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CPT code 21031: Exostosis removal, mandible2026 Medicare rate & RVUs in South Carolina

Removal of a bony exostosis of the mandible, such as a mandibular torus, when excision is performed by an oral surgeon or other qualified clinician.

CMS RVU26DEffective Oct 1, 2026One payment locality222 Medicare services in 2024

In South Carolina, Medicare pays $366.97 for 21031 in the office and $241.05 when it’s performed in a hospital or facility.

$366.97Office (non-facility)
$241.05Hospital or facility
−5.8%vs the national office rate ($389.45)

Check a contract rate as a % of Medicare · 21031 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 21031 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in South Carolina
  2. What 21031 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 21031 covers

This service removes a localized bony prominence from the mandible, commonly a mandibular torus that interferes with denture placement, oral hygiene, or function. An oral and maxillofacial surgeon or dentist typically performs the intraoral procedure in an office or surgical facility. Documentation should identify the mandibular site, the exostosis, and the clinical reason for removal.

Report this code for removal of a mandibular exostosis, not for excision of a different jaw lesion or removal of a maxillary torus. The code has a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures at 50%. For bilateral work, modifier 50 is paid at 150%. Assistant-at-surgery services are not paid; 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 South Carolina compares for 21031

Across 109 of 109 payment localities, the office rate for 21031 runs from $344.77 in Arkansas to $512.87 in San Benito County, CA. South Carolina pays $366.97. The RVUs are the same everywhere; the geographic indexes change the dollars.

21031 in South Carolina vs other payment areas
  1. South Carolina · this page$366.97
  2. Los Angeles, CA · California$438.00+$71.03
  3. Washington, DC area · District of Columbia$444.51+$77.54
  4. Miami, FL · Florida$422.38+$55.41
  5. Chicago, IL · Illinois$410.14+$43.17
  6. Manhattan, NY · New York$448.10+$81.13
  7. Alaska · Alaska$454.17+$87.20

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

Every other payment area

21031 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$349.78$230.54
ArkansasArkansas$344.77$227.70
ArizonaArizona$379.09$247.04
Bakersfield, CACalifornia$411.57$262.21
Chico, CACalifornia$410.30$260.94
El Centro, CACalifornia$410.37$261.02
Fresno, CACalifornia$410.30$260.94
Hanford, CACalifornia$410.30$260.94

21031 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.

$344.77

$461.59

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

View every state and territory as a table
21031 office rate range by state
State / territoryOffice rate rangeLocalities
AK$454.171
AL$349.781
AR$344.771
AZ$379.091
CA$410.30–$512.8729
CO$404.721
CT$415.221
DC$444.511
DE$385.331
FL$384.91–$422.383
GA$363.32–$396.942
GU$420.061
HI$420.061
IA$358.051
ID$360.481
IL$374.26–$410.144
IN$362.541
KS$356.651
KY$358.541
LA$358.08–$375.622
MA$402.44–$444.192
MD$392.56–$444.513
ME$362.62–$381.752
MI$368.03–$389.942
MN$387.101
MO$352.16–$376.643
MS$348.521
MT$389.431
NC$366.341
ND$380.921
NE$359.921
NH$398.631
NJ$419.76–$440.012
NM$370.141
NV$387.321
NY$371.81–$459.215
OH$366.291
OK$357.621
OR$384.12–$417.202
PA$366.73–$405.132
PR$392.181
RI$398.781
SC$366.971
SD$379.921
TN$358.461
TX$364.36–$403.558
UT$371.941
VA$380.68–$444.512
VI$392.181
VT$379.681
WA$401.60–$452.942
WI$368.281
WV$360.601
WY$385.721

See 21031 in every payment locality

How the 21031 rate is calculated

Each of 21031’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 · 21031

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.22

3.22 RVUs× 1.000 GPCI

Practice expense8.01

8.01 RVUs× 1.000 GPCI

Malpractice0.43

0.43 RVUs× 1.000 GPCI

Adjusted RVUs

11.6600

Conversion factor

$33.4009

Medicare rate

$389.45

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact South Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

1,847

Code
21031
Physician work
3.22
Practice expense
8.01
Malpractice
0.43

GPCI2026.csv

93

Locality
South Carolina
Physician work
1.000
Practice expense
0.924
Malpractice
0.850
Office calculation for 21031 in South Carolina
ComponentRVULocality factorAdjusted
Physician work3.22× 1.0003.2200
Practice expense8.01× 0.9247.4012
Malpractice0.43× 0.8500.3655
Total RVUs10.9867
Conversion factor× 33.4009

Office rate, South Carolina$366.97

Office: (3.22 × 1 + 8.01 × 0.924 + 0.43 × 0.85) × $33.4009 = $366.97

Facility: (3.22 × 1 + 3.93 × 0.924 + 0.43 × 0.85) × $33.4009 = $241.05

Open 21031 in the RVU calculator

Payment rules and modifiers for 21031

21031 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 21031

Exostosis removal, 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)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 · 21031

Exostosis removal, 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 50 · payment effect

With and without the modifier

21031 without 50 · national office

$389.45

Exostosis removal, mandible

21031-50 · Bilateral: 150%

$584.18

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 21031

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

Codes related to 21031
CodeHow it relatesOffice range, South Carolina
Same family
21032Maxillary exostosis, maxillaRemoval of a maxillary torus; the corresponding service for the upper jaw.$361.82
Used instead
21025Bone excision, mandibleExcision of lower-jaw bone when the target is bone rather than a mandibular exostosis.$797.78
21040Mandibular lesion excision, intraoral approachExcision of a mandibular lesion when the diagnosis is a lesion, not an exostosis.$454.19
21044Jaw tumor excision, mandible, intraoral approachRemoval of a jaw-bone lesion when the operative target is not a torus or exostosis.No office rate

How 21031 has changed in South Carolina

21031 · Office / nonfacility

$366.97

Effective 2026-10-01

The base rate is $19.71 higher than on 2025-10-01, moving from $347.26 to $366.97 (5.7%).

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

    $347.26changed to$366.97

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.30 changed to 3.22
    • Practice expense RVU 7.84 changed to 8.01
    • Malpractice RVU 0.34 changed to 0.43
    • Practice expense GPCI 0.913 changed to 0.924
    • Malpractice GPCI 0.817 changed to 0.850

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $358.58changed to$347.26

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.88 changed to 7.84

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $352.73changed to$358.58

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $362.08changed to$352.73

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.85 changed to 7.88
    • Practice expense GPCI 0.908 changed to 0.913
    • Malpractice GPCI 0.756 changed to 0.817

  5. January 1, 2023

    RVU23A

    $366.65changed to$362.08

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.84 changed to 7.85
    • Malpractice RVU 0.31 changed to 0.34
    • Practice expense GPCI 0.903 changed to 0.908
    • Malpractice GPCI 0.695 changed to 0.756

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $371.02changed to$366.65

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.89 changed to 7.84
    • Malpractice RVU 0.30 changed to 0.31

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $372.01changed to$371.02

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.52 changed to 7.89
    • Practice expense GPCI 0.907 changed to 0.903
    • Malpractice GPCI 0.624 changed to 0.695

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $375.08changed to$372.01

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 7.46 changed to 7.52
    • Malpractice RVU 0.55 changed to 0.30
    • Practice expense GPCI 0.912 changed to 0.907
    • Malpractice GPCI 0.553 changed to 0.624

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $377.63changed to$375.08

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 7.55 changed to 7.46

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $377.96changed to$377.63

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 7.54 changed to 7.55
    • Malpractice RVU 0.56 changed to 0.55
    • Malpractice GPCI 0.634 changed to 0.553

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $379.68changed to$377.96

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 7.57 changed to 7.54
    • Malpractice GPCI 0.715 changed to 0.634

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $380.21changed to$379.68

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 7.56 changed to 7.57
    • Malpractice RVU 0.54 changed to 0.56

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $378.31changed to$380.21

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $372.59changed to$378.31

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 7.53 changed to 7.56
    • Malpractice RVU 0.39 changed to 0.54
    • Practice expense GPCI 0.911 changed to 0.912
    • Malpractice GPCI 0.618 changed to 0.715

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $370.97changed to$372.59

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 8.13 changed to 7.53
    • Malpractice RVU 0.41 changed to 0.39
    • Practice expense GPCI 0.909 changed to 0.911
    • Malpractice GPCI 0.520 changed to 0.618

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $370.97

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$366.97$241.05RVU26D
2026-07-01$366.97$241.05RVU26C
2026-04-01$366.97$241.05RVU26B
2026-01-01$366.97$241.05RVU26A
2025-10-01$347.26$252.46RVU25D
2025-07-01$347.26$252.46RVU25C
2025-04-01$347.26$252.46RVU25B
2025-01-01$347.26$252.46RVU25A
2024-10-01$358.58$257.68RVU24D
2024-07-01$358.58$257.68RVU24C
2024-04-01$358.58$257.68RVU24B
2024-03-09$358.58$257.68RVU24AR
2024-01-01$352.73$253.47RVU24A
2023-10-01$362.08$258.69RVU23D
2023-07-01$362.08$258.69RVU23C
2023-04-01$362.08$258.69RVU23B
2023-01-01$362.08$258.69RVU23A
2022-10-01$366.65$259.15RVU22D
2022-07-01$366.65$259.15RVU22C
2022-04-01$366.65$259.15RVU22B
2022-01-01$366.65$259.15RVU22A
2021-10-01$371.02$262.00RVU21D
2021-07-01$371.02$262.00RVU21C
2021-04-01$371.02$262.00RVU21B
2021-01-01$371.02$262.00RVU21A
2020-10-01$372.01$270.86RVU20D
2020-07-01$372.01$270.86RVU20C
2020-04-01$372.01$270.86RVU20B
2020-01-01$372.01$270.86RVU20A
2019-10-01$375.08$277.47RVU19D
2019-07-01$375.08$277.47RVU19C
2019-04-01$375.08$277.47RVU19B
2019-01-01$375.08$277.47RVU19A
2018-10-01$377.63$282.74RVU18D
2018-07-01$377.63$282.74RVU18C
2018-04-01$377.63$282.74RVU18B
2018-01-01$377.63$282.74RVU18AR1
2017-10-01$377.96$285.34RVU17D
2017-07-01$377.96$285.34RVU17C
2017-04-01$377.96$285.34RVU17B
2017-01-01$377.96$285.34RVU17A
2016-10-01$379.68$286.94RVU16D
2016-07-01$379.68$286.94RVU16C
2016-04-01$379.68$286.94RVU16B
2016-01-01$379.68$286.94RVU16A
2015-10-01$380.21$286.81RVU15D
2015-07-01$380.21$286.81RVU15C
2015-04-01$378.31$285.38RVU15B
2015-01-01$378.31$285.38RVU15A
2014-10-01$372.59$281.21RVU14D
2014-07-01$372.59$281.21RVU14C
2014-04-01$372.59$281.21RVU14B
2014-01-01$372.59$281.21RVU14A
2013-10-01$370.97$276.64RVU13D
2013-07-01$370.97$276.64RVU13C
2013-04-01$370.97$276.64RVU13B
2013-01-01$370.97$276.64RVU13AR

Price 21031 for an earlier date of service

Where the South Carolina rate applies

South Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 475 cities and communities in South Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Abbeville
  • Abney Crossroads
  • Adams Run
  • Aiken
  • Alcolu
  • Allendale
  • Anderson
  • Andrews

Browse all communities in South Carolina

21031 billing questions

How is this code different from removal of a maxillary torus?

This code is for an exostosis of the mandible. Use 21032 for removal of a maxillary torus.

When would a mandibular bone-lesion code be more appropriate?

Use a lesion-excision code when the target is a mandibular lesion rather than a bony exostosis or torus. Document the nature and location of the condition being removed.

Does the code include related postoperative care?

Yes. Its 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

How is bilateral removal handled?

CMS identifies the procedure as bilateral; modifier 50 is paid at 150%. Document the exostoses on both sides.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery services are not paid for this code. Co-surgeons and team surgery are not permitted.

What happens when another procedure is performed in the same session?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedure or procedures 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 21031PPRRVU2026_Oct_nonQPP.csv, line 1,847 (RVU26D)
Geographic factors for South CarolinaGPCI2026.csv, line 93 (RVU26D)

Open CMS sourceHow we calculate rates

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