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CPT code 21026: Facial bone excision, one or more facial bones2026 Medicare rate & RVUs in North Carolina

Reports surgical removal of one or more facial bones when the documented procedure is bone excision rather than contouring or a site-specific tumor operation.

CMS RVU26DEffective Oct 1, 2026One payment locality835 Medicare services in 2024

In North Carolina, Medicare pays $542.64 for 21026 in the office and $390.88 when it’s performed in a hospital or facility.

$542.64Office (non-facility)
$390.88Hospital or facility
−5.8%vs the national office rate ($576.17)

Check a contract rate as a % of Medicare · 21026 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 21026 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Carolina
  2. What 21026 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 21026 covers

CPT 21026 describes surgical removal of facial bone, involving one or more bones of the face. An oral and maxillofacial surgeon, plastic surgeon, or otolaryngologist may perform the procedure in an operating room when the treatment plan calls for excision of facial bone. The operative report should identify the bone or bones treated and describe the extent of removal.

Select this code for facial bone excision, distinguishing it from lower-jaw bone excision and from codes describing contouring or a specified tumor operation. Documentation should support the anatomic site and the work performed. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this code; co-surgeons and team surgery 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 21026

Across 109 of 109 payment localities, the office rate for 21026 runs from $512.49 in Arkansas to $746.48 in San Benito County, CA. North Carolina pays $542.64. The RVUs are the same everywhere; the geographic indexes change the dollars.

21026 in North Carolina vs other payment areas
  1. North Carolina · this page$542.64
  2. Los Angeles, CA · California$642.23+$99.59
  3. Washington, DC area · District of Columbia$654.07+$111.43
  4. Miami, FL · Florida$629.45+$86.81
  5. Chicago, IL · Illinois$611.73+$69.09
  6. Manhattan, NY · New York$661.93+$119.29
  7. Alaska · Alaska$681.52+$138.88

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

Every other payment area

21026 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$519.62$377.29
ArkansasArkansas$512.49$372.77
ArizonaArizona$561.23$403.61
Bakersfield, CACalifornia$604.98$426.70
Chico, CACalifornia$602.78$424.50
El Centro, CACalifornia$602.90$424.63
Fresno, CACalifornia$602.78$424.50
Hanford, CACalifornia$602.78$424.50

21026 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.

$512.49

$681.52

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
21026 office rate range by state
State / territoryOffice rate rangeLocalities
AK$681.521
AL$519.621
AR$512.491
AZ$561.231
CA$602.78–$746.4829
CO$596.291
CT$613.281
DC$654.071
DE$570.181
FL$572.69–$629.453
GA$541.51–$587.602
GU$615.681
HI$615.681
IA$530.001
ID$533.731
IL$558.48–$611.734
IN$536.611
KS$528.661
KY$533.481
LA$533.09–$558.012
MA$593.42–$651.912
MD$580.35–$654.073
ME$537.46–$563.632
MI$547.61–$580.562
MN$569.131
MO$525.09–$558.683
MS$518.841
MT$576.121
NC$542.641
ND$561.291
NE$532.451
NH$588.021
NJ$619.64–$648.032
NM$550.871
NV$572.351
NY$550.46–$678.585
OH$544.581
OK$531.481
OR$567.26–$613.282
PA$544.82–$599.322
PR$579.811
RI$589.051
SC$544.641
SD$559.531
TN$531.321
TX$541.50–$594.878
UT$551.691
VA$562.59–$654.072
VI$579.811
VT$560.141
WA$591.96–$663.812
WI$543.481
WV$539.091
WY$569.651

See 21026 in every payment locality

How the 21026 rate is calculated

Each of 21026’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 · 21026

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.56

5.56 RVUs× 1.000 GPCI

Practice expense10.94

10.94 RVUs× 1.000 GPCI

Malpractice0.75

0.75 RVUs× 1.000 GPCI

Adjusted RVUs

17.2500

Conversion factor

$33.4009

Medicare rate

$576.17

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

1,844

Code
21026
Physician work
5.56
Practice expense
10.94
Malpractice
0.75

GPCI2026.csv

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 21026 in North Carolina
ComponentRVULocality factorAdjusted
Physician work5.56× 1.0005.5600
Practice expense10.94× 0.93310.2070
Malpractice0.75× 0.6390.4793
Total RVUs16.2463
Conversion factor× 33.4009

Office rate, North Carolina$542.64

Office: (5.56 × 1 + 10.94 × 0.933 + 0.75 × 0.639) × $33.4009 = $542.64

Facility: (5.56 × 1 + 6.07 × 0.933 + 0.75 × 0.639) × $33.4009 = $390.88

Open 21026 in the RVU calculator

Payment rules and modifiers for 21026

21026 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21026

Facial bone excision, one or more facial bones

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 · 21026

Facial bone excision, one or more facial bones

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

21026 without 51 · national office

$576.17

Facial bone excision, one or more facial bones

21026-51 · Second procedure: 50%

$288.09

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 21026

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

Codes related to 21026
CodeHow it relatesOffice range, North Carolina
Used instead
21025Bone excision, mandibleUse for excision of lower-jaw bone rather than facial bone excision.$792.77
21029Bone contouring, benign facial bone tumorDescribes contouring facial bone rather than excising it.$764.18
21030Bone lesion excision, maxilla or zygoma, benignFor excision of a benign maxillary or zygomatic tumor or cyst.$449.00
21034Tumor excision, malignant, maxilla or zygomaFor excision of a malignant tumor of the maxilla or zygoma.$1,231.55
21040Mandibular lesion excision, intraoral approachFor excision of a mandibular lesion, rather than general facial bone excision.$452.74

How 21026 has changed in North Carolina

21026 · Office / nonfacility

$542.64

Effective 2026-10-01

The base rate is $37.83 higher than on 2025-10-01, moving from $504.81 to $542.64 (7.5%).

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

    $504.81changed to$542.64

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 5.70 changed to 5.56
    • Practice expense RVU 10.26 changed to 10.94
    • Malpractice RVU 0.61 changed to 0.75
    • 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

    $505.80changed to$504.81

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 9.83 changed to 10.26
    • Malpractice RVU 0.59 changed to 0.61

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $497.55changed to$505.80

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $512.45changed to$497.55

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 9.70 changed to 9.83
    • Malpractice RVU 0.58 changed to 0.59
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665

  5. January 1, 2023

    RVU23A

    $520.78changed to$512.45

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 9.58 changed to 9.70
    • Malpractice RVU 0.56 changed to 0.58
    • 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

    $531.33changed to$520.78

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 9.79 changed to 9.58
    • Malpractice RVU 0.54 changed to 0.56

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $550.73changed to$531.33

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 9.84 changed to 9.79
    • 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

    $577.16changed to$550.73

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 10.37 changed to 9.84
    • Malpractice RVU 0.95 changed to 0.54
    • 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

    $596.38changed to$577.16

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 10.97 changed to 10.37
    • Malpractice RVU 0.94 changed to 0.95

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $602.21changed to$596.38

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 11.17 changed to 10.97
    • Malpractice RVU 0.93 changed to 0.94
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $602.26changed to$602.21

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 11.19 changed to 11.17
    • 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

    $604.77changed to$602.26

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 11.20 changed to 11.19

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $601.76changed to$604.77

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $596.64changed to$601.76

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 11.17 changed to 11.20
    • Malpractice RVU 0.79 changed to 0.93
    • 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

    $598.97changed to$596.64

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 12.22 changed to 11.17
    • Malpractice RVU 0.83 changed to 0.79
    • 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: $598.97

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$542.64$390.88RVU26D
2026-07-01$542.64$390.88RVU26C
2026-04-01$542.64$390.88RVU26B
2026-01-01$542.64$390.88RVU26A
2025-10-01$504.81$407.17RVU25D
2025-07-01$504.81$407.17RVU25C
2025-04-01$504.81$407.17RVU25B
2025-01-01$504.81$407.17RVU25A
2024-10-01$505.80$406.86RVU24D
2024-07-01$505.80$406.86RVU24C
2024-04-01$505.80$406.86RVU24B
2024-03-09$505.80$406.86RVU24AR
2024-01-01$497.55$400.22RVU24A
2023-10-01$512.45$411.30RVU23D
2023-07-01$512.45$411.30RVU23C
2023-04-01$512.45$411.30RVU23B
2023-01-01$512.45$411.30RVU23A
2022-10-01$520.78$416.41RVU22D
2022-07-01$520.78$416.41RVU22C
2022-04-01$520.78$416.41RVU22B
2022-01-01$520.78$416.41RVU22A
2021-10-01$531.33$423.50RVU21D
2021-07-01$531.33$423.50RVU21C
2021-04-01$531.33$423.50RVU21B
2021-01-01$531.33$423.50RVU21A
2020-10-01$550.73$446.68RVU20D
2020-07-01$550.73$446.68RVU20C
2020-04-01$550.73$446.68RVU20B
2020-01-01$550.73$446.68RVU20A
2019-10-01$577.16$470.46RVU19D
2019-07-01$577.16$470.46RVU19C
2019-04-01$577.16$470.46RVU19B
2019-01-01$577.16$470.46RVU19A
2018-10-01$596.38$485.78RVU18D
2018-07-01$596.38$485.78RVU18C
2018-04-01$596.38$485.78RVU18B
2018-01-01$596.38$485.78RVU18AR1
2017-10-01$602.21$490.28RVU17D
2017-07-01$602.21$490.28RVU17C
2017-04-01$602.21$490.28RVU17B
2017-01-01$602.21$490.28RVU17A
2016-10-01$602.26$490.38RVU16D
2016-07-01$602.26$490.38RVU16C
2016-04-01$602.26$490.38RVU16B
2016-01-01$602.26$490.38RVU16A
2015-10-01$604.77$491.82RVU15D
2015-07-01$604.77$491.82RVU15C
2015-04-01$601.76$489.37RVU15B
2015-01-01$601.76$489.37RVU15A
2014-10-01$596.64$485.48RVU14D
2014-07-01$596.64$485.48RVU14C
2014-04-01$596.64$485.48RVU14B
2014-01-01$596.64$485.48RVU14A
2013-10-01$598.97$481.96RVU13D
2013-07-01$598.97$481.96RVU13C
2013-04-01$598.97$481.96RVU13B
2013-01-01$598.97$481.96RVU13AR

Price 21026 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

21026 billing questions

How does 21026 differ from 21025?

21026 describes facial bone excision; 21025 is the jaw-specific code for excision of lower-jaw bone. Choose based on the bone and procedure documented.

When would 21029 be a better fit?

21029 describes contouring facial bone, such as reshaping a bony prominence or lesion. Use 21026 when the documented work is excision rather than contouring.

Should modifier 50 be reported for both sides?

No. CMS identifies bilateral adjustment as inappropriate for 21026, so modifier 50 should not be used.

What postoperative care is included?

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?

Medicare does not pay an assistant at surgery for 21026. Co-surgeons and team surgery are not permitted.

How does the multiple-procedure reduction work?

When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the other procedures are paid at 50%.

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 21026PPRRVU2026_Oct_nonQPP.csv, line 1,844 (RVU26D)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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