pabau claims management dashboard\"\n                    loading=\"lazy\"\n                \/>\n            <\/div>\n        <\/div>\n        \n\n\n<h2 id=\"h-conclusion\" class=\"wp-block-heading\">Conclusion<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The expensive mistake on CPT 21267 comes from reading the wrong half of the descriptor. Both 21267 and 21268 include grafting, so graft language cannot settle the choice. The answer sits after the semicolon, in the surgical approach.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Two checks handle almost all of the risk on these claims. Confirm from the operative report whether the cranial cavity was entered, then confirm the side that was operated on. Add those checks before submission and the 21267 versus 21268 decision stops being a guess.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For practices handling plastic and craniofacial billing, <a href=\"https:\/\/pabau.com\/blog\/practice-management-software\/\">practice management software<\/a> that links operative notes, diagnosis codes, and claim status removes most of the manual reconciliation. Pabau&#8217;s claims management tools are built for that workflow. <a href=\"https:\/\/pabau.com\/book-demo\/\">Book a demo<\/a> to see how it runs in a surgical practice.<\/p>\n\n\n        <div id=\"expert_picks\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/11\/Expert-Picks.svg\" alt=\"Continue your research\" height=\"42\" width=\"42\">\n                                <h3>Continue your research<\/h3>\n            <\/div>\n            <div class=\"content\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Billing the bone graft harvest separately?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-20902\/\">CPT code 20902<\/a> explains when a major autogenous graft harvest can be reported alongside the primary procedure.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Grafting bone in another surgical family?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-20938\/\">CPT code 20938<\/a> covers structural autograft reporting in spine surgery.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Want to reduce surgical claim denials at the source?<\/strong> <a href=\"https:\/\/pabau.com\/features\/claims-management-software\/\">Claims management software<\/a> shows how integrated claims tools reduce denial rates for specialty surgical practices.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Comparing claims tools before you commit?<\/strong> <a href=\"https:\/\/pabau.com\/blog\/claims-management-software-pabau-vs-waystar\/\">Pabau vs. Waystar<\/a> sets the two claims platforms side by side for specialty practices.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<h2 id=\"h-frequently-asked-questions\" class=\"wp-block-heading\">Frequently asked questions<\/h2>\n\n\n\n<div class=\"schema-faq wp-block-yoast-faq-block\"><div class=\"schema-faq-section\" id=\"faq-question-1786603195233\"><h3 class=\"schema-faq-question\">What does CPT code 21267 describe?<\/h3> <p class=\"schema-faq-answer\">CPT code 21267 describes unilateral orbital repositioning through periorbital osteotomies, performed with bone grafts and an extracranial approach. The surgeon cuts and repositions the bone around one eye socket, then places grafts to fill the defects. The cranial cavity is not entered. It is used in craniofacial reconstruction for traumatic, congenital, and post-resection orbital malposition.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786603195234\"><h3 class=\"schema-faq-question\">What is the difference between CPT 21267 and CPT 21268?<\/h3> <p class=\"schema-faq-answer\">The difference is the surgical approach, not the bone graft. Both descriptors require bone grafts, so graft use never separates the two codes. CPT 21267 covers the extracranial approach, where the cranial cavity is not entered. CPT 21268 covers the combined intra- and extracranial approach, which adds craniotomy and intracranial work.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786603195235\"><h3 class=\"schema-faq-question\">What is the Medicare reimbursement rate for CPT 21267?<\/h3> <p class=\"schema-faq-answer\">The 2026 Medicare national estimate for CPT 21267 is about $1,467. That figure comes from 43.91 total RVUs multiplied by the conversion factor of $33.4009. CMS assigns the same RVUs in facility and non-facility settings, so the setting does not change the allowable. Locality adjustments apply, so verify with the CMS Physician Fee Schedule lookup.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786603195236\"><h3 class=\"schema-faq-question\">What modifiers can be used with CPT code 21267?<\/h3> <p class=\"schema-faq-answer\">Common modifiers for 21267 include -51 for multiple procedures, -62 for co-surgery, -80 or -81 for an assistant surgeon, and -22 for increased complexity. Laterality modifiers -LT and -RT matter because the code is unilateral. Modifier -58 applies to a planned staged procedure inside the 90-day global period. Confirm every choice against current NCCI edits.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786603195237\"><h3 class=\"schema-faq-question\">Which ICD-10-CM codes support medical necessity for CPT 21267?<\/h3> <p class=\"schema-faq-answer\">Supporting diagnoses include orbital floor fracture codes S02.31XA and S02.32XA, craniosynostosis Q75.00, mandibulofacial dysostosis Q75.4, and congenital malformation codes Q75.8 and Q87.0. The diagnosis must reflect structural or functional impairment, and the side must match the reported laterality. Hypertelorism (Q75.2) usually points to codes 21260, 21261, or 21263 instead.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786603195240\"><h3 class=\"schema-faq-question\">Can the bone graft harvest be billed separately with CPT 21267?<\/h3> <p class=\"schema-faq-answer\">Possibly, because the 21267 descriptor requires bone grafts but does not say it includes obtaining them. When the surgeon harvests autogenous bone through a separate incision, a harvest code such as 20900 or 20902 may be separately reportable. Compare that with 21256, which bundles graft harvest into the code. Check NCCI edits and payer policy before billing the harvest.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786603195238\"><h3 class=\"schema-faq-question\">Does CPT 21267 require prior authorization?<\/h3> <p class=\"schema-faq-answer\">Traditional Medicare does not require prior authorization for CPT 21267, though MAC local coverage determinations may impose documentation criteria. Most commercial insurers do require it, usually requesting a CT scan, an ICD-10-CM diagnosis, and a physician letter of medical necessity. Medicaid rules vary by state. Some payers authorize 21267 and 21268 separately, so state the planned approach.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1786603195239\"><h3 class=\"schema-faq-question\">What RVU values apply to CPT code 21267?<\/h3> <p class=\"schema-faq-answer\">CPT 21267 carries 20.17 work RVUs, 19.99 practice expense RVUs, and 3.75 malpractice RVUs, giving 43.91 total RVUs for 2026. The values are identical in facility and non-facility settings. CMS updates them each January through the Physician Fee Schedule, so confirm current figures and apply your local geographic practice cost index.<\/p> <\/div> <\/div>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>CPT 21267 covers unilateral orbital repositioning with bone grafts, about $1,467 in 2026. The surgical approach separates it from 21268.<\/p>\n","protected":false},"author":83,"featured_media":177161,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_yoast_wpseo_linkdex":"92","_yoast_wpseo_content_score":"30","_yoast_wpseo_is_cornerstone":"","_yoast_wpseo_keywordsynonyms":"[\"\",\"\",\"\",\"\"]","_yoast_wpseo_focuskw_text_input":"","_seo_original_html":"","footnotes":""},"categories":[1433,1546],"tags":[],"class_list":["post-177162","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-billing-codes","category-cpt-codes"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.2 (Yoast SEO v28.2) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>CPT code 21267: 2026 RVUs, rates, and when to use 21268<\/title>\n<meta name=\"description\" content=\"CPT 21267 covers unilateral orbital repositioning with bone grafts, about $1,467 in 2026. The surgical approach separates it from 21268.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-21267\/\" \/>\n<meta property=\"og:locale\" content=\"de_DE\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"CPT code 21267: 2026 RVUs, rates, and when to use 21268\" \/>\n<meta property=\"og:description\" content=\"CPT 21267 covers unilateral orbital repositioning with bone grafts, about $1,467 in 2026. The surgical approach separates it from 21268.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-21267\/\" \/>\n<meta property=\"og:site_name\" content=\"Pabau\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/Pabau\/\" \/>\n<meta property=\"article:published_time\" content=\"2026-08-13T11:05:46+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-08-13T11:05:48+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/08\/cpt-code-21267.webp\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"630\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/webp\" \/>\n<meta name=\"author\" content=\"Anja Dodevska\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@pabaucrm\" \/>\n<meta name=\"twitter:site\" content=\"@pabaucrm\" \/>\n<meta name=\"twitter:label1\" content=\"Verfasst von\" \/>\n\t<meta name=\"twitter:data1\" content=\"Anja Dodevska\" \/>\n\t<meta name=\"twitter:label2\" content=\"Gesch\u00e4tzte Lesezeit\" \/>\n\t<meta name=\"twitter:data2\" content=\"16\u00a0Minuten\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-21267\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-21267\\\/\"},\"author\":{\"name\":\"Anja Dodevska\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/#\\\/schema\\\/person\\\/f2e43b25ed02313e8781f0f4507398b9\"},\"headline\":\"CPT code 21267: Orbital repositioning with bone grafts\",\"datePublished\":\"2026-08-13T11:05:46+00:00\",\"dateModified\":\"2026-08-13T11:05:48+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-21267\\\/\"},\"wordCount\":3127,\"publisher\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-21267\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/08\\\/cpt-code-21267.webp\",\"articleSection\":[\"Billing Codes\",\"CPT Codes\"],\"inLanguage\":\"de\"},{\"@type\":[\"WebPage\",\"FAQPage\"],\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-21267\\\/\",\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-21267\\\/\",\"name\":\"CPT code 21267: 2026 RVUs, rates, and when to use 21268\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-21267\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-21267\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/08\\\/cpt-code-21267.webp\",\"datePublished\":\"2026-08-13T11:05:46+00:00\",\"dateModified\":\"2026-08-13T11:05:48+00:00\",\"description\":\"CPT 21267 covers unilateral orbital repositioning with bone grafts, about $1,467 in 2026. 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She enjoys breaking down complex topics into clear, accessible content and has a soft spot for the often-overlooked aspects of clinic life. When she's not writing, she's exploring cafes, walking her dog, or spending time with friends and family.\",\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/blog\\\/author\\\/anja-dodevska\\\/\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-21267\\\/#faq-question-1786603195233\",\"position\":1,\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-21267\\\/#faq-question-1786603195233\",\"name\":\"What does CPT code 21267 describe?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"CPT code 21267 describes unilateral orbital repositioning through periorbital osteotomies, performed with bone grafts and an extracranial approach. The surgeon cuts and repositions the bone around one eye socket, then places grafts to fill the defects. The cranial cavity is not entered. It is used in craniofacial reconstruction for traumatic, congenital, and post-resection orbital malposition.\",\"inLanguage\":\"de\"},\"inLanguage\":\"de\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-21267\\\/#faq-question-1786603195234\",\"position\":2,\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-21267\\\/#faq-question-1786603195234\",\"name\":\"What is the difference between CPT 21267 and CPT 21268?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"The difference is the surgical approach, not the bone graft. Both descriptors require bone grafts, so graft use never separates the two codes. CPT 21267 covers the extracranial approach, where the cranial cavity is not entered. CPT 21268 covers the combined intra- and extracranial approach, which adds craniotomy and intracranial work.\",\"inLanguage\":\"de\"},\"inLanguage\":\"de\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-21267\\\/#faq-question-1786603195235\",\"position\":3,\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-21267\\\/#faq-question-1786603195235\",\"name\":\"What is the Medicare reimbursement rate for CPT 21267?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"The 2026 Medicare national estimate for CPT 21267 is about $1,467. That figure comes from 43.91 total RVUs multiplied by the conversion factor of $33.4009. CMS assigns the same RVUs in facility and non-facility settings, so the setting does not change the allowable. Locality adjustments apply, so verify with the CMS Physician Fee Schedule lookup.\",\"inLanguage\":\"de\"},\"inLanguage\":\"de\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-21267\\\/#faq-question-1786603195236\",\"position\":4,\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-21267\\\/#faq-question-1786603195236\",\"name\":\"What modifiers can be used with CPT code 21267?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Common modifiers for 21267 include -51 for multiple procedures, -62 for co-surgery, -80 or -81 for an assistant surgeon, and -22 for increased complexity. Laterality modifiers -LT and -RT matter because the code is unilateral. Modifier -58 applies to a planned staged procedure inside the 90-day global period. Confirm every choice against current NCCI edits.\",\"inLanguage\":\"de\"},\"inLanguage\":\"de\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-21267\\\/#faq-question-1786603195237\",\"position\":5,\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-21267\\\/#faq-question-1786603195237\",\"name\":\"Which ICD-10-CM codes support medical necessity for CPT 21267?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Supporting diagnoses include orbital floor fracture codes S02.31XA and S02.32XA, craniosynostosis Q75.00, mandibulofacial dysostosis Q75.4, and congenital malformation codes Q75.8 and Q87.0. The diagnosis must reflect structural or functional impairment, and the side must match the reported laterality. Hypertelorism (Q75.2) usually points to codes 21260, 21261, or 21263 instead.\",\"inLanguage\":\"de\"},\"inLanguage\":\"de\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-21267\\\/#faq-question-1786603195240\",\"position\":6,\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-21267\\\/#faq-question-1786603195240\",\"name\":\"Can the bone graft harvest be billed separately with CPT 21267?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Possibly, because the 21267 descriptor requires bone grafts but does not say it includes obtaining them. When the surgeon harvests autogenous bone through a separate incision, a harvest code such as 20900 or 20902 may be separately reportable. Compare that with 21256, which bundles graft harvest into the code. Check NCCI edits and payer policy before billing the harvest.\",\"inLanguage\":\"de\"},\"inLanguage\":\"de\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-21267\\\/#faq-question-1786603195238\",\"position\":7,\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-21267\\\/#faq-question-1786603195238\",\"name\":\"Does CPT 21267 require prior authorization?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Traditional Medicare does not require prior authorization for CPT 21267, though MAC local coverage determinations may impose documentation criteria. Most commercial insurers do require it, usually requesting a CT scan, an ICD-10-CM diagnosis, and a physician letter of medical necessity. Medicaid rules vary by state. Some payers authorize 21267 and 21268 separately, so state the planned approach.\",\"inLanguage\":\"de\"},\"inLanguage\":\"de\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-21267\\\/#faq-question-1786603195239\",\"position\":8,\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-21267\\\/#faq-question-1786603195239\",\"name\":\"What RVU values apply to CPT code 21267?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"CPT 21267 carries 20.17 work RVUs, 19.99 practice expense RVUs, and 3.75 malpractice RVUs, giving 43.91 total RVUs for 2026. The values are identical in facility and non-facility settings. CMS updates them each January through the Physician Fee Schedule, so confirm current figures and apply your local geographic practice cost index.\",\"inLanguage\":\"de\"},\"inLanguage\":\"de\"}]}<\/script>\n<!-- \/ Yoast SEO Premium plugin. -->","yoast_head_json":{"title":"CPT code 21267: 2026 RVUs, rates, and when to use 21268","description":"CPT 21267 covers unilateral orbital repositioning with bone grafts, about $1,467 in 2026. The surgical approach separates it from 21268.","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-21267\/","og_locale":"de_DE","og_type":"article","og_title":"CPT code 21267: 2026 RVUs, rates, and when to use 21268","og_description":"CPT 21267 covers unilateral orbital repositioning with bone grafts, about $1,467 in 2026. 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The surgical approach separates it from 21268.","mainEntity":[{"@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-21267\/#faq-question-1786603195233"},{"@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-21267\/#faq-question-1786603195234"},{"@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-21267\/#faq-question-1786603195235"},{"@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-21267\/#faq-question-1786603195236"},{"@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-21267\/#faq-question-1786603195237"},{"@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-21267\/#faq-question-1786603195240"},{"@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-21267\/#faq-question-1786603195238"},{"@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-21267\/#faq-question-1786603195239"}],"inLanguage":"de","potentialAction":[{"@type":"ReadAction","target":["https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-21267\/"]}]},{"@type":"ImageObject","inLanguage":"de","@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-21267\/#primaryimage","url":"https:\/\/pabau.com\/wp-content\/uploads\/2026\/08\/cpt-code-21267.webp","contentUrl":"https:\/\/pabau.com\/wp-content\/uploads\/2026\/08\/cpt-code-21267.webp","width":1200,"height":630},{"@type":"WebSite","@id":"https:\/\/pabau.com\/de\/#website","url":"https:\/\/pabau.com\/de\/","name":"Pabau","description":"Clinic Software for your Business | Go Paperless Today","publisher":{"@id":"https:\/\/pabau.com\/de\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/pabau.com\/de\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"de"},{"@type":"Organization","@id":"https:\/\/pabau.com\/de\/#organization","name":"Pabau","url":"https:\/\/pabau.com\/de\/","logo":{"@type":"ImageObject","inLanguage":"de","@id":"https:\/\/pabau.com\/de\/#\/schema\/logo\/image\/","url":"https:\/\/pabau.com\/wp-content\/uploads\/2022\/05\/Logo-4-e1654525062364.png","contentUrl":"https:\/\/pabau.com\/wp-content\/uploads\/2022\/05\/Logo-4-e1654525062364.png","width":736,"height":195,"caption":"Pabau"},"image":{"@id":"https:\/\/pabau.com\/de\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/Pabau\/","https:\/\/x.com\/pabaucrm","https:\/\/www.linkedin.com\/company\/pabau-ltd\/","https:\/\/www.instagram.com\/pabausoftware\/"],"description":"Pabau is an all-in-one healthcare practice management software platform designed for clinics, medspas, therapists, and medical professionals. 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She enjoys breaking down complex topics into clear, accessible content and has a soft spot for the often-overlooked aspects of clinic life. When she's not writing, she's exploring cafes, walking her dog, or spending time with friends and family.","url":"https:\/\/pabau.com\/de\/blog\/author\/anja-dodevska\/"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-21267\/#faq-question-1786603195233","position":1,"url":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-21267\/#faq-question-1786603195233","name":"What does CPT code 21267 describe?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"CPT code 21267 describes unilateral orbital repositioning through periorbital osteotomies, performed with bone grafts and an extracranial approach. The surgeon cuts and repositions the bone around one eye socket, then places grafts to fill the defects. The cranial cavity is not entered. It is used in craniofacial reconstruction for traumatic, congenital, and post-resection orbital malposition.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-21267\/#faq-question-1786603195234","position":2,"url":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-21267\/#faq-question-1786603195234","name":"What is the difference between CPT 21267 and CPT 21268?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"The difference is the surgical approach, not the bone graft. Both descriptors require bone grafts, so graft use never separates the two codes. CPT 21267 covers the extracranial approach, where the cranial cavity is not entered. CPT 21268 covers the combined intra- and extracranial approach, which adds craniotomy and intracranial work.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-21267\/#faq-question-1786603195235","position":3,"url":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-21267\/#faq-question-1786603195235","name":"What is the Medicare reimbursement rate for CPT 21267?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"The 2026 Medicare national estimate for CPT 21267 is about $1,467. That figure comes from 43.91 total RVUs multiplied by the conversion factor of $33.4009. CMS assigns the same RVUs in facility and non-facility settings, so the setting does not change the allowable. Locality adjustments apply, so verify with the CMS Physician Fee Schedule lookup.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-21267\/#faq-question-1786603195236","position":4,"url":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-21267\/#faq-question-1786603195236","name":"What modifiers can be used with CPT code 21267?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Common modifiers for 21267 include -51 for multiple procedures, -62 for co-surgery, -80 or -81 for an assistant surgeon, and -22 for increased complexity. Laterality modifiers -LT and -RT matter because the code is unilateral. Modifier -58 applies to a planned staged procedure inside the 90-day global period. Confirm every choice against current NCCI edits.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-21267\/#faq-question-1786603195237","position":5,"url":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-21267\/#faq-question-1786603195237","name":"Which ICD-10-CM codes support medical necessity for CPT 21267?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Supporting diagnoses include orbital floor fracture codes S02.31XA and S02.32XA, craniosynostosis Q75.00, mandibulofacial dysostosis Q75.4, and congenital malformation codes Q75.8 and Q87.0. The diagnosis must reflect structural or functional impairment, and the side must match the reported laterality. Hypertelorism (Q75.2) usually points to codes 21260, 21261, or 21263 instead.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-21267\/#faq-question-1786603195240","position":6,"url":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-21267\/#faq-question-1786603195240","name":"Can the bone graft harvest be billed separately with CPT 21267?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Possibly, because the 21267 descriptor requires bone grafts but does not say it includes obtaining them. When the surgeon harvests autogenous bone through a separate incision, a harvest code such as 20900 or 20902 may be separately reportable. Compare that with 21256, which bundles graft harvest into the code. Check NCCI edits and payer policy before billing the harvest.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-21267\/#faq-question-1786603195238","position":7,"url":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-21267\/#faq-question-1786603195238","name":"Does CPT 21267 require prior authorization?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Traditional Medicare does not require prior authorization for CPT 21267, though MAC local coverage determinations may impose documentation criteria. Most commercial insurers do require it, usually requesting a CT scan, an ICD-10-CM diagnosis, and a physician letter of medical necessity. Medicaid rules vary by state. Some payers authorize 21267 and 21268 separately, so state the planned approach.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-21267\/#faq-question-1786603195239","position":8,"url":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-21267\/#faq-question-1786603195239","name":"What RVU values apply to CPT code 21267?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"CPT 21267 carries 20.17 work RVUs, 19.99 practice expense RVUs, and 3.75 malpractice RVUs, giving 43.91 total RVUs for 2026. The values are identical in facility and non-facility settings. CMS updates them each January through the Physician Fee Schedule, so confirm current figures and apply your local geographic practice cost index.","inLanguage":"de"},"inLanguage":"de"}]}},"yoast":{"focus_keyword":"CPT Code 21267","seo_title":"CPT code 21267: %%currentyear%% RVUs, rates, and when to use 21268","meta_description":"CPT 21267 covers unilateral orbital repositioning with bone grafts, about $1,467 in %%currentyear%%. The surgical approach separates it from 21268.","content_score":"30","is_cornerstone":"","related_keyphrases":[{"keyword":"periorbital osteotomy billing code","score":61},{"keyword":"CPT code 21267 modifiers","score":61},{"keyword":"CPT code 21267 reimbursement","score":61}]},"_links":{"self":[{"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/posts\/177162","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/users\/83"}],"replies":[{"embeddable":true,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/comments?post=177162"}],"version-history":[{"count":5,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/posts\/177162\/revisions"}],"predecessor-version":[{"id":178106,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/posts\/177162\/revisions\/178106"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/media\/177161"}],"wp:attachment":[{"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/media?parent=177162"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/categories?post=177162"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/tags?post=177162"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}