CPT code 21030: Bone lesion excision, maxilla or zygoma, benign2026 Medicare rate & RVUs in California

Medicare pays $497.98–$615.37 for 21030 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 21030 covers

This service removes a benign tumor or cyst arising in the maxilla or zygoma by enucleating the lesion and curetting its bony site. Oral and maxillofacial surgeons commonly perform it for an intraosseous lesion identified on dental or facial imaging, with the specimen sent for pathologic examination. The approach and setting depend on the lesion and the patient; the defining work is enucleation and curettage, rather than resection of a malignant tumor or removal of a superficial facial mass.

Report the code when the operative record identifies a benign maxillary or zygomatic tumor or cyst and documents enucleation with curettage. A 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. For bilateral reporting with modifier 50, CMS pays at 150%. Assistant-at-surgery payment is restricted; 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.

Where 21030 pays more and less in California

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

29 of 29 payment localities

How the 21030 rate is calculated

Each of 21030’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.

Payment rules and modifiers for 21030

21030 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

21030 compared with similar codes

How to choose

21034Tumor excisionMalignant, maxilla or zygoma

Both concern the maxilla or zygoma, but 21030 describes enucleation and curettage of a benign lesion; 21034 is for a malignant tumor.

21026Facial bone excisionOne or more facial bones

Use 21030 for enucleation and curettage of a benign tumor or cyst in the maxilla or zygoma. Code 21026 describes excision of facial bone or bones.

21048Maxillary excisionExtraoral approach, partial maxillectomy

Code 21048 concerns a maxillary benign tumor or cyst requiring intraoral osteotomy. Code 21030 describes enucleation and curettage.

21040Mandibular lesion excisionIntraoral approach

Code 21040 describes enucleation and curettage of a benign tumor or cyst in the mandible; 21030 is for the maxilla or zygoma.

Codes related to 21030

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

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

Open CMS sourceHow we calculate rates