R658

LeFort II, subcranial hypertelorism correction Le Fort I maxillary advancement*

Fee

ComponentValue
Provider fee$2,928.10
Assistant, listing; PDF p. 61212 basic units
Anaesthesia, listing; PDF p. 61225 basic units
Schedule and sources
Fee edition
October 1, 2026
Record effective
2026-04-01
Schedule edition
July 22, 2026; effective July 1, 2026
Official files

PDF page 612 / N32

LeFort II, subcranial hypertelorism correction Le Fort I maxillary advancement* ..................................................... 12 2928.10 25
Passages mentioning R658

PDF page 612 / N32

Bilateral periorbital correction Treacher-Collins Syndrome
# R390 - with or without bone grafts* (extra-cranial).........................                         10        1699.45          20
# R653 - with skull and muscle transpositions* (includes skull
          reconstruction) (intracranial)...............................................                10        2196.35          25
    Pericranial flap to orbit or face
# R654 - unilateral.............................................................................                  307.15          6
  E973    - when in conjunction with coronal approach for main
            operation .................................................................... add                    178.90
# R655 - bilateral...............................................................................                 409.55          7
# E974    - when in conjunction with coronal approach for main
            operation .................................................................... add                    297.55
# R378 LeFort III total maxillary advancement* ..................................                      12        2037.35          25
# R656 LeFort III and subcranial hypertelorism correction* ................                            12        2590.35          25
# R657 LeFort III and LeFort I maxillary advancement*......................                            12        2334.85          25
# R658 LeFort II, subcranial hypertelorism correction Le Fort I
         maxillary advancement* .....................................................                  12        2928.10          25
    Upper LeFort III advancement without occlusal change*
# R659 - unilateral.............................................................................       6          932.10          10
# R675 - bilateral...............................................................................      12        1443.95          25
    Forehead advancement (bone grafts not included)
# R676 - unilateral.............................................................................       12        1187.50          25
# R393 - bilateral...............................................................................      12        1443.95          25
# R394 Cranial vault reshaping* - anterior or posterior half ................                          10        1525.30          20
# R677 Total cranial vault reshaping*..................................................                12        2078.35          25
    Medial transnasal canthopexy
# R398 - unilateral.............................................................................        6         414.30          6
# E557     - when done in conjunction with another procedure..... add                                             154.00
      Note:
      * Includes harvesting and grafting of bone or cartilage grafts.
Fee master record

Master, record 4883. Record Layout PDF, page 1.

R65820260401999999990002928100000001549200000000000000000399000000003990000

Auxiliary master fields are preserved as raw scaled values. The linked layout calls them zero-filled, but this edition contains non-zero values. They are not presented as final dollar fees or PDF units.

FieldRaw / scale 10,000
provider00029281000 / 2928.1
assistant00001549200 / 154.92
specialist00000000000 / 0
anaesthetist00003990000 / 399
non anaesthetist00003990000 / 399
Explanation

AI-generated. Unreviewed.

This listing is for LeFort II, subcranial hypertelorism correction and LeFort I maxillary advancement, under Orbito-cranial Surgery in the Skull and Mandible section.

Sources and updates
Fee master effective October 1, 2026Schedule effective July 1, 2026Source versions and changes
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