CPT code 21025: Bone excision, mandible2026 Medicare rate & RVUs in Washington, DC area
Reports surgical removal of mandibular bone, such as devitalized bone in osteomyelitis, when the operation is an excision rather than a lesion-specific procedure.
In Washington, DC area, Medicare pays $946.21 for 21025 in the office and $679.44 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 21025 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 21025 covers
An oral and maxillofacial surgeon or another qualified surgeon may use this service to remove a defined portion of the mandible, including devitalized bone associated with osteomyelitis. The operation may take place in a hospital or ambulatory surgical setting. The operative report should identify the mandibular site, the bone removed, and the clinical reason for excision; a diagnosis alone does not establish which procedure code describes the work.
Select 21025 for mandibular bone excision, distinguishing it from codes for a specified lesion, exostosis, or more extensive jaw operation. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, Medicare pays the highest-valued procedure in full and reduces the others to 50%. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
How Washington, DC area compares for 21025
Across 109 of 109 payment localities, the office rate for 21025 runs from $752.60 in Arkansas to $1,063.23 in San Benito County, CA. Washington, DC area pays $946.21. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Washington, DC area · this page$946.21
- Los Angeles, CA · California$924.66−$21.55
- Miami, FL · Florida$926.19−$20.02
- Chicago, IL · Illinois$901.33−$44.88
- Manhattan, NY · New York$962.66+$16.45
- Alaska · Alaska$1,014.24+$68.03
- Alabama · Alabama$762.34−$183.87
Other areas in District of Columbia first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| ArkansasArkansas | $752.60 | $558.07 |
| ArizonaArizona | $819.17 | $599.74 |
| Bakersfield, CACalifornia | $874.21 | $626.02 |
| Chico, CACalifornia | $870.37 | $622.17 |
| El Centro, CACalifornia | $870.59 | $622.39 |
| Fresno, CACalifornia | $870.37 | $622.17 |
| Hanford, CACalifornia | $870.37 | $622.17 |
| Madera, CACalifornia | $870.37 | $622.17 |
| Merced, CACalifornia | $870.37 | $622.17 |
| Modesto, CACalifornia | $870.37 | $622.17 |
| Napa, CACalifornia | $988.42 | $689.95 |
| Oxnard, CACalifornia | $918.15 | $650.48 |
| Redding, CACalifornia | $870.37 | $622.17 |
| Rest of CaliforniaCalifornia | $870.37 | $622.17 |
| Riverside, CACalifornia | $884.56 | $636.37 |
| Sacramento, CACalifornia | $908.04 | $644.67 |
| Salinas, CACalifornia | $904.53 | $642.06 |
| San Diego, CACalifornia | $921.84 | $650.99 |
| Marin County, CACalifornia | $1,039.94 | $720.63 |
| San Francisco, CACalifornia | $1,038.45 | $719.14 |
| San Benito County, CACalifornia | $1,063.23 | $736.68 |
| Santa Clara County, CACalifornia | $1,057.15 | $730.60 |
| San Luis Obispo, CACalifornia | $890.56 | $632.62 |
| Santa Cruz, CACalifornia | $927.56 | $652.41 |
| Santa Maria, CACalifornia | $906.83 | $642.78 |
| Santa Rosa, CACalifornia | $936.60 | $658.51 |
| Stockton, CACalifornia | $870.37 | $622.17 |
| Vallejo, CACalifornia | $986.28 | $687.81 |
| Visalia, CACalifornia | $870.37 | $622.17 |
| Yuba City, CACalifornia | $870.37 | $622.17 |
| ColoradoColorado | $864.43 | $623.47 |
| ConnecticutConnecticut | $891.91 | $648.02 |
| DelawareDelaware | $831.61 | $607.87 |
| Fort Lauderdale, FLFlorida | $881.49 | $652.09 |
| Rest of FloridaFlorida | $841.38 | $624.88 |
| Atlanta, GAGeorgia | $857.32 | $627.24 |
| Rest of GeorgiaGeorgia | $797.72 | $595.71 |
| Hawaii, Guam, HIHawaii | $885.95 | $628.47 |
| IowaIowa | $773.73 | $566.52 |
| IdahoIdaho | $779.40 | $571.06 |
| East St. Louis, ILIllinois | $846.83 | $638.49 |
| Rest of IllinoisIllinois | $823.81 | $617.05 |
| Suburban Chicago, ILIllinois | $888.78 | $656.21 |
| IndianaIndiana | $783.26 | $573.33 |
| KansasKansas | $773.25 | $568.53 |
| KentuckyKentucky | $784.19 | $582.86 |
| New Orleans, LALouisiana | $818.28 | $605.18 |
| Rest of LouisianaLouisiana | $784.19 | $583.77 |
| Metropolitan Boston, MAMassachusetts | $939.72 | $669.33 |
| Rest of MassachusettsMassachusetts | $861.27 | $622.81 |
| Baltimore area, MDMaryland | $889.91 | $646.92 |
| Rest of MarylandMaryland | $845.35 | $616.17 |
| Rest of MaineMaine | $785.92 | $577.58 |
| Southern Maine, MEMaine | $819.66 | $595.24 |
| Detroit, MIMichigan | $853.61 | $635.08 |
| Rest of MichiganMichigan | $804.82 | $598.06 |
| MinnesotaMinnesota | $822.85 | $589.82 |
| Metropolitan Kansas City, MOMissouri | $810.38 | $597.74 |
| Metropolitan St. Louis, MOMissouri | $817.58 | $601.99 |
| Rest of MissouriMissouri | $774.09 | $578.88 |
| MississippiMississippi | $763.34 | $568.36 |
| MontanaMontana | $839.95 | $613.49 |
| North CarolinaNorth Carolina | $792.77 | $581.49 |
| North DakotaNorth Dakota | $814.04 | $587.58 |
| NebraskaNebraska | $776.66 | $567.64 |
| New HampshireNew Hampshire | $853.82 | $618.07 |
| Northern New JerseyNew Jersey | $938.73 | $676.03 |
| Rest of New JerseyNew Jersey | $900.55 | $653.26 |
| New MexicoNew Mexico | $809.85 | $602.19 |
| NevadaNevada | $833.20 | $606.51 |
| NYC suburbs and Long Island, NYNew York | $987.19 | $717.94 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $908.53 | $660.56 |
| Queens, NYNew York | $965.75 | $698.08 |
| Rest of New YorkNew York | $803.56 | $588.42 |
| OhioOhio | $799.53 | $592.77 |
| OklahomaOklahoma | $780.03 | $577.80 |
| Portland, OROregon | $886.19 | $634.59 |
| Rest of OregonOregon | $825.16 | $599.61 |
| Metropolitan Philadelphia, PAPennsylvania | $873.61 | $637.87 |
| Rest of PennsylvaniaPennsylvania | $799.12 | $591.23 |
| Puerto RicoPuerto Rico | $844.54 | $615.59 |
| Rhode IslandRhode Island | $857.01 | $623.08 |
| South CarolinaSouth Carolina | $797.78 | $588.53 |
| South DakotaSouth Dakota | $810.98 | $584.52 |
| TennesseeTennessee | $777.04 | $571.19 |
| Austin, TXTexas | $862.94 | $623.34 |
| Beaumont, TXTexas | $794.66 | $588.58 |
| Brazoria, TXTexas | $828.79 | $604.37 |
| Dallas, TXTexas | $834.88 | $609.33 |
| Fort Worth, TXTexas | $830.75 | $607.47 |
| Galveston, TXTexas | $831.83 | $606.96 |
| Houston, TXTexas | $855.81 | $630.94 |
| Rest of TexasTexas | $811.84 | $596.93 |
| UtahUtah | $807.39 | $594.52 |
| VirginiaVirginia | $819.19 | $596.58 |
| Virgin Islands, VIUnited States Virgin Islands | $844.54 | $615.59 |
| VermontVermont | $813.72 | $589.53 |
| Rest of WashingtonWashington | $858.71 | $620.25 |
| King County, WAWashington | $954.96 | $677.10 |
| WisconsinWisconsin | $790.03 | $573.08 |
| West VirginiaWest Virginia | $797.37 | $600.58 |
| WyomingWyoming | $828.66 | $602.20 |
21025 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$752.60
$1,014.24
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $1,014.24 | 1 |
| AL | $762.34 | 1 |
| AR | $752.60 | 1 |
| AZ | $819.17 | 1 |
| CA | $870.37–$1,063.23 | 29 |
| CO | $864.43 | 1 |
| CT | $891.91 | 1 |
| DC | $946.21 | 1 |
| DE | $831.61 | 1 |
| FL | $841.38–$926.19 | 3 |
| GA | $797.72–$857.32 | 2 |
| GU | $885.95 | 1 |
| HI | $885.95 | 1 |
| IA | $773.73 | 1 |
| ID | $779.40 | 1 |
| IL | $823.81–$901.33 | 4 |
| IN | $783.26 | 1 |
| KS | $773.25 | 1 |
| KY | $784.19 | 1 |
| LA | $784.19–$818.28 | 2 |
| MA | $861.27–$939.72 | 2 |
| MD | $845.35–$946.21 | 3 |
| ME | $785.92–$819.66 | 2 |
| MI | $804.82–$853.61 | 2 |
| MN | $822.85 | 1 |
| MO | $774.09–$817.58 | 3 |
| MS | $763.34 | 1 |
| MT | $839.95 | 1 |
| NC | $792.77 | 1 |
| ND | $814.04 | 1 |
| NE | $776.66 | 1 |
| NH | $853.82 | 1 |
| NJ | $900.55–$938.73 | 2 |
| NM | $809.85 | 1 |
| NV | $833.20 | 1 |
| NY | $803.56–$987.19 | 5 |
| OH | $799.53 | 1 |
| OK | $780.03 | 1 |
| OR | $825.16–$886.19 | 2 |
| PA | $799.12–$873.61 | 2 |
| PR | $844.54 | 1 |
| RI | $857.01 | 1 |
| SC | $797.78 | 1 |
| SD | $810.98 | 1 |
| TN | $777.04 | 1 |
| TX | $794.66–$862.94 | 8 |
| UT | $807.39 | 1 |
| VA | $819.19–$946.21 | 2 |
| VI | $844.54 | 1 |
| VT | $813.72 | 1 |
| WA | $858.71–$954.96 | 2 |
| WI | $790.03 | 1 |
| WV | $797.37 | 1 |
| WY | $828.66 | 1 |
How the 21025 rate is calculated
Each of 21025’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 21025
RVUs × geographic indexes × conversion factor
Work9.78
9.78 RVUs× 1.000 GPCI
Practice expense14.06
14.06 RVUs× 1.000 GPCI
Malpractice1.31
1.31 RVUs× 1.000 GPCI
Adjusted RVUs
25.1500
Conversion factor
$33.4009
Medicare rate
$840.03
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Washington, DC area inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
1,843
- Code
- 21025
- Physician work
- 9.78
- Practice expense
- 14.06
- Malpractice
- 1.31
GPCI2026.csv
39
- Locality
- Washington, DC area
- Physician work
- 1.054
- Practice expense
- 1.178
- Malpractice
- 1.113
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.78 | × 1.054 | 10.3081 |
| Practice expense | 14.06 | × 1.178 | 16.5627 |
| Malpractice | 1.31 | × 1.113 | 1.4580 |
| Total RVUs | 28.3288 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Washington, DC area$946.21
Office: (9.78 × 1.054 + 14.06 × 1.178 + 1.31 × 1.113) × $33.4009 = $946.21
Facility: (9.78 × 1.054 + 7.28 × 1.178 + 1.31 × 1.113) × $33.4009 = $679.44
Payment rules and modifiers for 21025
21025 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 21025
Bone excision, mandible
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.10/0.69/0.21 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 21025
Bone excision, mandible
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
21025 without 51 · national office
$840.03
Bone excision, mandible
21025-51 · Second procedure: 50%
$420.02
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
How 21025 has changed in Washington, DC area
21025 · Office / nonfacility
$946.21
Effective 2026-10-01
The base rate is $54.67 higher than on 2025-10-01, moving from $891.54 to $946.21 (6.1%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$891.54changed to$946.21
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 10.03 changed to 9.78
- Practice expense RVU 13.18 changed to 14.06
- Malpractice RVU 1.07 changed to 1.31
- Work GPCI 1.057 changed to 1.054
- Practice expense GPCI 1.192 changed to 1.178
- Malpractice GPCI 1.168 changed to 1.113
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$900.39changed to$891.54
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 12.73 changed to 13.18
- Malpractice RVU 1.09 changed to 1.07
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$885.70changed to$900.39
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$918.60changed to$885.70
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 12.56 changed to 12.73
- Malpractice RVU 1.03 changed to 1.09
- Work GPCI 1.056 changed to 1.057
- Practice expense GPCI 1.214 changed to 1.192
- Malpractice GPCI 1.231 changed to 1.168
January 1, 2023
RVU23A
$937.14changed to$918.60
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 12.32 changed to 12.56
- Malpractice RVU 0.99 changed to 1.03
- Work GPCI 1.054 changed to 1.056
- Practice expense GPCI 1.236 changed to 1.214
- Malpractice GPCI 1.294 changed to 1.231
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$951.73changed to$937.14
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 12.52 changed to 12.32
- Malpractice RVU 0.95 changed to 0.99
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$981.81changed to$951.73
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 12.67 changed to 12.52
- Work GPCI 1.049 changed to 1.054
- Practice expense GPCI 1.221 changed to 1.236
- Malpractice GPCI 1.277 changed to 1.294
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$1025.57changed to$981.81
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 13.17 changed to 12.67
- Malpractice RVU 1.67 changed to 0.95
- Work GPCI 1.045 changed to 1.049
- Practice expense GPCI 1.205 changed to 1.221
- Malpractice GPCI 1.261 changed to 1.277
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$1048.72changed to$1025.57
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 13.74 changed to 13.17
- Malpractice RVU 1.66 changed to 1.67
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$1057.54changed to$1048.72
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 13.98 changed to 13.74
- Work GPCI 1.048 changed to 1.045
- Malpractice GPCI 1.271 changed to 1.261
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$1062.76changed to$1057.54
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 14.10 changed to 13.98
- Malpractice RVU 1.68 changed to 1.66
- Work GPCI 1.051 changed to 1.048
- Malpractice GPCI 1.280 changed to 1.271
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$1064.35changed to$1062.76
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 14.08 changed to 14.10
- Malpractice RVU 1.65 changed to 1.68
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$1059.05changed to$1064.35
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$1044.40changed to$1059.05
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 14.11 changed to 14.08
- Malpractice RVU 1.38 changed to 1.65
- Work GPCI 1.050 changed to 1.051
- Practice expense GPCI 1.202 changed to 1.205
- Malpractice GPCI 1.205 changed to 1.280
Held through RVU15B.
January 1, 2014
RVU14A
$1034.10changed to$1044.40
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 15.23 changed to 14.11
- Malpractice RVU 1.44 changed to 1.38
- Work GPCI 1.049 changed to 1.050
- Practice expense GPCI 1.198 changed to 1.202
- Malpractice GPCI 1.130 changed to 1.205
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $1034.10
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $946.21 | $679.44 | RVU26D |
| 2026-07-01 | $946.21 | $679.44 | RVU26C |
| 2026-04-01 | $946.21 | $679.44 | RVU26B |
| 2026-01-01 | $946.21 | $679.44 | RVU26A |
| 2025-10-01 | $891.54 | $737.31 | RVU25D |
| 2025-07-01 | $891.54 | $737.31 | RVU25C |
| 2025-04-01 | $891.54 | $737.31 | RVU25B |
| 2025-01-01 | $891.54 | $737.31 | RVU25A |
| 2024-10-01 | $900.39 | $743.27 | RVU24D |
| 2024-07-01 | $900.39 | $743.27 | RVU24C |
| 2024-04-01 | $900.39 | $743.27 | RVU24B |
| 2024-03-09 | $900.39 | $743.27 | RVU24AR |
| 2024-01-01 | $885.70 | $731.13 | RVU24A |
| 2023-10-01 | $918.60 | $756.92 | RVU23D |
| 2023-07-01 | $918.60 | $756.92 | RVU23C |
| 2023-04-01 | $918.60 | $756.92 | RVU23B |
| 2023-01-01 | $918.60 | $756.92 | RVU23A |
| 2022-10-01 | $937.14 | $769.47 | RVU22D |
| 2022-07-01 | $937.14 | $769.47 | RVU22C |
| 2022-04-01 | $937.14 | $769.47 | RVU22B |
| 2022-01-01 | $937.14 | $769.47 | RVU22A |
| 2021-10-01 | $951.73 | $780.51 | RVU21D |
| 2021-07-01 | $951.73 | $780.51 | RVU21C |
| 2021-04-01 | $951.73 | $780.51 | RVU21B |
| 2021-01-01 | $951.73 | $780.51 | RVU21A |
| 2020-10-01 | $981.81 | $817.44 | RVU20D |
| 2020-07-01 | $981.81 | $817.44 | RVU20C |
| 2020-04-01 | $981.81 | $817.44 | RVU20B |
| 2020-01-01 | $981.81 | $817.44 | RVU20A |
| 2019-10-01 | $1,025.57 | $860.54 | RVU19D |
| 2019-07-01 | $1,025.57 | $860.54 | RVU19C |
| 2019-04-01 | $1,025.57 | $860.54 | RVU19B |
| 2019-01-01 | $1,025.57 | $860.54 | RVU19A |
| 2018-10-01 | $1,048.72 | $879.97 | RVU18D |
| 2018-07-01 | $1,048.72 | $879.97 | RVU18C |
| 2018-04-01 | $1,048.72 | $879.97 | RVU18B |
| 2018-01-01 | $1,048.72 | $879.97 | RVU18AR1 |
| 2017-10-01 | $1,057.54 | $888.45 | RVU17D |
| 2017-07-01 | $1,057.54 | $888.45 | RVU17C |
| 2017-04-01 | $1,057.54 | $888.45 | RVU17B |
| 2017-01-01 | $1,057.54 | $888.45 | RVU17A |
| 2016-10-01 | $1,062.76 | $892.34 | RVU16D |
| 2016-07-01 | $1,062.76 | $892.34 | RVU16C |
| 2016-04-01 | $1,062.76 | $892.34 | RVU16B |
| 2016-01-01 | $1,062.76 | $892.34 | RVU16A |
| 2015-10-01 | $1,064.35 | $892.88 | RVU15D |
| 2015-07-01 | $1,064.35 | $892.88 | RVU15C |
| 2015-04-01 | $1,059.05 | $888.44 | RVU15B |
| 2015-01-01 | $1,059.05 | $888.44 | RVU15A |
| 2014-10-01 | $1,044.40 | $875.18 | RVU14D |
| 2014-07-01 | $1,044.40 | $875.18 | RVU14C |
| 2014-04-01 | $1,044.40 | $875.18 | RVU14B |
| 2014-01-01 | $1,044.40 | $875.18 | RVU14A |
| 2013-10-01 | $1,034.10 | $858.84 | RVU13D |
| 2013-07-01 | $1,034.10 | $858.84 | RVU13C |
| 2013-04-01 | $1,034.10 | $858.84 | RVU13B |
| 2013-01-01 | $1,034.10 | $858.84 | RVU13AR |
Where the Washington, DC area rate applies
Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.
- Washington
21025 billing questions
How is 21025 different from removal of a mandibular lesion?
Use 21025 when the documented operation is excision of mandibular bone. If the procedure is directed at a specified lesion and a lesion-specific code describes the work, consider that code instead.
Is modifier 50 appropriate when bone is removed on both sides?
No. The CMS bilateral adjustment does not apply to 21025, and modifier 50 is inappropriate.
What postoperative care is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant surgeon or co-surgeon be paid for 21025?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.
What happens if another procedure is performed in the same session?
Medicare pays the highest-valued procedure in full and reduces the other procedures to 50% under the standard multiple-procedure rule.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
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Fee sheets
Put 21025 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
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