Summary & Overview
CPT 21141: LeFort I Maxillary Osteotomy, Midface Reconstruction
CPT code 21141 represents LeFort I midface reconstruction, a surgical procedure that mobilizes and advances the maxilla and adjacent facial bones to correct congenital or acquired deformities such as long face syndrome. Nationally, this code captures a range of corrective orthognathic surgeries that impact facial form, dental occlusion, and, in many cases, airway and functional outcomes. Its use is relevant to hospital and ambulatory surgery billing, surgical specialty practice patterns, and payer medical necessity determinations.
Key payers relevant to coverage and reimbursement discussions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical purpose of the code, typical sites of service, and common billing contexts. The publication also provides benchmarks for utilization and reimbursement frameworks, summarizes prevailing policy considerations from major payers, and outlines the clinical context that supports coding and claim submission for orthognathic midface procedures.
This summary is intended for clinicians, coding professionals, and policy analysts seeking a concise reference on CPT code 21141, its clinical role in midface reconstruction, and the payer landscape that commonly applies to such procedures across the United States.
Billing Code Overview
CPT code 21141 describes surgical reconstruction of the midface using a LeFort I osteotomy, in which the provider mobilizes and advances the maxilla and associated bones to correct congenital or acquired midfacial deformities such as long face syndrome. The procedure repositions the teeth-bearing segment of the upper jaw to restore facial form and occlusion.
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Service type: Orthognathic midface reconstruction (LeFort I maxillary osteotomy)
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Typical site of service: Inpatient or outpatient hospital operating room or ambulatory surgery center, depending on clinical complexity and perioperative needs.
Clinical & Coding Specifications
Clinical Context
A 19-year-old patient with long face syndrome presents with vertical maxillary excess, malocclusion, and functional breathing issues after years of mouth breathing. Preoperative orthodontic alignment is complete and the multidisciplinary team (oral and maxillofacial surgeon, orthodontist, and anesthesiologist) determines a LeFort I osteotomy with maxillary advancement is indicated to correct midface hypoplasia and improve occlusion and facial proportions. The clinical workflow includes preoperative imaging (panoramic radiograph and CT or cone-beam CT), surgical planning with occlusal splints, general endotracheal anesthesia, performance of a LeFort I osteotomy with mobilization and advancement of the maxilla, fixation with plates/screws, intraoperative dental occlusal verification, and postoperative inpatient or outpatient recovery with routine follow-up for wound care, orthodontic finishing, and monitoring for complications such as infection, bleeding, malocclusion, or sensory changes.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work, time, and effort substantially exceed typical for 21141 (document rationale and increased work). |
23 |