21436 Optx crnfcl sep complicated mlt int
Also known as: complex Le Fort multi-fixation, craniofacial separation complex multi-site fixation
Open treatment of craniofacial separation with complex internal fixation of multiple sites. Surgical reconstruction addressing craniofacial separation with sophisticated multi-point internal fixation addressing maxilla, nasal complex, and orbital elements.
In Plain Language
extensive upper face and orbital reconstruction surgery; major multi-level facial fracture repair
Clinical Context
Indicated for most complex craniofacial separations with involvement of orbital rims, nasal bones, and pterygoid plates requiring reconstruction at multiple anatomic levels. Highest morbidity case representing severe facial trauma.
RVU Breakdown
| Work RVU | 29.54 |
| Total RVU | 29.54 |
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 29.54, this code ranks in the 92nd percentile among Surgery codes — 3.7x the median (8.00). The highest wRVU in this category is 106.19.
Specialties
Frequently Asked Questions
What is CPT code 21436?
CPT 21436 (Optx crnfcl sep complicated mlt int) is a Surgery code. Open treatment of craniofacial separation with complex internal fixation of multiple sites. Surgical reconstruction addressing craniofacial separation with sophisticated multi-point internal fixation addressing maxilla, nasal complex, and orbital elements.
What is the wRVU value for CPT 21436?
The work RVU for CPT 21436 is 29.54. This code is primarily used by Oral Surgery, Otolaryngology, Plastic Surgery. It has a 90-day global period.
When is CPT 21436 used?
Indicated for most complex craniofacial separations with involvement of orbital rims, nasal bones, and pterygoid plates requiring reconstruction at multiple anatomic levels. Highest morbidity case representing severe facial trauma.
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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.