21256 Reconstruction of orbit
Also known as: orbital reconstruction, eye socket repair
Reconstruction of the orbital skeleton following defect or fracture to restore proper position and protection of ocular contents.
In Plain Language
Repairing the eye socket bone; Eye socket reconstruction
Clinical Context
Used for orbital fractures, tumor resection, or congenital deformities. Critical for preventing enophthalmos and diplopia.
RVU Breakdown
| Work RVU | 17.22 |
| Total RVU | 17.22 |
Est. Medicare Payment
National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).
Billing & Documentation
As a surgical CPT code, proper documentation must include the operative report detailing the procedure performed, patient positioning, approach, findings, and any complications. This code has a 90-day global period, which includes the day of the procedure, 1 day preoperative, and 90 days of postoperative care. Ensure the diagnosis code (ICD-10) supports medical necessity for the procedure.
How This Code Compares
With a work RVU of 17.22, this code ranks in the 78th percentile among Surgery codes — 2.2x the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 21256?
CPT 21256 (Reconstruction of orbit) is a Surgery code. Reconstruction of the orbital skeleton following defect or fracture to restore proper position and protection of ocular contents.
What is the wRVU value for CPT 21256?
The work RVU for CPT 21256 is 17.22. This code is primarily used by Oculoplastic Surgery, Maxillofacial Surgery, Plastic Surgery. It has a 90-day global period.
When is CPT 21256 used?
Used for orbital fractures, tumor resection, or congenital deformities. Critical for preventing enophthalmos and diplopia.
Track This Code in RVU Edge
Log procedures, calculate wRVUs, and benchmark against MGMA data — all in one app.
CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.