CPT code 21025: Bone excision, mandible2026 Medicare rate & RVUs in South Dakota

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 South Dakota, Medicare pays $810.98 for 21025 in the office and $584.52 when it’s performed in a hospital or facility.

$810.98Office (non-facility)
$584.52Hospital or facility
−3.5%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 South Dakota
  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 South Dakota 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. South Dakota pays $810.98. The RVUs are the same everywhere; the geographic indexes change the dollars.

21025 in South Dakota vs other payment areas
  1. South Dakota · this page$810.98
  2. Los Angeles, CA · California$924.66+$113.68
  3. Washington, DC area · District of Columbia$946.21+$135.23
  4. Miami, FL · Florida$926.19+$115.21
  5. Chicago, IL · Illinois$901.33+$90.35
  6. Manhattan, NY · New York$962.66+$151.68
  7. Alaska · Alaska$1,014.24+$203.26

Other areas in South Dakota 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.

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 South Dakota 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

94

Locality
South Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.336
Office calculation for 21025 in South Dakota
ComponentRVULocality factorAdjusted
Physician work9.78× 1.0009.7800
Practice expense14.06× 1.00014.0600
Malpractice1.31× 0.3360.4402
Total RVUs24.2802
Conversion factor× 33.4009

Office rate, South Dakota$810.98

Office: (9.78 × 1 + 14.06 × 1 + 1.31 × 0.336) × $33.4009 = $810.98

Facility: (9.78 × 1 + 7.28 × 1 + 1.31 × 0.336) × $33.4009 = $584.52

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

How 21025 has changed in South Dakota

21025 · Office / nonfacility

$810.98

Effective 2026-10-01

The base rate is $47.00 higher than on 2025-10-01, moving from $763.98 to $810.98 (6.2%).

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

    $763.98changed to$810.98

    • 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
    • Malpractice GPCI 0.382 changed to 0.336

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $771.48changed to$763.98

    • 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

    $758.89changed to$771.48

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $778.22changed to$758.89

    • 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
    • Malpractice GPCI 0.364 changed to 0.382
  5. January 1, 2023

    RVU23A

    $785.34changed to$778.22

    • 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
    • Malpractice GPCI 0.347 changed to 0.364

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $798.34changed to$785.34

    • 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

    $831.85changed to$798.34

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 12.67 changed to 12.52
    • Malpractice GPCI 0.368 changed to 0.347

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $859.52changed to$831.85

    • 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
    • Malpractice GPCI 0.389 changed to 0.368

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $878.96changed to$859.52

    • 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

    $885.22changed to$878.96

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 13.98 changed to 13.74
    • Malpractice GPCI 0.395 changed to 0.389

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $888.02changed to$885.22

    • 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
    • Malpractice GPCI 0.400 changed to 0.395

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $890.07changed to$888.02

    • 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

    $885.64changed to$890.07

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $885.33changed to$885.64

    • 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
    • Malpractice GPCI 0.416 changed to 0.400

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $880.59changed to$885.33

    • 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
    • Malpractice GPCI 0.432 changed to 0.416

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $880.59

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$810.98$584.52RVU26D
2026-07-01$810.98$584.52RVU26C
2026-04-01$810.98$584.52RVU26B
2026-01-01$810.98$584.52RVU26A
2025-10-01$763.98$634.60RVU25D
2025-07-01$763.98$634.60RVU25C
2025-04-01$763.98$634.60RVU25B
2025-01-01$763.98$634.60RVU25A
2024-10-01$771.48$639.67RVU24D
2024-07-01$771.48$639.67RVU24C
2024-04-01$771.48$639.67RVU24B
2024-03-09$771.48$639.67RVU24AR
2024-01-01$758.89$629.22RVU24A
2023-10-01$778.22$645.04RVU23D
2023-07-01$778.22$645.04RVU23C
2023-04-01$778.22$645.04RVU23B
2023-01-01$778.22$645.04RVU23A
2022-10-01$785.34$649.68RVU22D
2022-07-01$785.34$649.68RVU22C
2022-04-01$785.34$649.68RVU22B
2022-01-01$785.34$649.68RVU22A
2021-10-01$798.34$659.82RVU21D
2021-07-01$798.34$659.82RVU21C
2021-04-01$798.34$659.82RVU21B
2021-01-01$798.34$659.82RVU21A
2020-10-01$831.85$697.24RVU20D
2020-07-01$831.85$697.24RVU20C
2020-04-01$831.85$697.24RVU20B
2020-01-01$831.85$697.24RVU20A
2019-10-01$859.52$722.57RVU19D
2019-07-01$859.52$722.57RVU19C
2019-04-01$859.52$722.57RVU19B
2019-01-01$859.52$722.57RVU19A
2018-10-01$878.96$738.92RVU18D
2018-07-01$878.96$738.92RVU18C
2018-04-01$878.96$738.92RVU18B
2018-01-01$878.96$738.92RVU18AR1
2017-10-01$885.22$744.90RVU17D
2017-07-01$885.22$744.90RVU17C
2017-04-01$885.22$744.90RVU17B
2017-01-01$885.22$744.90RVU17A
2016-10-01$888.02$746.59RVU16D
2016-07-01$888.02$746.59RVU16C
2016-04-01$888.02$746.59RVU16B
2016-01-01$888.02$746.59RVU16A
2015-10-01$890.07$747.78RVU15D
2015-07-01$890.07$747.78RVU15C
2015-04-01$885.64$744.06RVU15B
2015-01-01$885.64$744.06RVU15A
2014-10-01$885.33$744.54RVU14D
2014-07-01$885.33$744.54RVU14C
2014-04-01$885.33$744.54RVU14B
2014-01-01$885.33$744.54RVU14A
2013-10-01$880.59$734.29RVU13D
2013-07-01$880.59$734.29RVU13C
2013-04-01$880.59$734.29RVU13B
2013-01-01$880.59$734.29RVU13AR

Price 21025 for an earlier date of service

Where the South Dakota rate applies

South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Agar
  • Agency Village
  • Akaska
  • Albee
  • Alcester
  • Alexandria
  • Allen

Browse all communities in South Dakota

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 South DakotaGPCI2026.csv, line 94 (RVU26D)

Open CMS sourceHow we calculate rates

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