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CPT code 21025: Bone excision, mandible2026 Medicare rate & RVUs in North Carolina

Reports surgical removal of mandibular bone, such as devitalized bone in osteomyelitis, when the operation is an excision rather than a lesion-specific procedure.

CMS RVU26DEffective Oct 1, 2026One payment locality1.6K Medicare services in 2024

In North Carolina, Medicare pays $792.77 for 21025 in the office and $581.49 when it’s performed in a hospital or facility.

$792.77Office (non-facility)
$581.49Hospital or facility
−5.6%vs the national office rate ($840.03)

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.

We’ll open 21025 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Carolina
  2. What 21025 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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 North Carolina 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. North Carolina pays $792.77. The RVUs are the same everywhere; the geographic indexes change the dollars.

21025 in North Carolina vs other payment areas
  1. North Carolina · this page$792.77
  2. Los Angeles, CA · California$924.66+$131.89
  3. Washington, DC area · District of Columbia$946.21+$153.44
  4. Miami, FL · Florida$926.19+$133.42
  5. Chicago, IL · Illinois$901.33+$108.56
  6. Manhattan, NY · New York$962.66+$169.89
  7. Alaska · Alaska$1,014.24+$221.47

Other areas in North Carolina first, then benchmark localities. Bars start at $0.

Every other payment area

21025 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$762.34$564.19
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

21025 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
21025 office rate range by state
State / territoryOffice rate rangeLocalities
AK$1,014.241
AL$762.341
AR$752.601
AZ$819.171
CA$870.37–$1,063.2329
CO$864.431
CT$891.911
DC$946.211
DE$831.611
FL$841.38–$926.193
GA$797.72–$857.322
GU$885.951
HI$885.951
IA$773.731
ID$779.401
IL$823.81–$901.334
IN$783.261
KS$773.251
KY$784.191
LA$784.19–$818.282
MA$861.27–$939.722
MD$845.35–$946.213
ME$785.92–$819.662
MI$804.82–$853.612
MN$822.851
MO$774.09–$817.583
MS$763.341
MT$839.951
NC$792.771
ND$814.041
NE$776.661
NH$853.821
NJ$900.55–$938.732
NM$809.851
NV$833.201
NY$803.56–$987.195
OH$799.531
OK$780.031
OR$825.16–$886.192
PA$799.12–$873.612
PR$844.541
RI$857.011
SC$797.781
SD$810.981
TN$777.041
TX$794.66–$862.948
UT$807.391
VA$819.19–$946.212
VI$844.541
VT$813.721
WA$858.71–$954.962
WI$790.031
WV$797.371
WY$828.661

See 21025 in every payment locality

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

Office or facility?

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 North Carolina 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

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 21025 in North Carolina
ComponentRVULocality factorAdjusted
Physician work9.78× 1.0009.7800
Practice expense14.06× 0.93313.1180
Malpractice1.31× 0.6390.8371
Total RVUs23.7351
Conversion factor× 33.4009

Office rate, North Carolina$792.77

Office: (9.78 × 1 + 14.06 × 0.933 + 1.31 × 0.639) × $33.4009 = $792.77

Facility: (9.78 × 1 + 7.28 × 0.933 + 1.31 × 0.639) × $33.4009 = $581.49

Open 21025 in the RVU calculator

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

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.10/0.69/0.21Share 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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

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%).

When to use modifier 51

Codes related to 21025

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 21025
CodeHow it relatesOffice range, North Carolina
Same family
21026Facial bone excision, one or more facial bonesCovers excision of facial bone outside the mandible-specific scope of 21025.$542.64
Used instead
21031Exostosis removal, mandibleUse for removal of a mandibular exostosis when that is the documented target.$366.34
21040Mandibular lesion excision, intraoral approachA lesion-specific mandibular procedure; distinguish it from general mandibular bone excision.$452.74
21045Mandible tumor resection, extensive malignant resectionConsider when the documented jaw operation meets the criteria for extensive surgery.No office rate

How 21025 has changed in North Carolina

21025 · Office / nonfacility

$792.77

Effective 2026-10-01

The base rate is $50.54 higher than on 2025-10-01, moving from $742.23 to $792.77 (6.8%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $742.23changed to$792.77

    • 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
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $750.39changed to$742.23

    • 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.

  3. March 9, 2024

    RVU24AR

    $738.15changed to$750.39

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $760.34changed to$738.15

    • 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
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665

  5. January 1, 2023

    RVU23A

    $770.81changed to$760.34

    • 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
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $782.53changed to$770.81

    • 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.

  7. January 1, 2021

    RVU21A

    $813.18changed to$782.53

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 12.67 changed to 12.52
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $845.19changed to$813.18

    • 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
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $863.11changed to$845.19

    • 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.

  10. January 1, 2018

    RVU18AR1

    $870.68changed to$863.11

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 13.98 changed to 13.74
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $874.82changed to$870.68

    • 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
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $876.48changed to$874.82

    • 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.

  13. July 1, 2015

    RVU15C

    $872.11changed to$876.48

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $865.06changed to$872.11

    • 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
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $855.64changed to$865.06

    • 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
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $855.64

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$792.77$581.49RVU26D
2026-07-01$792.77$581.49RVU26C
2026-04-01$792.77$581.49RVU26B
2026-01-01$792.77$581.49RVU26A
2025-10-01$742.23$622.42RVU25D
2025-07-01$742.23$622.42RVU25C
2025-04-01$742.23$622.42RVU25B
2025-01-01$742.23$622.42RVU25A
2024-10-01$750.39$628.33RVU24D
2024-07-01$750.39$628.33RVU24C
2024-04-01$750.39$628.33RVU24B
2024-03-09$750.39$628.33RVU24AR
2024-01-01$738.15$618.08RVU24A
2023-10-01$760.34$636.89RVU23D
2023-07-01$760.34$636.89RVU23C
2023-04-01$760.34$636.89RVU23B
2023-01-01$760.34$636.89RVU23A
2022-10-01$770.81$644.92RVU22D
2022-07-01$770.81$644.92RVU22C
2022-04-01$770.81$644.92RVU22B
2022-01-01$770.81$644.92RVU22A
2021-10-01$782.53$653.98RVU21D
2021-07-01$782.53$653.98RVU21C
2021-04-01$782.53$653.98RVU21B
2021-01-01$782.53$653.98RVU21A
2020-10-01$813.18$687.99RVU20D
2020-07-01$813.18$687.99RVU20C
2020-04-01$813.18$687.99RVU20B
2020-01-01$813.18$687.99RVU20A
2019-10-01$845.19$717.69RVU19D
2019-07-01$845.19$717.69RVU19C
2019-04-01$845.19$717.69RVU19B
2019-01-01$845.19$717.69RVU19A
2018-10-01$863.11$732.74RVU18D
2018-07-01$863.11$732.74RVU18C
2018-04-01$863.11$732.74RVU18B
2018-01-01$863.11$732.74RVU18AR1
2017-10-01$870.68$740.04RVU17D
2017-07-01$870.68$740.04RVU17C
2017-04-01$870.68$740.04RVU17B
2017-01-01$870.68$740.04RVU17A
2016-10-01$874.82$743.29RVU16D
2016-07-01$874.82$743.29RVU16C
2016-04-01$874.82$743.29RVU16B
2016-01-01$874.82$743.29RVU16A
2015-10-01$876.48$744.14RVU15D
2015-07-01$876.48$744.14RVU15C
2015-04-01$872.11$740.44RVU15B
2015-01-01$872.11$740.44RVU15A
2014-10-01$865.06$734.27RVU14D
2014-07-01$865.06$734.27RVU14C
2014-04-01$865.06$734.27RVU14B
2014-01-01$865.06$734.27RVU14A
2013-10-01$855.64$720.03RVU13D
2013-07-01$855.64$720.03RVU13C
2013-04-01$855.64$720.03RVU13B
2013-01-01$855.64$720.03RVU13AR

Price 21025 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

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

Show the CMS file lines behind this rate
RVUs for 21025PPRRVU2026_Oct_nonQPP.csv, line 1,843 (RVU26D)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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