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

Reports enucleation and curettage of a benign tumor or cyst involving the maxilla or zygoma, typically performed by an oral and maxillofacial surgeon.

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

In North Carolina, Medicare pays $449.00 for 21030 in the office and $319.05 when it’s performed in a hospital or facility.

$449.00Office (non-facility)
$319.05Hospital or facility
−5.7%vs the national office rate ($475.96)

Check a contract rate as a % of Medicare · 21030 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 21030 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Carolina
  2. What 21030 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 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.

How North Carolina compares for 21030

Across 109 of 109 payment localities, the office rate for 21030 runs from $424.63 in Arkansas to $615.37 in San Benito County, CA. North Carolina pays $449.00. The RVUs are the same everywhere; the geographic indexes change the dollars.

21030 in North Carolina vs other payment areas
  1. North Carolina · this page$449.00
  2. Los Angeles, CA · California$530.12+$81.12
  3. Washington, DC area · District of Columbia$539.56+$90.56
  4. Miami, FL · Florida$518.24+$69.24
  5. Chicago, IL · Illinois$504.08+$55.08
  6. Manhattan, NY · New York$545.75+$96.75
  7. Alaska · Alaska$566.37+$117.37

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

Every other payment area

21030 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$430.38$308.51
ArkansasArkansas$424.63$304.99
ArizonaArizona$463.94$328.98
Bakersfield, CACalifornia$499.74$347.09
Chico, CACalifornia$497.98$345.33
El Centro, CACalifornia$498.08$345.43
Fresno, CACalifornia$497.98$345.33
Hanford, CACalifornia$497.98$345.33

21030 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.

$424.63

$566.37

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

View every state and territory as a table
21030 office rate range by state
State / territoryOffice rate rangeLocalities
AK$566.371
AL$430.381
AR$424.631
AZ$463.941
CA$497.98–$615.3729
CO$492.531
CT$506.111
DC$539.561
DE$471.221
FL$472.84–$518.243
GA$447.75–$485.142
GU$508.251
HI$508.251
IA$438.901
ID$441.881
IL$461.28–$504.084
IN$444.211
KS$437.751
KY$441.401
LA$441.06–$461.162
MA$490.22–$537.832
MD$479.50–$539.563
ME$444.81–$466.022
MI$452.73–$479.112
MN$470.681
MO$434.57–$461.783
MS$429.641
MT$475.921
NC$449.001
ND$464.261
NE$440.891
NH$485.651
NJ$511.53–$534.782
NM$455.331
NV$472.971
NY$455.30–$559.085
OH$450.351
OK$439.871
OR$468.92–$506.362
PA$450.59–$494.792
PR$478.931
RI$486.651
SC$450.491
SD$462.881
TN$439.881
TX$447.90–$491.228
UT$456.181
VA$465.13–$539.562
VI$478.931
VT$463.271
WA$489.03–$547.612
WI$449.881
WV$445.651
WY$470.841

See 21030 in every payment locality

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.

How the rate is built · 21030

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.79

4.79 RVUs× 1.000 GPCI

Practice expense8.87

8.87 RVUs× 1.000 GPCI

Malpractice0.59

0.59 RVUs× 1.000 GPCI

Adjusted RVUs

14.2500

Conversion factor

$33.4009

Medicare rate

$475.96

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

1,846

Code
21030
Physician work
4.79
Practice expense
8.87
Malpractice
0.59

GPCI2026.csv

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 21030 in North Carolina
ComponentRVULocality factorAdjusted
Physician work4.79× 1.0004.7900
Practice expense8.87× 0.9338.2757
Malpractice0.59× 0.6390.3770
Total RVUs13.4427
Conversion factor× 33.4009

Office rate, North Carolina$449.00

Office: (4.79 × 1 + 8.87 × 0.933 + 0.59 × 0.639) × $33.4009 = $449.00

Facility: (4.79 × 1 + 4.7 × 0.933 + 0.59 × 0.639) × $33.4009 = $319.05

Open 21030 in the RVU calculator

Payment rules and modifiers for 21030

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

CMS payment indicators · 21030

Bone lesion excision, maxilla or zygoma, benign

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)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
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 · 21030

Bone lesion excision, maxilla or zygoma, benign

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 50 · payment effect

With and without the modifier

21030 without 50 · national office

$475.96

Bone lesion excision, maxilla or zygoma, benign

21030-50 · Bilateral: 150%

$713.94

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

Codes related to 21030

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

Codes related to 21030
CodeHow it relatesOffice range, North Carolina
Used instead
21034Tumor excision, malignant, maxilla or zygomaFor excision of a malignant tumor of the maxilla or zygoma rather than a benign lesion.$1,231.55
21026Facial bone excision, one or more facial bonesExcision of facial bone or bones, rather than enucleation and curettage of a specified benign lesion.$542.64
21029Bone contouring, benign facial bone tumorContouring a facial bone lesion is distinct from enucleating and curetting a benign maxillary or zygomatic lesion.$764.18
21048Maxillary excision, extraoral approach, partial maxillectomyFor a maxillary benign tumor or cyst requiring intraoral osteotomy.No office rate
21049Maxillary cyst excision, with extraoral approach and repairFor a maxillary benign tumor or cyst requiring extraoral osteotomy and partial maxillectomy.No office rate
Same family
21040Mandibular lesion excision, intraoral approachEnucleation and curettage of a benign tumor or cyst in the mandible.$452.74

How 21030 has changed in North Carolina

21030 · Office / nonfacility

$449.00

Effective 2026-10-01

The base rate is $25.42 higher than on 2025-10-01, moving from $423.58 to $449.00 (6.0%).

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

    $423.58changed to$449.00

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.91 changed to 4.79
    • Practice expense RVU 8.48 changed to 8.87
    • Malpractice RVU 0.50 changed to 0.59
    • 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

    $432.37changed to$423.58

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.38 changed to 8.48
    • Malpractice RVU 0.48 changed to 0.50

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $425.32changed to$432.37

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $441.45changed to$425.32

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice RVU 0.47 changed to 0.48
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665

  5. January 1, 2023

    RVU23A

    $451.19changed to$441.45

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 8.37 changed to 8.38
    • Malpractice RVU 0.44 changed to 0.47
    • 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

    $465.90changed to$451.19

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 8.70 changed to 8.37
    • Malpractice RVU 0.45 changed to 0.44

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $481.77changed to$465.90

    • Conversion factor 36.0896 changed to 34.8931
    • Malpractice RVU 0.46 changed to 0.45
    • 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

    $496.19changed to$481.77

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 8.91 changed to 8.70
    • Malpractice RVU 0.81 changed to 0.46
    • 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

    $503.27changed to$496.19

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 9.13 changed to 8.91
    • Malpractice RVU 0.82 changed to 0.81

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $506.15changed to$503.27

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 9.23 changed to 9.13
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $507.29changed to$506.15

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 9.27 changed to 9.23
    • Malpractice RVU 0.83 changed to 0.82
    • 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

    $507.90changed to$507.29

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 9.25 changed to 9.27
    • Malpractice RVU 0.81 changed to 0.83

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $505.38changed to$507.90

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $503.20changed to$505.38

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 9.26 changed to 9.25
    • Malpractice RVU 0.73 changed to 0.81
    • 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

    $501.36changed to$503.20

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 10.03 changed to 9.26
    • Malpractice RVU 0.76 changed to 0.73
    • 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: $501.36

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$449.00$319.05RVU26D
2026-07-01$449.00$319.05RVU26C
2026-04-01$449.00$319.05RVU26B
2026-01-01$449.00$319.05RVU26A
2025-10-01$423.58$337.61RVU25D
2025-07-01$423.58$337.61RVU25C
2025-04-01$423.58$337.61RVU25B
2025-01-01$423.58$337.61RVU25A
2024-10-01$432.37$342.06RVU24D
2024-07-01$432.37$342.06RVU24C
2024-04-01$432.37$342.06RVU24B
2024-03-09$432.37$342.06RVU24AR
2024-01-01$425.32$336.48RVU24A
2023-10-01$441.45$347.52RVU23D
2023-07-01$441.45$347.52RVU23C
2023-04-01$441.45$347.52RVU23B
2023-01-01$441.45$347.52RVU23A
2022-10-01$451.19$352.92RVU22D
2022-07-01$451.19$352.92RVU22C
2022-04-01$451.19$352.92RVU22B
2022-01-01$451.19$352.92RVU22A
2021-10-01$465.90$362.60RVU21D
2021-07-01$465.90$362.60RVU21C
2021-04-01$465.90$362.60RVU21B
2021-01-01$465.90$362.60RVU21A
2020-10-01$481.77$382.76RVU20D
2020-07-01$481.77$382.76RVU20C
2020-04-01$481.77$382.76RVU20B
2020-01-01$481.77$382.76RVU20A
2019-10-01$496.19$398.22RVU19D
2019-07-01$496.19$398.22RVU19C
2019-04-01$496.19$398.22RVU19B
2019-01-01$496.19$398.22RVU19A
2018-10-01$503.27$406.75RVU18D
2018-07-01$503.27$406.75RVU18C
2018-04-01$503.27$406.75RVU18B
2018-01-01$503.27$406.75RVU18AR1
2017-10-01$506.15$410.59RVU17D
2017-07-01$506.15$410.59RVU17C
2017-04-01$506.15$410.59RVU17B
2017-01-01$506.15$410.59RVU17A
2016-10-01$507.29$412.06RVU16D
2016-07-01$507.29$412.06RVU16C
2016-04-01$507.29$412.06RVU16B
2016-01-01$507.29$412.06RVU16A
2015-10-01$507.90$411.66RVU15D
2015-07-01$507.90$411.66RVU15C
2015-04-01$505.38$409.61RVU15B
2015-01-01$505.38$409.61RVU15A
2014-10-01$503.20$408.35RVU14D
2014-07-01$503.20$408.35RVU14C
2014-04-01$503.20$408.35RVU14B
2014-01-01$503.20$408.35RVU14A
2013-10-01$501.36$402.33RVU13D
2013-07-01$501.36$402.33RVU13C
2013-04-01$501.36$402.33RVU13B
2013-01-01$501.36$402.33RVU13AR

Price 21030 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

21030 billing questions

How does this differ from code 21034?

Code 21030 is for enucleation and curettage of a benign maxillary or zygomatic tumor or cyst. Code 21034 is for excision of a malignant tumor in those bones.

When would code 21026 be a better fit?

Code 21026 describes excision of facial bone or bones. Use 21030 when the documented service is enucleation and curettage of a benign tumor or cyst specifically involving the maxilla or zygoma.

Is the related postoperative care included?

Yes. The 90-day global period includes the day-before preoperative visit and related postoperative care during the 90 days after surgery.

How are other procedures in the same session paid?

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

Can an assistant surgeon or co-surgeon be billed?

CMS lists a statutory restriction on assistant-at-surgery payment for this code. Co-surgeons and team surgery are not permitted.

What should the operative documentation establish?

Document the maxillary or zygomatic site, the benign tumor or cyst, and the enucleation and curettage performed. The record should distinguish this work from malignant tumor excision or a different bone-removal procedure.

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 21030PPRRVU2026_Oct_nonQPP.csv, line 1,846 (RVU26D)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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