CPT® Code 21147

Reconstruction midface, LeFort I; 3 or more pieces, segment movement in any direction, requiring bone grafts (includes obtaining autografts) (eg, ungrafted bilateral alveolar cleft or multiple osteotomies)

The procedure described by CPT® Code 21147 involves the reconstruction of the midface using a LeFort I osteotomy technique, which is particularly relevant for patients with significant facial bone deformities or for cosmetic enhancements. This complex surgical intervention is characterized by the movement of three or more segments of the maxilla, the upper jawbone, in any direction. The procedure necessitates the use of bone grafts, which may include obtaining autografts from the patient’s own body, such as the iliac crest. The LeFort I osteotomy specifically targets the lower maxillary region, situated below the infraorbital nerve and medial to the zygomatic-maxillary suture, allowing for substantial repositioning of the midface. The surgical approach includes careful planning and execution to ensure minimal trauma to surrounding tissues, with specific techniques employed to facilitate the movement of bone segments and the integration of grafts. This procedure is essential for addressing conditions such as ungrafted bilateral alveolar clefts or cases requiring multiple osteotomies, ultimately aiming to restore functional and aesthetic balance to the facial structure.