Unlisted code for a craniofacial or maxillofacial procedure on the skull or facial bones that has no specific CPT code.
- Medicare
- $0.00
- Work RVU
- 0
- Global, days
- Region
- Other
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Operative note describing the bones involved and the technique
- Reason no listed craniofacial code applies
- Comparison code from the 21010-21296 range
- Functional indication (airway, bite, vision, trauma) rather than appearance
- Imaging that supports the diagnosis
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 3 cited references ↓
21299 is the unlisted code for procedures on the skull, facial bones, and jaws that do not match any listed code in the head section (21010 through 21296). Plastic surgeons, oral and maxillofacial surgeons, and ENT surgeons use it most.
For an orthopedic practice, it comes up in polytrauma. A patient with a femur fracture and a facial fracture may have both handled the same day by different surgeons in the same group. The ortho side bills its own codes; 21299 belongs to whoever did the facial work. Coders should not borrow it for head work that belongs under the general head musculoskeletal unlisted code, 21499.
It has no Medicare fee and a YYY global. The MAC sets both when it reviews the claim. Send the op note, a short letter explaining why no listed code fits, and a comparison code from the same section. Elective craniofacial work also tends to draw cosmetic review, so document the functional problem clearly.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
| Work RVU | 0 |
| Practice expense RVU | 0 |
| Malpractice RVU | 0 |
| Total RVU | 0 |
| Medicare national rate | $0.00 |
| Global period | days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $0.00 |
HOPD (APC 5161) Hospital outpatient department | $241.98 |
Common denial reasons
The recurring reasons claims for CPT 21299 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Treated as cosmetic due to weak functional documentation
- A listed craniofacial code describes the service
- Missing procedure description on the claim
- No comparison code or cover letter
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01When is CPT 21299 used?
02Is 21299 the same as 21499?
03Does 21299 have a global period?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe documents the functional problem and the exact bony work performed, so the claim reads as medically necessary rather than cosmetic.
See how Mira captures CPT 21299 documentation